Today was yet another "follow-up" appointment for my mom. (81, mini-strokes, small vessel disease, recurring AFIB, in memory care although she is presently behaving like someone who never had any psychosis or cognitive impairment, because what's life without crazy changes?)Another day off work for me. Cardiologist told mom she is in great shape and he lowered her dosage of metoprolol, and said she'll be on eliquis forever. Okey dokey. Then he says come back in 6 months. Neurologist recently said come back in 4 months. In addition, she has appointments with dentist to fill cavities, eye doctor for new glasses, primary care for yearly checkup, separate appt for lab work, podiatrist for toenails curling into the skin. Y'ALL! I'm not a spring chicken myself and I've got my own appointments to catch up with. If we are seeing her primary care doctor, I can just cancel the neurologist and cardiologist, right? I don't want to deny her medical care, but I just can't think of any benefit right now. I didnt think we'd have to keep going back.
I’d drop the cardiologist . The primary can treat her blood pressure ( metoprolol ).
You don’t say what the neurologist is doing for her med wise and Mom seems to be having a more lucid time right now .
You could stretch that appt out to 6 months and make it virtual .
If the neurologist isn’t doing anything drop him/her .
The primary physician can prescribe meds for anxiety or other behaviors .
Ask the facility if they have a mobile dentist who comes and an eye doctor .
If so , use them instead of taking Mom out .
My father in law would go to appts driven by the facility car . My husband would meet him at the doctor office . Then the facility car drove FIL back to facility . It saved my husband a lot of time, not having to pick up and drop off his father . Hubs also could go back to work and stay late to make up the time . Idk if this is an option for you.
Once she moved to mc, I stopped taking her to her eye doctor and audiologist. I noticed at her last appointments, she could no longer accurately participate in the exams for them to be any benefit. After several instance of losing her reading glasses and hearing aids, and no longer understanding what they're for, we discontinued their use. Her geriatrician now writes the prescription for her glaucoma drops.
Mom has always been adamant she never wanted any life extending measures and obtained legal documentation (advanced directive, health care POA) for that before she was diagnosed with dementia. When she was first diagnosed with dementia at age 93, she completed a MOLST form with her geriatrician. She is mobile but frail, and trips out of the facility are risky, so they are limited to things she enjoys.
All medical decisions are based on comfort and quality of life rather than life extension.
I was lucky because my sister and I split the appointments which made it a lot easier.
I just hated having to get them to their appointments because they used walkers and were unsteady, and it wasn't easy getting either of them into and out of my car.
Yet you loose a day's work for it, spend money on gas, have to drive and babysit Mom in the office while you invariably WAIT. I only book appts. with doctors I need to see for a reason. I usually get scheduled for 2 follow ups, which I cancel after I leave.
I've learned the Patient is who hires the doctor, so they are entitled to speak up and insist on limited follow-ups (once a year is plenty), as to not have such an overblown amount of time wasted on these half baked "follow up" appts.
When the Doctor says "See you in 4 months" (after he just made $600 for chatting 3 minutes, and not even touching the Patient) simply don't make the appt. in 4 months, make it for 10 months or more instead. Don't buy into the game. These Doctors don't care about anything but making easy money.
See the Doctor for painful conditions, like the Podiatrist. Unless Mom complains she can't see or read, she doesn't need new glasses every year. Fill those cavities (as needed) to prevent pain and expensive root canals. Her Primary should give a quick physical and get all labs done the same visit, once a year. The Cardiologist can sit on the backburner, along with the Neurologist.
I agree the appts get out of control quick. Put your foot down.
Have you considered hiring a Geriatric Care Manager to maybe handle the bulk of the appointments (thinned out of course)? Would your Mom have the funds to pay for such a service?
If several are ordering lab work can all the orders be sent at the same time so all the labs can be done at once? And some facilities have the ability to do lab work and it gets sent out. If that is the case at her facility maybe look into that as an option.
Is the Neurologist actually doing anything that her primary can's do? If not then drop the Neurologist and let the Primary order any meds that the Neuro is prescribing.
Is she actually compliant at the dentist? If not and she has to be medicated then maybe consider dropping that. Is she in any pain from the cavities that need to be filled?
Same question about compliance for the eye exam. Can she read an eye chart? will she know what set of lenses is "sharper/ clearer /? Even I hate that.
Does the facility have a podiatrist that comes there? If so start using that one so you do not have to take her out for that appointment.
At some point doctor visits are a decision you make. Are they really necessary? There is Benefit VS Burden when it comes to medical appointments.
If PCP can handle her prescriptions I'd cancel the cardiologist and neurologist.
All the neurologist had Mom do was draw the clock at each appointment and it was highly stressful for Mom. Mom would practice her clock drawing 2 weeks out in preparation for the neurologist.
Here's how I feel about PCPs. They know a little about everything and alot about nothing. Keep her Neurologist but tell him every 4 months is just too much. Cardiologist I would also keep but explain to him that your own health is being put on the back burner because you have to take off from work and you only have so much PTO.
In Memory Care, the purpose of life is not to extend it to 100 but to make life as comfy and enjoyable as possible for mom until she passes away. And not to drive YOURSELF to an early grave schlepping her around to a ton of appointments.
There of course are time that there is necessity of frequent blood work to measure things if on blood thinners, diabetes medications, diuretics and etc. If your mom is in memory care there should be someone coming to her to do the blood draws. I would check this all out to get things in place for her.