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Starting the Dialogue with your Aging Parents: Questions for Doctor/Patient Collaboration

April 8, 2013

For those of you who’ve been following this blog for a while you know that my desire is to encourage you to break down the communication barriers between the generations. In other words, I want to get adult children talking with their aging parents about any and all subjects.  For some families the conversations flow easily and there’s an easy segueway from every day banter to more involved subjects such as health care and end-of-life planning.

Some recent posts dealt with questions and scenarios to help those with not-so-good communication between the generations and hopefully you’ve tried out the questions, or come up with your own questions,  and had stellar results. If you missed those posts you can access them from this site and see if they have any value for you.

Today I’d like to explore a subject that is dear to my heart and also necessary if your parents are going to navigate through the health care system with an understanding of what is going on with their health.  I encourage adult children to frequently accompany their aging parents to medical and dental appointments. This is not only for those with parents who have fading memories, but for everyone. (In coming years I would hope you have someone accompanying you to your appointments.  Maybe you’re already doing it now–that’s good!)

Some of you will be saying it isn’t necessary because your parents are fully functional and independent.  Let me be clear; this is not so you can monitor the health of your parents or interfere in their treatment, but rather so there can be more successful results, greater understanding, and quicker resolution to any non-chronic health issues. An extra set of eyes and ears during a health care visit can help alleviate confusion for both the doctor and the patient, help the patient remain calm and receptive to what is being said, and offer support to the patient who may become nervous or overwhelmed by what the doctor is saying. (Today we’re focusing on routine health care, not necessarily crisis visits.)

If your parent is being seen in a clinic setting there is probably a short period (15-20 minutes) allotted for the appointment.  In most instances clinics  are run by large corporations and the aim of those corporations is to make money. Whether you agree with that paradigm of health care or not it is the reality in most areas of today’s health care system.

Here are some things you can do to assist your aging parents in having a successful medical or dental appointment with their care provider:

  • Take a complete list of all medications your parent is using. The list should include over-the-counter medicines such as aspirin, Tylenol, or Maalox. Also include all vitamins or herbal supplements such as a daily multivitamin with minerals, echinacea, goldenseal, St. John’s Wort, etc. On the list make sure the frequency of use is noted and include the dosage, time of day, and what the medication or supplement is used for.  It’s helpful to be able to leave a copy with the medical provider and also have one for yourself and one for your parent to refer to during the appointment.
  • If your parent has questions about the purpose of a medication be sure to write the question down and ask the medial provider. Be sure you and your parent have a clear understanding of why the medication is being prescribed and what to expect as a result of taking it.
  • Ask if you should be aware of any potential side effects and what to do if they are noted. You may also want to ask the pharmacist the same question if new medications are prescribed.
  • If your parent is going in for a routine physical be sure the medical provider gives a complete list of any health issues he/she feels your parent is facing.
  • Ask for full explanations of any plan of treatment related to any medical condition.
  • Set goals with the health care provider to achieve the highest results from the plan of treatment.
  • If the medical provider orders tests or procedures be sure you understand what he/she is looking for and why the tests are being ordered.
  • If your parent is not comfortable having the test done explore other options with the health care provider and find out what adverse events may occur as a result of not having the test done. The decision whether to have the test or not is completely up to your parent. It is not for you, or the doctor, to force them to do something they are not comfortable with.
  • If tests, or procedures are ordered and your parent agrees to them be sure you understand the risks involved and when the results can be expected. Honor your parent’s choice as to whether they want you to be informed of the results or not. If they do want you to be informed be sure that the clerical staff are aware and that it is noted on the patient chart who is to be allowed access to results.
  • When going to a follow-up appointment to receive test results be sure to inquire about the next step. Get a clear understanding of what the results are and if the medical provider now has a clear understanding of what the problem is. What is the course of treatment? What are the expectations? What is the time frame for expected results.
  • In the process of setting goals with the medical/dental provider be sure both sides completely understand the goal, have a defined time frame for completion, and are looking for the same results.

In the medical field we call this patient centered care. It requires collaboration and cooperation by both parties. Why is this important?

The obvious importance of such interactions is that it involves the patient and empowers them in their own plan of care. The second aspect of importance is something most individual patients don’t think about, and aren’t exposed to, but it is what will be measured by insurance companies, Medicare, Medicaid, and other payors as the next wave of health care unfolds.

We are already seeing this in everyday practice in the health profession. Payors (the insurance companies, etc.) want to see positive outcomes and some are even basing their payments for services on the outcomes achieved. How can there be positive outcomes unless both the patient and the medical provider are on the same page? How can outcomes be measured unless goals are set, understood, and initiated by both the patient and the provider? How can we as individuals make the health care system work so that patients receive the best care and providers are held accountable for the care they give and reimbursement is paid at an acceptable level to continue the process of a successful health care delivery system?

It is important that every patient take ownership for their part in the health care decision making process. Informed patients with supportive families and collaborative attitudes will enhance the entire process.

Please feel free to express your experiences in dealing with a changing health care system. Have you had successes? Are there areas you’d like to see focused on? Please share in the comments.

Thank you for reading and participating in my blog! Your support is greatly appreciated!

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