Managing Caregiving Details: The Basics
By: Source: AARP.org Date Posted: 2003-06-19 12:38:00-04:00
Session 2: Communicating with Health Professionals
Regular contact with the medical community and caring for an older parent go hand-in-hand. Communicating effectively with doctors, dentists, nurses, pharmacists, social workers and other health professionals is critical to participating actively in medical decisions, getting the best results, and improving peace of mind. While potential barriers exist for both older persons and their family members, communicating with health professionals boils down to three things:
- Asking the right questions to get the information your parent and you need to make decisions.
- Giving health professionals the information they need about your parent to make informed judgments.
- Getting the information, services and quality care your parent deserves.
Your mother wants to save money. Without telling her doctor, she starts taking only half of her heart medicine and as a result needs emergency care. Your father returns from a clinic visit with a referral for tests, but he doesn’t know what they’re for. The doctor can’t find any cause for your mother’s pain and suggests it may be a natural part of aging. You ask how your father’s checkup went, and he replies, “The doctor didn’t say much, so it must have been fine.”
These kinds of situations occur every day because of communication barriers between health care professionals and older patients. Key issues include the following.
Patient attitudes. Older patients are less likely than younger ones to ask questions of their doctors and nurses and are more likely to follow doctor’s orders without understanding the reasons. In addition, they are less likely to actively seek health information. They often prefer not to know the details but rely instead on the doctor’s expertise. They may also view asking questions as bothering or insulting the doctor. They may not realize they can get reliable information from other health professionals. The many changes that have occurred over their lifetime in how medical care is delivered may add to the problem.
Physician training and demands. Many doctors say they are uncomfortable with counseling patients, feeling that patients often ignore their advice on matters such as smoking and losing weight. When they do provide information, they may use words that patients cannot understand. Communication takes time, and insurance companies rarely pay for as much time with the doctor as patients may want.
Ageism. This problem is common among all types of health professionals, who often share the negative attitudes of the rest of society. Many providers expect older people to be frail, confused, depressed, overly talkative, needy or quarrelsome. An older patient may feel like an invisible person at a medical visit, as the health care professional speaks exclusively to the adult child. Without specific training in working with older people, health professionals may simply be unaware of their needs.
What you can do
It is critical to respect your parents’ wishes about how much they want to communicate with health professionals and how much they want to tell you about their health. You may want to talk with them about the importance of communication for safe and effective care. Your parents may want you to know about their health, but may be unable or unwilling to talk directly to the doctor. With their permission, you can communicate with their doctor or nurse yourself. If your parents are going to the doctor on their own, you could share the following tips with them to ensure they get the most out of the visit:
Ask questions. Many people come to the doctor with a list of questions and concerns on paper and/or bring a tape recorder for capturing the answers. Questions to ask: What illness do I have? What are the drug and non-drug treatment options? What is likely to happen with and without treatment? What costs can we expect? Does the insurance cover the treatment? What is the name of the medicine prescribed? What is its benefit? Is a generic drug available? What are the risks and possible side effects? How often should I take it? For how long? What foods, other medicines or activities should I avoid while taking it? Do you have any written information I can take home? If I have other questions that I think of after the visit, how can I contact you?
Give information. The doctor needs information about a patient to make proper diagnoses and prescribe safe and effective treatment. Because many older people see more than one physician, their medical records don’t always contain all the facts each doctor needs to know. It's important for each doctor to know everything about the patient's health, particularly recent hospitalizations. Information to give: The names of all chronic illnesses and relevant test results, such as blood pressure and recent blood sugar levels. The names and doses of all medicines taken regularly, including over-the-counter medicines, vitamins and herbal remedies. Drug allergies. It is important to share lifestyle issues with the physician, such as alcohol consumption, smoking, sleeping problems or an inability to drive. Any problems with a medicine’s side effects or barriers to following a treatment plan, such as forgetting to take medicines or worrying about money. Results of the treatment. Problems with confusion or depression.
Talk to other health professionals in addition to the doctor. Options to consider: Nurses are trained in patient education and counseling. For example, they can explain a diagnosis and teach patients how to follow treatment, measure blood pressure at home and give injections. Pharmacists are the drug experts. They can usually answer any questions about how to use a medicine properly, and some offer broader counseling and assistance. Social workers can help people navigate the medical care and social service systems. Dietitians can provide information on meal planning, cooking for one and special meal plans for various medical conditions.
Do your own research. Bookstores, libraries, volunteer health organizations and the Internet have a wealth of materials that can make you and your parent more informed partners in treatment.
Advocate for your parent’s interest. While health professionals have the medical expertise you need, the service, attention and quality of care required don’t always come automatically. You or your parent must often take an active role in getting the best service. Options to consider: get a second opinion before choosing surgery or treatment for serious illnesses (check to see if your insurance covers the cost). Consider changing doctors if the doctor does not listen or explain things well. Be persistent with managed care or specialist visits. Don’t accept diagnoses or treatment options that could be based on ageist stereotypes. Find out why the doctor or nurse is proposing treatment, and keep asking if you are not satisfied with the answer.
Use legal tools. Legal documents called advance directives are an effective, binding way to communicate a patient’s wishes to health professionals and hospitals. Options to consider: Living wills record a person’s wishes regarding life-sustaining medical care in end-of-life situations. Health care proxies, also known as durable medical powers of attorney, give an appointed person the power to make decisions on behalf of patients when needed, interpret written instructions from the patient and respond to changing medical situations.
Be a team player. Just as you and your parent deserve respect, so do the health professionals with whom you interact. No matter how frustrating a situation becomes, you are more likely to get what your parent needs if you remain constructive, polite and involved.
Inside This Lesson
Communicating with Health Professionals
Public Programs to Investigate
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