You probably received basic education on older adult patient psychology when you were studying to be a clinician. Now that you’re a clinician practicing with older adults, you’ve most likely discovered a significant part of your work is caring for your patients’ emotional and social health.

Your patients’ psychosocial health influences their physical health — and vice versa. As a clinician working with older adults, you have to attend to both. Careful, compassionate listening is always the first step. When you are really tuning in to what your patients and their families share, you’ll be better able to tailor a treatment plan. And even more importantly, you can be a source of hope during a very challenging time in your patients’ lives.

But even if you’re newer to the field, there are three clinical practices you can use to make a positive impact in your patients’ treatment program.

1. Learn and Adjust Outcome Expectations

One of the most important things you can do as a clinician is ask your patients what their treatment goals are. When you understand what’s truly important to them, you can personalize their therapy. Patients are more motivated to start and continue a course of treatment when they feel it supports what they most value.

However, you may discover that your patient’s expectations aren’t feasible. For example, many older adult patients are focused on walking again. They don’t want to be wheelchair-bound. But walking again may be a goal that is not appropriate or safe. In circumstances like these, it’s challenging — but absolutely necessary — to reset your patients’ expectations.

Families may also need to adjust their expectations. Spouses and children often want the patient to return back to “normal.” And families don’t want to see the patient experience the difficult emotions that arise with a loss of ability and independence.

You can gently lead patients and families to a more realistic treatment expectation by asking why the patient (or family member) is insistent on a particular goal. Understanding your patient’s motivation can open up a frank discussion about their new lives and limits.

One of the messages patients often need to hear is that clinical treatment is designed to maintain current abilities as long as possible and slow down further decline. Clinical treatment will not return them to a previous state. That’s a hard truth for patients. Clinicians should be open to the patient and family’s emotional process and allow them to express whatever arises.

2. Educate Your Patients and Their Families

Patients need to start accepting and caring for the “new” version of themselves. Clinicians often need to educate patients and families that while adjusting expectations may be necessary, it doesn’t mean giving up.

You can teach your patients how to reimagine their goals when necessary. For example, the patient may need to use a wheelchair, but you can show her how to use simple tools to preserve some independence. A bag attached to the wheelchair (to store and carry favorite items) can help a patient feel more resourceful. Grabber tools allow patients to reach something without assistance. And she may need to be reminded that it is better to be safe than sorry. Falling can lead to a hospital stay.

Families need to be introduced to helpful tools, too. You can offer practical products to make life easier. For example, a sliding board can be a huge help to family members who are helping patients transfer from bed to wheelchair.

Sometimes families need to be educated about extra support the patient is entitled to. You can point them to resources available through Medicare. The complexity of government programs and websites can be intimidating, so families will be grateful for your guidance, explanations, and recommendations.

3. Encourage the Right Kind of Family Support

Your patients may feel like their new limits and needs are a burden to their families. They may not want to adhere to the guidelines you’ve given them because it means accepting more help. And patients may not ask for help when they need it because they don’t want to cause anyone more worry. It’s normal for patients to feel frustrated, angry, sad, and ashamed.

Families can struggle with how much and what kind of support to offer. If families do too much for them, patients can lose confidence and strength. If families don’t do enough, patients are at risk of accidents and injury.

As a clinician, you’re in a position to advise both patients and their families about the right kind of support — not too much and not too little.

You can help patients understand that their families will worry more if they refuse or don’t ask for help. When patients fight your recommendations and an accident or injury occurs, families undergo tremendous stress. When your patients come to terms with that, they’re more likely to cooperate with the treatment plan.

Families may need help discerning the best ways to practically support the patient. Talking with the family privately (outside of patient earshot) will give them a chance to be honest and open. You can listen empathetically and work to gain consensus about the best plan of action. The more everyone is on the same page — patients, families, and clinicians — the more likely the patients are to meet their treatment goals.

You are a Support System for Patients and Their Families

As a clinician, you witness all the stages of grief in your patients as they grapple with the loss of physical and mental abilities — denial, anger, bargaining, depression, and acceptance. Each one of those stages calls for special attention and interventions. Your patients’ families will also experience a wide range of emotions as they adapt to their loved one’s new limitations. They, too, need your expert support and guidance.

It can take time and experience to learn how to best help patients and their families cope with their changing realities. After all, every patient and every situation is unique.