Bridging the Gap: Strategies to Strengthen Connection Between Residents and Physicians

Physicians play a vital role in ensuring that senior care residents receive the comprehensive, high-quality care needed to maintain their health and well-being. However, significant physical and communication barriers often exist between residents and their physicians.

To overcome these challenges, from keeping physicians informed with timely updates to ensuring residents can attend necessary appointments, communities must implement effective strategies to bridge this gap and promote better continuity of care.

Factors Contributing to Physical and Communication Gaps

John Enwere, co-founder and media lead at Caringene

Physical and communication gaps between residents and physicians arise for many reasons. Because residents often see rotating doctors, on-call providers, or telehealth physicians, it can be challenging to establish continuity of care. As a result, physicians may lack a long-term, contextual understanding of each patient’s health history. Additionally, many residents experience memory loss, hearing impairments, or mobility challenges that make it difficult to communicate their needs clearly or attend medical appointments consistently.

A lack of advocacy presents another significant challenge. “Many older adults in senior care do not have family within proximity or a caregiver present at their visits,” says John Enwere, a CNA who is co-founder and media lead at Caringene. Without a consistent advocate, important details can easily get lost or misunderstood. In addition, care staff, physicians, and family members often operate on different communication systems, which creates disconnects that can lead to delays, errors, and unmet resident needs.

Strategies to Bridge the Gaps

Enwere advocates for giving CNAs and caregivers the confidence and structure to document what they observe each day. “Many times, they are the only individuals in the picture that see the full picture, yet their voice isn’t counted in care planning,” he says.

Communities can also strengthen continuity of care by creating resident summaries that travel with each person to every appointment. These summaries can be updated by the community or home care team to reflect key changes in health status, behaviors, or medications, ensuring that every provider has access to the most current information.

Josh Klein, founder and CEO of Emerest Health

Josh Klein, founder and CEO of Emerest Health, notes that virtual health tools can provide quick and easy access between visits. Emerest Connect uses tablets to provide residents with daily engagement and direct access to physicians, reducing travel challenges and simplifying communication. The technology can also help overcome language barriers, promoting clearer understanding between residents and care providers.

Senior care staff also play an important role in supporting communication and coordination. Klein emphasizes that communities can train caregivers and staff to better support residents in these areas. For instance, staff can assist residents in preparing for appointments by helping them identify symptoms and communicate any recent changes in their medications.

How to Facilitate Physician Appointments

To improve access and outcomes, senior care communities often need to take a proactive approach in coordinating appointments. Partnering with on-site physicians who visit regularly can make a meaningful difference. “These in-home visits can reduce no shows, provide way more context, plus the providers can see what the resident’s environment is actually like,” says Enwere.

“We’ve also had success using structured virtual visits, where a caregiver joins the telehealth call, provides background, and asks follow-ups,” Enwere explains. “Without that structure, most seniors struggle with virtual appointments alone.”

While telehealth offers flexibility, it isn’t a full replacement for in-person care. According to Klein, telehealth helps bridge gaps by reducing wait times for appointments and removing transportation barriers, and lowering overall healthcare costs – a win-win for residents and providers alike. “We believe that in the future, [telehealth] will become a standard part of care models, offering ongoing monitoring and faster intervention,” he says.

Enwere agrees that telehealth works best when supported by thoughtful processes. It’s especially valuable for monitoring chronic conditions, adjusting medications, and assessing new symptoms or behavioral changes before they escalate.

Empowering Health Care Coordinators

On-site health care coordinators can be crucial to bridge gaps between residents and physicians. “Coordinators act as the connective tissue between residents, physicians, and caregivers, ensuring medical updates, medication lists and follow-ups are communicated effectively,” says Klein.

According to Enwere, the most effective coordinators take a proactive approach, including following up with residents after appointments, ensuring care plans are implemented correctly, and acting as the single point of contact for family members, physicians, and the resident’s direct care team.

“Health care coordinators are crucial,” says Enwere. “And more importantly, they need to be supported and empowered – not grounded in administrative roles. When no one in an organization takes on that role, important information falls through the cracks, and the resident suffers as a result.”

How Senior Care Communities Can Start Bridging the Gaps

Enwere suggests starting small by mapping the care journey of one resident. Review recent medical interactions to see who was involved, what information was missed, and where delays occurred. This process can reveal the weak points in your system and highlight opportunities for improvement.

Next, he recommends assigning a dedicated care communication lead, even on a part-time basis. Create a single-page “resident health snapshot” for each individual, and train caregivers to observe and record not only vitals, but also mood, routines, and subtle behavioral changes that might indicate underlying issues.

Klein advises communities to assess specific resident barriers, such as mobility issues, communication challenges, or limited access to providers. “Evaluate current workflows for appointment scheduling, follow-up, and record sharing,” he says.

He also suggests using resident surveys to evaluate satisfaction and identify challenges in accessing care. Tracking missed or delayed appointments can uncover systemic gaps, while piloting telehealth programs can help communities measure results and refine their processes.

While closing gaps between residents and physicians is essential for delivering responsive healthcare, it also has other important benefits. “Closing these gaps is not only about clinical care. It’s also about human connection,” says Klein. “When residents feel engaged and supported, outcomes improve across physical health, mental health, and overall quality of life.”

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.