Health care proxies may overestimate, underestimate patient symptoms depending on circumstance

INDIANAPOLIS (WISH) – Older patients suffering from cognitive decline may have trouble conveying physical and mental health information to their doctor. So, they bring a friend or family member to help them out and make sure the information they’re sharing is correct. These people are called health care proxies.

But sometimes there is a disconnect between what patients and proxies report leaving doctors confused and patients in danger. 

“Doctors are at the risk of not treating their depression, their pain and whatever other symptoms they are having,” said Dr. Kurt Kroenke, scientist at the Regenstrief Institute and study author of a recent paper on the subject. “On average, if a person has more severe symptoms, the proxy may actually under-report their symptoms. So, if you’re a doctor taking care of a patient and relying on a proxy report and they report moderate depression, the patient probably has at least moderate depression.”

Kroenke says there are also circumstances when a caregiver will over-report patient symptoms. This occurs when they are feeling stressed and inadvertently fail to separate their own feelings from the feelings of the person they are responsible for.

However, Kroenke adds, it’s better to have a proxy report than none at all. It’s useful, he says, to get both views because most of the time the truth is halfway in between.