Has anyone butted heads with the primary doctor in what's best for your loved one?

Why is it too late to change doctors? If he doesn't meet your expectations, wouldn't it be better to find someone who does?

I wouldn't tolerate his attitude toward giving up. I assume he's not a geriatric doctor?

We had two PCPs who were lousy; only a few visits and they were history. There were also 2 internists who were more thorough but clearly didn't know how to deal with older folk and they're history now too. I've got recommendations for a geriatric doctor, so that'll be the next one, and hopefully he'll work out.

I tried to work with the doctors who are now history, but some of them weren't worth the effort. One of them insisted that my father should be taking Fosamax, and insisted that he "has to take something!" Never once did he raise the issue that walking is the best exercise for osteoporosis. Nor was he concerned about the side effects of dangerous drugs like Fosmax. After a few discussions and he just couldn't grasp the fact that we don't see medicine as the solution for everything, and after his office failed to cooperate in getting home care, we moved on.

You can try one last time but if the doctor doesn't change his attitude, I'd find another one. It isn't worth the agony of trying to make some of the old style doctors get on board. Some of the younger doctors are so much more progressive. I love to work with them.

Dear cadams,

Good of you to advocate for your mom. GardenArtist is right, its never too late to find another doctor. Or report this doctor the Medical Association if necessary. I know its hard to find a good doctor but its worth it. Take the time to call around and see if you can get a second and third opinion.

Cadams; I sympathize with your problem with mom's primary. We had a similar situation with mom's primary back in the day and we were able to find her a wonderful geriatrician who practiced at/near the Independent Living place where we moved her. So don't give up on the idea of finding a doctor who will be a better fit; find out if there are doctors who make house calls in your area.

As to hospice, it sounds as though it might be a good idea, even though she is not actively dying. If the doctor will recommend it, it gets you a new set of medical professionals who will evaluate and support you in your keeping mom at home, and keeping her comfortable.

Many patients "graduate" from hospice because they do well.

It sounds as though there is not really a definitive dx for your mom at this point and what she needs is comfort care. That is really the definition of hospice.

I would have been someone who did not settle for "she's going to die" - I had to know an actual diagnosis too. Not just dementia, but how is her heart, etc. When a financial person reminded me that my parents were going to die, that was different; I needed to hear that to been to accept they were declining and that taking over everything for them and selling the house rather than keeping every option open for indefinite lengths of time was really the right thing to do.

A geriatrician who shares or at least fully appreciates your perspective on mom's life could be a better pick if your heart-to-heart talk does not work out. I would also have loved to have had more time to make memories with both my parents (especially with their grandkids) despite the onset of dementia and needs for care; we still respected their advance directives and all but didn't want to hasten death even with benign neglect, which is sometimes not so benign. I felt I had to tell my dad's doc that his quality of life was not so bad, and he did listen to me, but we did limit hospital stays for both my parents at the end when the status of major life-threatening impairments was non-reversible.

Oh, I understand this. My Moms primary was just like that...I felt sure he just did not care...she was very old and he just shrugged and said.."well, she is very old". I ended up having to point blank ask for everything..he never volunteered any.

As for changing docs. That is t going to happen. There are near no physicians accepting new Medicare patients. With the reimbursement cut and cut again...docs don't want more of this patient/payer. My Mom tried to fire this doc years ago...and found she couldn't get a new one.

I became eligible for Medicare...but..I do not have a primary. Because I cannot find one accepting new Medicare patients. So..I just stick with the urgent care "doc-n-a-box" services. Just make sure it is not Emergency care... Medicare won't pay for that.

Reading again and reading between the lines - bedbound may mean time is limited, and if that means time is precious, they may have misunderstood your trying to communicate that and thought you did not know. There is a tendency still to make sure people are not "in denial" that is carried way too far by some older docs!

And if hospice does not offer anything you need or any financial/coverage advantages for you or mom at this time, there is no reason they have to be involved. If you do find a good reason to start that though make sure their philosophy is compatible with what you and mom want too, in terms of medication use, etc., and not just a cookie cutter approach like everyone gets morphine and Ativan around the clock, and stop all the other meds that may help them function or feel better. Had to fight tht a little for my mom... difficult memories there!

Do you have the option of palliative care where you live? This could give you access to a visiting nurse to work with you about mom's health care issues and limit contact with the doctor to prescription renewals. AgingCare has a couple of article about palliative care, or you can search the site for what others have written

www.agingcare.com/articles/palliative-care-how-it-can-help-your-aging-parent-achieve-quality-of-life-136281.htm

www.agingcare.com/articles/palliative-care-what-is-it-and-how-is-it-different-from-hospice-197744.htm

Well, I guess life has a way of working things out ...... I called my mother's Primary Dr. to set up an appt. to have a heart to heart talk to see if we could work things out, but found out that he just quit the field last Friday!!!! I am stunned as well as his staff. So, now I will have a meeting with the Dr. they transferred us to and see about a fresh start. I am thinking mom's former Dr. may have been experiencing burn out and that is why the awful attitude.....quite unlike his usual warm, friendly, helpful ways. Feedback? cadams

Katiekate......I hadn't heard that drs. are not accepting new medicare patients. Is that across the board, all over the USA? Kinda scary. Now what do we do? I am on medicare myself......
cadams

Just got call from sister, who is also pressuring me to go the way of hospice. Sorry, but I feel we are on par or even better than hospice at this point. I am taking care of mom 24/7 and have 3 good helpers with another one I am interviewing plus I just signed with a terrific nursing agency that is sending a nurse, OT, PT and speech therapist. What more can hospice offer that we are not already doing. Mom does NOT have a terminal illness, is not wanting to die, is not in pain or suffering. She is bedbound due to recovering from falling out of bed. Yes, that invites new issues to deal with, but I/we are addressing them as they come. I am frustrated and angry about this. It is my understanding that hospice would NOT have sent mom to the hospital when she had BM issues or a UTI and would just let it happen and go the way of death instead of dealing with those issues. Am I off here? cadams

Cadams,
There are two kinds of Medicare. With Traditional Medicare, it's pretty easy to find doctors. If you have Medicare Advantage, it can be much more difficult because you are restricted to a network. And about the doc saying LO is at the end of life, my Dad's doc said this to me 11 years ago and he's still going strong.
Blessings,
Jamie

Totally agree, it is never too late to find another Dr. See if you can get one. Call medicare. Your Mother deserves better then Dr who doesn't care.

Yes, I would meet with the doctor and not hesitate to change if he is unable to meet your mom's needs. I am a nurse and advocated for my mom for two years. I have reported doctor's to the medical board and also given them a piece of mind over time.
One battle I could not win was medication. The Nursing Home and physicians "double teamed" me here. My back was against the wall (so to speak). As far as Hospice, for us, it was a prayer answered. Mom had so much more attention and care and had Hospice for close to a year. Advocating for our loved ones can be bone-sucking, but I am so thankful I was able to do this for my mom.

I am going through this as well with my mother's doctor.
Several times I have written a note with my concerns and "secretly" given it to the receptionist before the appointment. Twice the doctor has talked to my mom about concerns I wanted addressed, but at the last appointment, nothing.
She doesn't think she needs new hearing aids, or to even get the ones she has checked and adjusted, but she is constantly saying "What?". Then she gets upset when I need to talk louder. I told the doctor, hoping he would recommend a hearing check (since she won't do it at my suggestion) and he didn't mention it. He ignored another issue as well.
He pats her hand, says, "I just think you're doing real well", and sends us on our way.
To add a complication to this, I (and a professional therapist I consulted) have decided she probably has schizoid personality disorder, and has had it for a long, long, time. So of course she knows what's best and sees no need to find another doctor.
It's extremely frustrating on many levels, and I just keep trying to take care of myself.

Cadams, your profile says that your mother has Alzheimers. Is that right? I'd try to find an expert who treats patients with this condition on a regular basis. They may be able to provide more information and guidance on her care and what can be expected in her progression. I wish you luck.

My husband has many health issues. We were with the same doctor for over 20 years. Frankly, because my husband was uncooperative with the doctor, we started to have the inklings he had given up on hubby. His wife was my doctor. Without any warning, hubby's doctor started working only with Workmen's Comp cases and was only seeing patients one day a month. We waited 3 months for an appointment. Hubby's health issues do not permit that. My doctor changed offices and is now located about an hour away from our home. This was also with no warning. Both of us have new doctors and in my opinion, they are much better. Don't hesitate to change and explain to Mom why. She will understand why.

My mother's internist recommended Hospice or nursing home after her hip fracture and due to dementia and for medication management. Mom got very angry. Went to a new GP who does just the basics. Point being one year down the road, my mom does in fact need professional medication management. She has placed back in her home (by my brother) to live alone and is shut-in. I would far rather have taken the doctor's advice than see my mother live in such haphazard conditions.

Which brings up new question? When mom left rehab from hip fracture she had approx 100 Percocet tablets. I separated her meds in dosing dividers. I've just learned that when my brother busted her out of respite care, his wife took the Percocet away from her. What she did with them nobody knows. Point being she is here at my house riding out the storm and is having pain. What to do?

I recommend that you at least meet with Hospice and gain clarity as to what Hospice is about. You say you are caring for mom 24/7 and she is recovering. Thats terrific and okay. Please understand that Hospice (in home visits) will certainly not replace your active caregiving. But you will gain some valuable assistance and help in mom's recovery. They can be a great "add-on" to your care and right arm to help you understand what comes next with mom, expected outcomes, arrange some PT or therapies to help optimize mom's recovery. Lots of folks misundertand that Hospice is only end of life; thats not necessarily true. If the doctors support Hospice visit and you can get it -- then by all means take advantage. If it doesn't work out -- then you can always stop Hospice.

Sorry to hear that. My parents have/had an amazing primary Dr. so I have been lucky. I had a friend who had the same problem (except it was other family members, siblings) so she went and got a Hospice referral. Her mom was denied. The family members just didn't want to care for her anymore.

Hopefully you have all the legal documents in place (DPOA, medical directives, etc).
As others have questioned, why is it too late to change doctors? I see by default (doctor up and quit) you are now going that route and hope you have more luck with the "new" one - if not, do not hesitate to seek out someone who will work appropriately with you.
Although our mom's doctor did not behave like this, we had to change because he or his office just was not working with us. In order to work with federal pension, we needed a specific Dx for mom. They required we come in for exam, which we did. I had to leave the exam room when she started getting belligerent with the tech doing tests. The doc talked to me before going in, and assured me he would provide that letter. Despite pinging them at least once/month via the portal (or by phone if I could ever get through) AND her regular physical several months later (brother took her), I got the run around. No response or we need to know what you need - I SENT that to you via mail, copies of the documents explaining it all, BEFORE the first visit... but hey, here is a way to update via the portal, here you go AGAIN. Oh we need the DPOA, here you go! End result, 6 months later, lots of frustration and no letter. I still tried, but meanwhile took her to my PC who not only provided a letter, but SEVERAL because the just right magic words were not in place. NEVER heard from the other doctor.
No doctor should be saying there's nothing to be done, she's going to die. We're ALL going to die, sometimes too soon, but that is totally unacceptable and ridiculous.
Yes, others have said it can be difficult to find a new doctor - they might not take your insurance, etc. I had to choose my MA plan carefully (even the previous one too) to make sure the doctors in my area that I have been to accept that insurance.

Hopefully by now you have a new, better doc in place and mom's care is proceeding. As for sister, again that question about DPOA and medical directives are important. If YOU have that in place and YOU are the primary, sister cannot do anything but moan and complain. If SHE has that power, you could have a battle brewing. If none of you has this power, in order to ensure mom gets the care YOU want, not what sister wants, you might have to go the court route to get guardianship and stewardship. This can be costly and time-consuming. If sister's primary concern is $$$, remind her that if this battle is taken there will be little or no $$ left! If she does not have to care for mom then just what is her complaint?

Cadams,
The folks who are recommending hospice are likely not aware that you already have great in-home care assistance.
I suggest you ask the care manager and/or the nurse and therapists to recommend a new PCP.

C Adams: I would suggest to change doctors...it is never too late when it comes to her care.....you can have a heart to heart but it may not change the outcome...if he is providing her with the best care..then you may want to keep the doctor..or get a second opinion from another doctor if her insurance allows it...are just change to another.
Medicine/Insurance/Home Health and Hospice agencies may sometimes seem like you are hitting a brick wall and you are because your hands are tied...it is always a problem in getting the doctor to approve their care...I do not know what the problem is..because you contact the insurance agency and they say it's covered but if you can get through to the doctors office you may not get your answers, you may never get the returned phone call and then you only get half of what you asked for.

The sad part is you need a doctor to approve all the orders with Home Health. Hospice they have a medical director that can handle all of the issues..so it's a 50/50 split...because Hospice is only for palletive care...they do not care if the patient, eats, drinks, poops, takes their medicine or if they slowly decline and die.

The best thing for you is to put your  emotions aside and deal with them on a logical standpoint...this is hard to do..but it is the only way to handle all the aspects of taking care of her.   A word of wisdom...plan ahead...know what you want to ask....before you talk to the doctor, nurse or agency and document everything that happens...this may be of benefit to you one day.

Does your mother have a hospital bed..can you get one for her with the side rails so she will not fall out of bed...if your insurance does not cover it..you can rent one...or buy one...look on line someone might have an inexpensive one to sell..if she goes under Hospice ...she should be able to get one if the doctors approves it.

Do some research and if you have care for her at home...and it meets your expectations..then keep her at home..because a nursing home is the last place you would want to see her..In order for her to get the care be... firm..and direct.     Good luck you will be in my thoughts and prayers..

I had many of the same problems with my mom's PCP that have previously been stated. My advice: Run, don't walk to find a mobile/house call doctor! It has made all the difference in the world!! Google mobile doctors, house call doctors, homebound, in your area. If you have regular Medicare it is easier than a Medicare Advantage for this service. They come once a month (either a PA or NP) write prescriptions, can do any lab tests in the home, etc. The best thing about a group like this is that you don't have to do any explaining. They get it because this is mostly what they deal with. You may have to do some calling but they are out there and are a LIFESAVER! Sometimes the larger Hospice organizations have a group they work with. Hope this helps. My mom is 95 with Alzheimers.

I am not the person who takes Mother to her drs appts. I am a girl and I don't understand medical things :) Mother has brother who is an EMT take her. Her dr is nearly as old as she is--88, he's 85. Why in the world is she seeing this ancient guy? He can barely walk, himself.

Mother loves him, for some weird reason. She has attached herself to every dr she's ever liked. And I mean, over the years she was a weekly visitor to the clinic for one thing or another.

My sis researched geriatric physicians for mother, as hers was sick a year ago and didn't look like he'd come back. She got her in to a young, female and mother refused to go. Wouldn't even consider it.
My "beef" with mother's PCP is his age and lack of up to date medicine!! Two of my kids are drs and they are appalled at the 20+ drugs mother is on--most are for s/e of something else she's on.

Also, the dr kids have both stated that the best care you will ever get is from a younger female doctor. Just saying.

BTW, Mother routinely waits 6 months to get in for a visit for, say, a cold. Seriously?? The wait list for her dr is obscene--you could die while waiting to be seen. She has routinely got a UTI and she can't WAIT months to get in.

Grrrrrrrrr......the "heart to heart" with her about changing drs just resulted in my being sent to timeout (again).

I thank you all for all your feedback, support and encouragement.
I DID end up changing doctors simply because mom's primary Dr.
quit the field. I have to say the new Dr., while not nearly as mature, was pretty upbeat and more positive, so you all were absolutely right on about changing drs......
Sad to report now though that mom DID pass away peacefully in her sleep the day before Hurricane Irma hit Florida. So......now I am dealing with the shock of all that and in a whole different phase.
Thanks again. cadams

Had amazing result with visiting Hospice care. For starters, the 'hospital bed suppliers' were not able to come up with a bed. Hospice got one delivered and set up next day. Visiting Hospice is the best of care because of their direct hands-on experience. I knew that it was not necessary to go to a hospice center, but the mere fact that I hadn't yet called meant that I didn't know enough about the program. My out -of -town daughter made the call. When she later called the doctor to ask if he would sign the medical consent Hospice needs....he answered the phone: Yes!!! He didn't say hello, staff told him why she was calling, he picked up with Yes. I'll always wonder why he didn't hand me a brochure or mention something in our appointment three weeks before. You wouldn't suggest in the presence of the patient, of course. Thank goodness for daughters. I had been on the approach side of calling, but would think of it late at night. My daughter went right to the source. Hospital affiliated, Hospice is five miles away. Hospice knows what is needed and can assess at once. The hygiene supply is premium quality, delivered overnight. I was using myriad supply houses, the quality was sub par by comparison. These visiting professionals who are angels in disguise, offer....nay....welcome calls 24/7, welcome them. I was impressed with the fact that their appointments were so concise. Part of me worried about people being underfoot, but no, they go to what is needed straightaway. Nurse takes vitals and chats with the patient. The physical aide changed the bed and bathed the patient. Each visit was 45 minutes, that was all that was needed. Made an enormous difference. Once when a prescription was needed, nurse called the Hospice doc. The prescription was delivered three hours later....in a thunderstorm. Helpful not to have to leave the patient? Yes. As you read here, please remember that you might want to relieve someone of the burden as my daughter did me. I wasn't given information about Hospice. I hadn't researched it yet, though it was a nagging thought at the end of any day. Do this for someone. Get the contact information and offer to make the call. At the least, find out if Hospice is available at your local hospital, we should all know that as a simple matter of reference. We can do do much better. Boards like this, the helpful questions and replies. Families want to keep the beloved at home, but we need information and help. And daughters.

Cadams, sincere condolences on the death of you mothers. I hope that the knowledge that you did everything you could for her will be of some comfort.

Dear cadams,

My deepest sympathies and condolences on the passing of your mother. I am very sorry for your loss. Thinking of you and your family during this difficult time. Take care of yourself.

Cadams , I'm so sorry to hear about your mom passing. May you have peace knowing you took such good care of her.