Health illiteracy hampers seniors

A significant percentage of the older adult population has health illiteracy, "a limited ability to read and understand the instructions on prescriptions, medicine bottles, informed consent documents, insurance forms and health educational materials."

Think about it. Have you read through your health insurance policy front to back lately? Have you even wanted to try? Maybe you did — to find out if you had coverage for a recommended treatment. I suspect it was a frustrating exercise. If for strong and motivated readers it’s tough, think about how it is for the 85 percent of the older adult population with reading difficulties. (You read that right — 85 percent.)

Have you ever been prescribed a medication and found the accompanying instructions in small, nearly unreadable type? "Take one tablet with meals for the first two days, two tablets before bed on an empty stomach for three days and one-half tablet daily for a week." I exaggerate just a bit in this illustration, but not much. And the instructions don’t ever seem to address what you do if you take two tablets when it should have been one or forget to take any tablets at all on that second day.

I’m thinking maybe this is why health-care costs are skyrocketing. Medications are taken incorrectly, and people land in expensive hospital placements. Physicians’ instructions are heard inaccurately, and a condition deteriorates and gets more costly.

Our family is experiencing this first-hand. We’re trying valiantly to advise my 88-year-old mother-in-law on how to proceed with a recommendation she’s been given for lung cancer surgery. It’s a difficult time for her, and our health literacy on her behalf is crucial. We got caught up in trying to understand why the oncologist calls her tumor "small" and the surgeon calls it "large." We didn’t initially understand what a "lobe" was. The surgeon talked fast and mumbled. My mother-in-law didn’t like him. "Too short," she said, but it wasn’t really his height she was referring to.

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So, we of course want another surgeon, maybe another oncologist. We’ve identified loads of science-based articles on lung cancer surgery and quality of life following it. As our family’s designated reader on all health-care topics, I’m trying to plow through them. I’m a strong reader. I’m motivated, but whew!

Health literacy starts with understanding health-related information. It involves the size of the print on the medication bottle and the complexity of the words spoken by your physician. Even the speed and pace of a health provider’s voice can make a difference.

Some health providers use the "teach-back" method where they take more time, break information into smaller, more understandable parts, and then ask the patient to repeat what they heard.

I like the concept. It seems like it could be very helpful. I’ve not seen it in use much by the health providers we’ve encountered. Maybe next time.

Sharon Johnson is an assistant professor in family and community development at OSU Extension and a member of the Senior Advisory Council. E-mail her at s.johnson@oregonstate.edu or call 776- 7371, Ext. 210.