What do you do when disagree with doctors?

You need to be the advocate for your mom....I don't know this med but if you feel the doctors are not listening to you, speak up! And if they still don't listen, contact administration! The doctors hate it when their bosses get involved, but all of our parents (or those we care for) deserve the best attention possible...not 5 minutes of the doctors time. God knows their bills are high enough, and whether we pay for the bills or Medicare does we ALL deserve the best of care. Blessings to you, Linda

Thank you, Llamalover.

It is not hypercritical to be request enough clarity to understand what has been asked. We all understand and forgive typos. The text does not have to be elegant.

Get a second or third opinion.
I always question doctors when they give me a vague answer.
My Mom's kidney doctor had her on four different high blood pressure medications!
I ran out of one of them, and it made no difference in her high blood pressure level.
I asked the doctor if we could discontinue the medication since it did nothing.
She didn't have an answer, but wanted her to continue taking it.
I think they were more interested in pushing drugs and making money than my Mom's health.

I find one of the biggest faults with us doctors is we are too quick to assume things...by that I mean if an older person is not thinking or walking right, they assume it has been that way for a long time, and don;t think hmm, its a big change in function, maybe something had to have caused it that needs to be addressed. I have a few colleagues who just do not get it when it comes to recognizing and dealing with side effects and needs for lower doses in the elderly and those with low muscle mass. OTOH, very few of us get paid any more for prescribing more meds and any kind of kickback is illegal; in academic medicne we are not even supposed to accept drug company pens or lunches or anything beyond educational pamphlets. One factor that can be a real one is some qulity metrics look for the % of patients with a given condition who are taking the "right" medication for it, but that is mostly preventive medicine post heart attack or stroke, not psych meds. Zyprexa is an antipsychotic and can be either a Godsend or can have bad motor and cogitive effects, or both. Motor effects can be counteracted with a second medication if need be.

DO realize that most people do not get most side effects, or nothing would be left on the market :-) and keep a running list of definite side effects, especially if you can confirm them and they are to things that are most commonly used.

I think the reason you got questioned at first is that something happened that could have made someone ask if the previous meds were actually not working. I think all of us have had cases where the person thinks they are having a side effect but it is really the condition changing. I have people who come back after a surgery that was hopefully going to help their child walk - they may say something like 2 years ago my child was walking and now after the operation they can't anymore! But, what they are not remembering is that they had stopped walking and that is why they decided to have the surgery...it just did not turn out as well as hoped.

Vstefans, I'm assuming you are a doctor. I do believe that doctors do NOT prescribe because they are getting a kick back from the drug companies...but why do they often NOT listen to the families of the one who is sick? My mom has recently died of Alz. and many of her "specialists" did not know how to deal with a person with advanced ALZ. They expected her to be able to answer questions and were terribly annoyed when my father an I tried to explain to them that she was unable to answer them....Do they not teach this in medical school or in residency???? Blessings to the doctors that understand, Lindaz.

Stick up for yourself and your loved ones. Docs are highly educated men and women, but they are just that - humans - and not Gods! Some are dedicated and devoted to helping people, and others are dedicated and devoted to making money and basking in the prestige their profession affords them. You may not be the most popular person in the place, but if you don't agree with something being done with or to you or a loved one, or if your own information or knowledge of a situation is ignored, you need to put your foot down and push until you are heard! I'm sure there are some files out there with a big capital "B" on them next to my name, but I really don't care... My 95 year old Mom lives with me, and even her Internist asked her what she’d do without me, and said she probably would have died several times in the past 4 or 5 years if I hadn't been so "involved" - read persistent, stubborn, pushy, nosy, demanding? Too darn bad! Don’t let anyone bully you or talk down to you. Insist they explain things to you in “plain English”, and not medical jargon. If you still don’t understand, ask them again and persist until you do understand. Don’t let them brush you off, bully you or condescend to you. Correct them if they misunderstand or dismiss something you’ve told them, and persist until you understand the issues and feel able to decide on your own what the right course is. Mom is blind (has peripheral vision from macular degeneration), has major mobility issues (uses a walker at all times), etc., but mentally she's pretty bright. I have to stand up for her, because she isn’t able to do that herself. I don’t care if she’s 150 years old – by God they are going to treat her just as humanely and thoroughly as someone younger. If she’s hospitalized, they are going to treat her as well as they would any other adult… They’d better respond if she needs the restroom, or soils herself, and not try to just diaper her and leave her (that was tried ONE time!) No matter how old someone is, they have a right to dignity and compassionate care! And they are NOT going to drug her up to keep her malleable and quiet, thus robbing her of her best tools to recovery, her mind and will. They’re busy? Short-staffed? TOO DARN BAD!! I’m NOT saying be rude, or unreasonably demanding, but you do have a right to expect good and competent care. Your hospital bill isn’t going to reflect otherwise, is it? Will you get a discount for subpar care? If people insisted on getting what they are actually paying for in the way of care, hospitals would have to actually provide that level. Anyway, I guess I’m getting riled up thinking about this, so… Just stick up for what you know to be right – listen to and believe in your “gut”!

There are some big egos in the medical profession vs.
There are also some big egos outside it.

Doctors' communication skills are generally pretty woeful (I blame their training - it seems to cover no middle ground between e.g. cryptogenic fibrosing alveolitis and "oo dear you've got a bit of a nasty chest there") vs.
They are often trying to explain extremely specialised concepts to people who have not spent four or five years in medical school.

They do not always apply their extensive knowledge and full concentration to a particular situation vs.
"When you hear hoofbeats, think 'horses' not 'zebras.'" In other words, their own clinical experience, lack of time and gambling odds all conspire to push doctors towards the obvious answer or the easiest course of treatment - so they jump to conclusions, and unfortunately that often means that they jump over us.

Particularly in the context of the forum, many patients a) have complex, competing co-morbidities and b) have a lousy prognosis. Our loved ones are likely to decline and die no matter how gifted, thoughtful, well-equipped and efficient their medical team. We need to accept that sometimes there aren't any good answers: the doctors may not be completely right, but that doesn't make us any righter.

Communication being a two-way street, we need to play our part by dealing openly and courteously with professionals while explaining our concerns as clearly as possible. But by and large, I believe it's wrong and self-defeating to ask for medical advice and then ignore it or overrule it. That belief is currently being tested to destruction - wish me luck and I'll let you know how this morning's telephone consult. goes!

It's a shame that we haven't heard back from the OP. I agree that communication is a two way street with doctors, to understand that doctors are seeing your parent as a patient, while our job is to be their advocate. In the original post, the patient is taken to the hospital (reason unknown) and her meds changed. Poster assumes that mom's decline is due to new meds, but the bigger question is, what brought her to the hospital? Was her overall condition worsening? Was there a reason for changing meds, like interaction with a newly prescribed med? Confusion, in the elderly, is often a result of a simple change in routine and venue, doesnt need to be a drug issue. My job with tegard to my mom when she's "in house" is to portray accurately what state she was in prior to hospitalization, ie, she was alert and oriented with short term memory loss and aphasia. Having hysterics in hospitals buys your parent poor care.

With regard to "experimenting" at a psych hospital, i believe what is being offered is in house psychiatric unit where they can trial meds to get the patient stable. Sandy, I hope things are going better!

Sandy 22 has posted under "discussion". The title is "excuse me". Sounds like she got upset by the criticisms of her typing.

Babalou, sometimes hysterics can be effective. One time I was visiting a young man with AIDS in a south Alabama hospital. He was in a lot of pain and his medicines were late. I went to the nurse's desk really nasty about it. The nurses got their butts in action. I reminded myself of the scene in "Terms of Endearment" with Shirley McClain at the nurse's desk. There is a time for hysterics when it comes to advocating for a patient. It can remind people what their job is and let them know someone IS watching and caring. The only thing is we have to know we're justified in doing it first. There can be a lot of complacency in some hospitals, so the wheels that don't squeak can get ignored.

You need to stand your ground on this. At the very least ask some very specific questions of the doctor: why the meds change, what will be the benefit, what is the reason for discontinuing previous medications, what are other alternatives. Good luck, dear heart. It is not easy, but you will feel better for doing your best to fight for your loved one's best interests. Make sure the doctors have that in mind, too, and make sure they explain to you why they feel it is right. Do not be afraid to seek out a second opinion, either. Good luck. {{{{hugs}}}}

Hopefully, all is well with Sandy and her mom. I see where she posted on another board (thank you, CMagnum for the link).

There are forty good answers here, hopefully she'll be able to read them and go from there.

My only advice is not to be afraid of the drugs the doctor ordered. Like I said before, that particular drug is only ordered by a psychiatrist or at least that was how it was in both Massachusetts and FL.

And it helped my mother immensely despite the bad reviews it got from my 'kids'.

Everyone is different. What works for one may not work for another. But you have to give these drugs a certain amount of time to actually kick in. As they are kicking in, sometimes the side effects aren't so great. I'd give it a good three to four weeks, unless you are seeing something majorly wrong.

You need to rest while you can if she's still in the hospital. Also, do some homework, i.e., Google the name of the drug and try to look for references related to hospitals, not people's reviews. If you have concerns, do not be afraid to ask the doctor. S/he won't bite. S/he's a person, not a god.

I will be thinking about you.

i do not argue with docs , period . they need the best input possible from close family members , especially in phsyc medicine but to try to prescribe or reject medicines should be left to someone with extensive pharm education .
my sis tried to run the intensive care unit when mom was in there based on all the med tv shows sis has watched . i generously offered to have her tossed out of the hospital .
everything is based on science , bloodwork and federal guidelines . docs arent just taking wild guesses .

@lindaz, yep, guilty as charged, I'm a pediatric rehab doc who got into the geriatric end of things when my parents lost their health and their faculties a few years back.

And, short answer is no, they did not teach much at all about dementia in medical school when I went through - they did not really KNOW that much back then - and even now, probably they don't do nearly enough. At UAMS we do have a strong geriatric presence and I think they do get involved in the med student curriculum, but familiarity with the legal and funding aspects (aka "systems of service") is still not great among students or residents.

You will still run into docs who seem to expect that everyone should respond to what I call cookie-cutter medicine, and just kind of get mad or frustrated and blame the patient when things do not work the way they are supposed to. Some, even most of us care deeply about our patients and will take the time and energy to think things through, revise a diagnosis or treatment plan and listen well...some of us are either burnouts or just never really cared enough in the first place. Those "80%ers" among us will meet the standard of care or practice that does work 80% of the time, but go no further. And they said if we ever stopped learning, we'd be at the bottom 10% of our profession in 10-15 years, but today its even faster than that, but some old curmudgeonly types unfortunately think ALL the old ways are better and common sense is all they really need. In their defense, you really can get burned by people who believe every d*mn thing they read on the internet or who have decided all meds are poisons and all therapies are scams, and right up front before they even know you as a human being they have clearly decided you must be getting kickbacks and withholding information and care for fun and profit.

Just my $0.02!!

Had something like this happen recently. Dad's cardiologist wanted to prescribe some blood thinner, and Dad wasn't wild about the idea. Fortunately, I was there for the meeting.

I asked about side effects, and the doc said yes, there is a risk of stroke. I said something like, "y'all, he's had two of those already." Which he has, and I'm surprised the doc forgot about all that. But he didn't push that blood thinner any more.

Do I have POA? Well, kinda sorta. But the doctors know me, and my type-A, borderline pushy nature does help. So does stating my objections with a few well-placed questions.

The more I read here, the more I find myself agreeing with Captain's view. Your dad has had a stroke and he' NOT on a blood thinner? My goodness, that does seem neglectful of someone not to have had that conversation.

Unless you have extensive medical training, you cannot possibly understand all the possibilities, downsides and upsides of each treatment. Yes, your risk stroke with certain blood thinners, but you also risk stroke NOT being on them. Yes, less is more in terms of meds for the elderly, but some meds bring better quality of life. I think we should all listen a little harder.

My husband has Parkinsons (25 yrs) The biggest problem with hospitals is that they give medications on their schedule not his. I always insist that I give him all but his bedtime PD meds...yes, they say that's impossible but I say..I will do it and if you give him more you will overdose him! I fight them every day but I continue. They also (because of fear of falling) put an alarm on his bed so when I am there and get him up alarms go off...that's their problem altho I push the nurse call to alert them. It's all a matter of liability but I know we would rather have him fall than die from inactivity! It's really tough and with the last 2 hospital visits I have checked him out after 3 days (I know him with 24/7 care...they don't) Yes, we take a chance but I also know there is something to quality of life. Every time after checking him out he was back to his normal within 4-6 hours. I now have a reputation at the local hospital for checking him out w/o authority........oh, well! As their advocate we really have to stand up for their rights as hard as it sometimes can be.

A few months ago there was a discussion about in home caretakers and how crooked they are. Well, it goes without saying that there are bad ones out there but just as many great ones. I feel the same way about doctors. My dad's doctors are wonderful, knowledgeable, caring people. When I had shoulder surgery I was given the name of "one of the best" orthopedic surgeons in the universe. I'm sure he has helped many people over the years but I wouldn't recommend that man if he was the last doctor on earth. Flip, arrogant, UNcaring man that I have ever met. Plus my shoulder is still messed up and that was 9 years ago. I did everything he told me and he just couldn't figure out why "I" wasn't cooperating and not getting better. Sooo, in my humble opinion I have learned you have to go with your instinct, get second opinions, and do your homework. This isn't the only doctor story I have but this isn't about me. It's about taking care of your loved ones and being their advocate when they can't do it for themselves. And vstefans.....thanks for the input and your 2 cents. Wish they would teach more about elder care in med schools.