O R I G I N A L R E S E A R C H The therapeutic effects of the physician-older patient relationship: Effective communication with vulnerable older patients Summer L Williams Kelly B Haskard M Robin DiMatteo Department of Psychology, University of California, Riverside, CA, USA Correspondence: M Robin DiMatteo Department of Psychology, University of California, Riverside, 900 University Ave., Riverside, CA, 92521, USA Tel + 951 827 5734 Fax +951 827 3985 Email robin@ucr.edu Abstract: There is growing evidence that the outcomes of health care for seniors are dependent not only upon patients’ physical health status and the administration of care for their biomedical needs, but also upon care for patients’ psychosocial needs and attention to their social, economic, cultural, and psychological vulnerabilities. Even when older patients have appropriate access to medical services, they also need effective and empathic communication as an essential part of their treatment. Older patients who are socially isolated, emotionally vulnerable, and economically disadvantaged are particularly in need of the social, emotional, and practical support that sensitive provider-patient communication can provide. In this review paper, we examine the complexities of communication between physicians and their older patients, and consider some of the particular challenges that manifest in providers’ interactions with their older patients, particularly those who are socially isolated, suffering from depression, or of minority status or low income. This review offers guidelines for improved physician-older patient communication in medical practice, and examines interventions to coordinate care for older patients on multiple dimensions of a biopsychosocial model of health care. Keywords: physician-patient communication, adherence, health outcomes, vulnerable populations Overview With the impressive advances of modern medicine, individuals are living longer lives than they did just a decade ago. Since 1990, the United States has seen a 12% increase in the number of Americans over the age of 65 (Hetzel and Smith 2001). The baby boomer generation is nearing retirement age and will soon be faced with the many challenges associated with aging, such as changes in income level, health insurance coverage, health status, career involvement, and social status. While a number of Americans will age in relative physical, economic, and psychological comfort, there are many for whom medical, financial, and social limitations and maladaptive emotional responses will lead to problematic consequences that affect their health. Effective communication with physicians and health care professionals at all levels can serve as a vital link to health and adaptation to the aging process. This paper reviews the specific challenges faced by the vulnerable aging population, examines the important role that physicians and other health professionals can play in the care of patients who face multiple challenges of aging, and offers tools for helping patients to cope with the vast array of challenges they face in the aging process. Clinical Interventions in Aging 2007:2(3) 453–467 © 2007 Dove Medical Press Limited.All rights reserved 453