Stepping Into the Caregiver Role
Caregiver's Guide to Doctor's Visits
As your parent ages, you may find yourself acting as his/her spokesperson and health advocate. He may have an increasing number of health issues leading to complicated conversations with doctors…an array of drugs…plus some possible hearing loss or mental decline—all of which make it challenging for him to navigate doctors’ visits alone. There also may be some age bias that leads the doctor to offer your parent too much (or too little) treatment.
Whether you’re already involved as a caregiver or just stepping in to this new role, here’s how to make it better…
It’s fun to talk about grandkids but not so much fun to talk about your dad’s fungal infection. So you both avoid it.
Why that matters: If you are largely unaware of your parent’s health issues, you’re going to be blindsided when a crisis happens. You might not be knowledgeable enough to answer a doctor’s questions in the ER or involved enough to mention an additional symptom your parent forgot. This needs to change.
Start by asking for permission. It’s hard to dive right into a health conversation. Lay the groundwork first. Example: “Dad, I’d like to talk with you about how you’re feeling. Any health concerns?” You also can add, “It’s not that I think you can’t handle things yourself. But if I ever have to step in and be your advocate in an emergency, I really want to know this information so that I can best support you.”
Additional benefit: If you make it clear that you want to understand and support him, it helps remove the concern that he’s burdening you.
Once understood, suggest that you begin to attend doctors’ visits with your parent. Before the first agreed-upon appointment, go over your parent’s health complaints. Ask about what you’ve heard or observed: “Mom, you told me that you don’t like this drug you’re taking. What effects are you noticing?” Make a written list of her concerns.
Assuming that it works for your parent, request a morning appointment, when the office is more likely to be running on time and the doctor and staff are likely to be fresher and more attentive. Or ask for the first appointment after the office’s lunch break.
Why that matters: It’s not just the annoying wait and your parent’s exhaustion that are problems. The doctor is not in top form either. According to a study published in JAMA Network Open, in the afternoon doctors may not order as many screening tests as they should—a result, in part, of decision fatigue.
Additional benefit: If there are tests ordered, you may be able to have them done the same day.
Note: For an older adult, his routine (including using the toilet) tends to be paramount, and late risers may not be up to an early doctor’s visit.
BE ORGANIZED AT EVERY APPOINTMENT
Bring the list of health concerns to the appointment. It’s easy for you or your parent to forget to mention something. At a routine checkup, prioritize the most important items at the top. There often isn’t time to deal with everything, and this will ensure that the doctor will hear the most pressing problems. Review the list with your parent on the way to the office so that it’s fresh in your minds.
When you arrive at the appointment, make sure that the doctor’s office has any necessary paperwork needed to allow you to speak on your parent’s behalf. Take notes that you and your parent can refer back to.
AVOID MEDICATION MIX-UPs
Be sure the list of your parent’s medications and supplements is up to date.
Physically go through all drugs—prescription and over-the-counter—as well as vitamin/mineral and herbal supplements before the appointment. Create an updated list or take photos of the labels on each drug to ensure accuracy—and then review them with the doctor. Many medications need careful monitoring and dosing adjustments.
Additional benefit: As you go through the medicines, you could discover that your mom has an unopened drug or an empty bottle in need of refill. If you notice your parent is confused by his medications, you may need to start helping to organize his meds every week—or arrange for someone else to do so. A weekly phone call to fill the pill box together is a good way to ensure accuracy.
MAINTAINING THE RIGHT FOCUS
Avoid the trap of doing all of the talking to the doctor yourself—even if your parent is sitting right there, especially if your parent has trouble hearing.
Why that matters: It undercuts your parent’s involvement in his own health care and makes it easier for him to ignore advice when you’re not around.
How to do it better: Be mindful not to answer questions for your parent. After mentioning a few health issues, turn the focus to your parent. Example: “These are the things Mom would like to discuss, and she would like to share with you some of the symptoms she’s experiencing.” Don’t hesitate to prompt your parent—“Remember, Mom, you told me about the pain you’re having in your feet. Can you describe it to Dr. Brown?”
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Also: Take notes while they talk. It’s very common for a doctor’s advice to go in one ear and out the other—in a survey reported in Journal of the Royal Society of Medicine, patients who had just left their doctors’ offices forgot 40% to 80% of the medical information provided. Better: At the end of the appointment, read back from your notes and ask if you missed anything. FOLLOW-UP PLANS
Let your parent know that you will help keep the care plan on track.
Why that matters: Seniors often assume that their doctor will handle follow-up. If your parent is homebound and you can’t drive him to get tests, ask the doctor’s office if someone there can arrange for a lab tech to visit your parent’s home and draw blood there. For test results, arrange for someone from the doctor’s office to call you as well.
Also helpful: Find a pharmacy that delivers prescriptions so that your parent gets needed meds in a timely manner. Or use an online or mail-order pharmacy. You also can ask the pharmacy to “reconcile” your parent’s various prescriptions so that they are filled on the same date and with the same supply time frame to simplify things.