How to motivate senior patients to improve their eating habits
If you’ve ever tried to adhere to a new year’s resolution, you know that making and sustaining behavior change is hard work. That’s true even when such changes are necessary to prolong or improve the quality of life for older adult patients.
Motivational interviewing is one of the most effective tools physicians can use to guide patients toward healthy life changes. It’s a conversational approach designed to help both patients and providers identify and overcome obstacles that are preventing the patient from taking the actions they need to improve their lives.
In this post, I’ll give a brief overview of motivational interviewing, and demonstrate how providers can use this method to guide patients toward healthier relationships with food and better eating habits.
What is motivational interviewing?
Motivational interviewing has been defined by health psychologist Bruce Berger as a “collaborative, person-centered form of information exchange to facilitate constructive sense-making by patients about their health.”
This approach differs from the traditional doctor-patient relationship in that both parties operate on an equal plane. Typically, a power differential exists; the doctor imparts guidance to the patient, and the patient is expected to follow those instructions. In motivational interviewing, however, the doctor and the patient are in partnership, working together to find the best path forward for the patient. Key skills used in motivational interviewing include seeking permission before sharing information with a patient, asking open-ended questions, and demonstrating reflective and active listening.
Many studies have shown the benefits of incorporating motivational interviewing into patient care. The approach allows patients and providers to gain a better understanding of and trust in one another. The provider learns the patient’s underlying motivations and life goals, as well as what obstacles may be preventing them from achieving those goals. This results in overall better care for the patients as well as a more positive experience for providers.
For a physician, it can be frustrating and burnout-inducing when patient outcomes aren’t what you expect, and you can’t pinpoint why. Motivational interviewing can alleviate those feelings, allowing both the patient and the provider to move through care plan setbacks in a healthier way.
How can motivational interviewing encourage senior patients to change their behavior?
In American society, there’s stigma around weight and nutrition, as well as judgment about how people should manage both. Physicians know this and are often hesitant to talk with their patients about these topics for fear of offending them. Yet many patients do want to have this conversation with their doctor—if they trust their doctor has their best interests at heart. Motivational interviewing can bridge this divide.
Providers can start by asking permission to have the conversation: “I see your weight has gone up a bit. How would you feel if we were to talk about that today?” Asking about their comfort level in talking about the subject, rather than forcing the issue, shows the patient that you’re here to help when they are ready.
When your patient demonstrates they’re prepared to speak about their weight and nutrition, you can ask questions about their “why.” Why do they want to achieve better health? What do they want to do in their life? How might their health be holding them back? The answer is almost never as simple as “I want to lose weight” or “I want to control my diabetes.” There’s usually something deeper, and those underlying desires are the keys to a patient’s making sustainable changes in their habits.
I lead classes for ChenMed patients living with chronic conditions, and a woman in a recent session was trying to manage her diabetes. Her progress had plateaued, and she believed her habit of having a sweet treat after every meal might be a factor. She admitted that she struggled to break that habit even though it likely wasn’t good for her condition.
In response, I presented her with the “why” question: Why was it important for her to manage her diabetes? What were her goals for her life? She expressed her fear of developing kidney disease, becoming more reliant on medication, and ending up on dialysis. I shared with her information that showed how reducing her intake of sweet treats—even gradually—could help decrease her blood sugar and reduce her risk of the outcomes she feared.
Over the course of a few sessions, I offered her a handful of recommendations on how to improve her eating habits—but was careful not to overwhelm her with information. She did the hard work, coming to the classes each week and working on my recommendations in between them. Three months later, she’s lost weight and has her diabetes under better control. Thus far, she’s avoided kidney disease, new medications, and dialysis, just as she wished.
Creating the ideal conditions for patient success stories
Motivational interviewing can facilitate healthy decision-making in a number of vital areas, including encouraging patients to take potentially life-saving vaccines. Yet it’s important to remember that the results of motivational interviewing are not achieved immediately. Successful outcomes require multiple interactions with a patient. Although a physician cannot do the heavy lifting of behavior change, their consistent reinforcement and support are critical to keeping the patient on track and remembering their deeper “why.”
In this regard, ChenMed doctors have a decided advantage over our fee-for-service peers, who may see their patients only once or twice per year. Here, we see our patients a minimum of once per month—and more often if the situation requires it. We’re able to take as much time as needed to listen to and validate our patients’ desires and concerns, then share information with them at a pace that’s acceptable to them, not to us. We can monitor and celebrate incremental progress toward their goals, motivating them to stay the course toward a healthier, happier life.
To learn more about motivational interviewing and how we incorporate this tool in our ChenMed centers, listen to this episode of the Faisel and Friends podcast featuring health psychologist Bruce Berger.
Be part of something bigger.
Let’s connect and explore the ways you can practice medicine with ChenMed.
Media Inquiry
We want to share how ChenMed is transforming healthcare for the neediest population.