Examining the context and helpfulness of family companion contributions to older adults' primary care visits.
Older adults commonly involve family (broadly defined) in their care. We examined communication behaviors of family companions during older adults' primary care visits, including whether these behaviors vary with respect to how older adults manage their health, preferences for involving family in medical decision-making, and ratings of companion helpfulness.



Analysis of audio-taped primary care visits of older patients who were accompanied by a family companion (n=30 dyads) and linked patient surveys.



Family companions predominantly facilitated doctor and patient information exchange. More than half of companion communication behaviors were directed at improving doctor understanding of the patient. Companions were more verbally active during visits of patients who delegated the management of their health to others than visits of patients who co-managed or self-managed their health. Companions were rated as more helpful by patients who preferred active involvement of family in medical decision-making.



Family companion participation and helpfulness in primary care communication varies by patients' preferences for involving family in medical decision-making and approach to manage their health.



Research to examine the effects of clarifying patient and family companion expectations for primary care visits could inform strategies to improve the patient-centeredness of medical communication.
Department of Health Policy and Management and Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 692, Baltimore, MD 21205, United States; Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Center Tower, Baltimore, MD 21224-2734, United States; Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 2024 E. Monument Street, Suite 2-700, Baltimore, MD 21205-2223, United States; Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Suite 316, Baltimore, MD 21205-2110, United States. Electronic address: jwolff2@jhu.edu.
Jennifer L
JL
Wolff
Program in Personalized & Genomic Medicine, Division of Endocrinology, Diabetes & Nutrition, Department of Medicine, University of Maryland School of Medicine, 685 W. Baltimore St., MSTF 3-14D, Baltimore, MD 21201, United States. Electronic address: yguan@medicine.umaryland.edu.
Yue
Y
Guan
Department of Health Policy and Management and Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 692, Baltimore, MD 21205, United States; Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Center Tower, Baltimore, MD 21224-2734, United States; Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 2024 E. Monument Street, Suite 2-700, Baltimore, MD 21205-2223, United States; Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Suite 316, Baltimore, MD 21205-2110, United States. Electronic address: cyboyd@jhmi.edu.
Cynthia M
CM
Boyd
Johns Hopkins University School of Medicine, Edward D. Miller Research Building, 733 North Broadway, Suite 137, Baltimore, MD 21205-2196, United States.
Judith
J
Vick
Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Center Tower, Baltimore, MD 21224-2734, United States; Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 2024 E. Monument Street, Suite 2-700, Baltimore, MD 21205-2223, United States; Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Suite 316, Baltimore, MD 21205-2110, United States. Electronic address: hamjad1@jhmi.edu.
Halima
H
Amjad
Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Center Tower, Baltimore, MD 21224-2734, United States; Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 2024 E. Monument Street, Suite 2-700, Baltimore, MD 21205-2223, United States; Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Suite 316, Baltimore, MD 21205-2110, United States. Electronic address: droth@jhu.edu.
David L
DL
Roth
Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Center Tower, Baltimore, MD 21224-2734, United States; Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 2024 E. Monument Street, Suite 2-700, Baltimore, MD 21205-2223, United States; Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Suite 316, Baltimore, MD 21205-2110, United States. Electronic address: lgitlin1@jhu.edu.
Laura N
LN
Gitlin
Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 750, Baltimore, MD 21205205, United States. Electronic address: droter@jhsph.edu.
Debra L
DL
Roter
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making; D003142:Communication; D005260:Female; D033062:Friends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D057240:Patient Preference; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011368:Professional-Family Relations
Family caregiver; Patient-provider communication; Physician office; Primary health care