Two in the Exam Room: The Rise of Dyadic Senior Care

With caregivers routinely accompanying older patients to appointments, clinicians need to account for both people in the room to achieve the best outcomes, investigators said at the Gerontological Society of America (GSA) 2026 Annual Scientific Meeting in National Harbor, Maryland.Caring for a spouse often upends long-established roles and strains communication, said Lana Kinnear, MS, doctoral student at Colorado State University in Fort Collins, Colorado, who led a study of theoretical and ethical considerations for dyadic clinical interventions involving older adults. When partners face cognitive decline or a terminal diagnosis, anticipatory grief can take a heavy toll — giving clinicians an opportunity to identify relationship distress and step in with support.“If you’re caring for older adults, you quickly realize that all care is largely dyadic, or triadic,” said Aanand Naik, MD, executive director of the UTHealth Houston Institute on Aging, who attended the conference. The relationship could manifest with a spouse who “is there just to give flavor and color commentary,” he said.With an aging patient and adult child, potentially confusing role reversals can occur that necessitate adjustments. Patients often struggle with a loss of autonomy in these dynamics, Kinnear said. Visits involving aging siblings can surface long-standing family tensions that clinicians may need to mediate.Grandparents who bring a grandchild may have generational differences or technology barriers to work through. Dyads with friends or nonkin partners can present unclear boundaries or ambiguous roles, she said.“We should still be considering who’s involved in the dyad and what the relationship is because that could have the potential to improve the outcome,” Kinnear said.Medical schools historically have not taught dyadic skills because the dominant culture is of doctor and patient, Naik said. He said he has learned from other cultures to work with both parties on concrete goals that the caregiver is willing to work toward.“It’s almost like a shared mental model that they have of each other’s health, so you have to approach that within that relationship, and negotiate with both of them,” he said. “It’s still the patient’s values and goals that should drive it, but it’s much more of a conversation of the three of us together.”Kinnear and Naik reported no relevant financial disclosures.Karen Blum is a freelance medical and science writer in the Baltimore area.