Preparing Elders with Dementia for a Doctor's Visit

8 Comments

Effective communication with your doctor is important for you and your family when someone you love suffers from early-onset dementia or Alzheimer's disease. Here are some tips for having the most effective doctor's appointments.

Let Them Be In Charge If They Are Able

Your loved one wants to be in charge of their health as long as they can. When they feel like they are losing control of their independence, a common defense mechanism that these patients use is: "It's my doctor and my appointment. I can do it on my own." In this case, try to position yourself as a partner (instead of the overseer, or dictator) of your elderly parent's health. The key is try to get your loved one to view you as a member of the health care team, rather than someone who is making them feel incompetent.

Prepare for the Appointment Together

Make a list of questions or concers that you want to ask the doctor, so you do not forget anything when you are at the office. Using a cooperative approach to work with your loved one and prepare for the appointment will probably work better than handing them a list of questions without asking for their input.

It is best to make a list of your own observations of changes in their behavior and actions. If possible, choose a time when they seem receptive to give them the opportunity to share their thoughts about this concern. This can keep them from feeling interrogated and becoming defensive.

Have Someone Accompany Them

If you cannot go with them, find someone who can. A person with dementia or Alzheimer's may tend to forget important information after the appointment. Due to nervousness during the appointment, or the nature of the the disease itself, your loved one might promptly forget everything that the doctor told them.

Ask Questions

If you do not understand something while you are at the appointment, ask questions until you do. Do not be afraid to speak up and share your point of view. If you were unable to attend the appointment, and you have questions, follow up with the doctor directly.

Ask the Doctor To Write Things Down

Get the doctor to write everything down and then duplicate it. This proves helpful in keeping the family informed, ensuring important information is not omitted, and providing other doctors with comprehensive records of your parent's health history.

Most health care providers have digital records programs that are integrated within their healthcare system. Ask for a printout of the physician's notes for the visit. Sometimes just having the proper names for conditions and prescriptions can assist you in conducting a little of your own research to broaden your understanding of what is going on or what to expect from a certain prescription or treatment process.

Get Permission in Writing

Doctor's offices continue to improve confidentiality practices to avoid lawsuits. The physician will require a release form to be signed by your parent, which gives the provider permission to speak with you directly about your parent's health conditions.

Communicating with the Doctor Ahead of Time

People with Alzheimer's or dementia sometimes can become masters of disguise in the early and middle stages of the disease, particularly during doctor's appointments. Will your loved one seem coherent and "normal" and convince the doctor that everything is fine? With today’s changing health systems, we do not always see the same providers regularly. Be sure to let the doctor's office know ahead of time about your parent's tendency to cover up or sugar coat the truth. This frustrating behavior is common for many reasons, but perhaps the main concern of your aging loved one is their fear of losing their freedoms and independence, therefore they withhold certain thoughts or observations about their own behaviors.

Doctors are a critical member of the support structure that we need in caring for someone with Alzheimer's. To be successful, you may need to figure out how to become an accepted partner in your loved one's medical health. Develop processes so that you and all attending physicians and care providers can stay in the loop, and provide your loved one with as much control in the decision-making process for as long as possible. By taking a team approach instead of just taking over, your loved one will be more likely to work with you to achieve their health goals.

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8 Comments

I used to have the same problems with my mom. The progression was, the doctor started to talk to me instead of to her, then she said i could not come in but she never remembered what he told her. Finally she lets me come in. The doctor asks her questions-- she answers which I sometimes contradict by saying dont you remember this? and then he tells her and me what needs to be done. I write everything down because there is usually alot of instructions and her doctor has the habit of going through options out loud. Very confusing for her and for me so i end up repeating what I think the final answer is. This is her gp. When she goes to specialists they generally treat her like she is deaf and talk to me instead. I am the one that brings her into the conversation. What really bugs me is when she is in the hospital and the doctors come at 6:30 in the morning. They tell her things but dont tell me anything and nurses have her sign papers that she is not allowed to sign. I have my guardianship papers on file at the hospital that she is at but they still do that. She cannot legally sign anything so I dont know what they think her signature is worth. Again the gp usually calls me ---- at 6:30 but at least he calls. Everyone else only calls me when she is biligerant.
Both of my parents are at a place where they have memory loss. My Dad will need to go to a home soon. I have arranged for a Dr.'s appointment with both of my parents, myself and a senior social worker. I feel the conversation needs to be held with all present. My folks won't remember much of it, but at least the rest of us will all be on the same page and hopefully get a clear plan on what steps need to be taken. This is such a rough time, I always have to remind myself that this is just part of the aging process for many people.
have you every heard of visiting physicians? I just signed up with them to be my mother's doctor. They COME TO HER HOME!!!!!