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"There are implications for clinicians, for companion visitors as well as for the older patient him or herself," Ory added. "Physicians need to know how to appropriately interact with the [companion visitor]. The companion visitor needs to understand what their role is. It's also important for the message to go to the patient that the patient is ultimately responsible for their own health care, but they don't do it in a vacuum. They live in families."

"In the past, we've ignored the third party, but we don't want the pendulum to swing and ignore older patients," Ory said. "It's that delicate balance that will get us the best quality of care."

More information

Visit the National Family Caregivers Association for more on this topic.

SOURCES: Jennifer L. Wolff, Ph.D., assistant professor, health policy and management, Johns Hopkins Bloomberg School of Public Health, Baltimore; Debra L. Roter, Dr.P.H., professor, health behavior and society, Johns Hopkins Bloomberg School of Public Health, Baltimore; Marcia G. Ory, Ph.D., professor, social and behavioral health, Texas A&M Health Science Center School of Rural Public Health, College Station; July 14, 2008, Archives of Internal Medicine