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Table 1 Principles of care for older adults

From: Perspectives on optimizing care of patients in multidisciplinary chronic kidney disease clinics




Sensory deficits

Screening for visual acuity and hearing loss formally, informally

-Referral for aids (glasses, hearing aids)

-Optimize the learning environment (adequate lighting, minimize glare, limit background noise)

-Written instructions with large font sizing and multimodal information (visual and verbal through writing, pictogram, hands-on experience, videos, web-links, online)

-Appropriate voice intensity, pitch, pacing, eye level, direct visualization to allow for lip reading

Cognitive impairment

Screening with MMSE, MoCA, clock drawing, cognitive battery testing

-Breakdown information into small units (focus on only 3–5 issues or ess per session, <15 minutes per session)

-Explain each element separately

-Direct, actional, concrete language (“take one tablet in the morning and one at night” not “take twice a day”)

-Individualized, tailored educational sessions

-“Right branching” (“take a seat and you won’t miss the session” not “if you don’t want to miss the session, take a seat”)

-Teach-back technique

-Involvement of caregiver

-Refer for treatment as indicated

Mood disorders

Screening formally, informally




-Refer for treatment as indicated (medications, CBT)

Health literacy

Assuming baseline limited health literacy vs. screening

-Limiting language complexity

-The use of appropriate terminology in all forms and venues of communications (“high blood pressure” not “hypertension”)


“How many times have you missed (behavior) in the last week?”


-Explain (indications, consequences, prioritization)


-Checking/rechecking understanding

-Address feasibility, acceptability

-Involvement of caregiver

  1. MMSE Mini Mental Status Examination, MoCA Montreal cognitive assessment, CBT cognitive behavioral therapy