Mom is going into an assisted living place She has diabetes and dementia and Kidney disease. I don’t know what questions to ask the ALF to determine if we should use their Primary Care Physician?
Unless you want to take your mom out in the car to see her PCP off the premises, I highly recommend using the doctor that comes into the ALF. It's much easier b/c the doc that comes into my mother's Memory Care ALF does so on a weekly basis; she writes or changes mom's prescriptions on the spot and the MC orders the new ones and has them delivered so the staff can dole them out, she can order xray techs to come out and do tests on the spot, same with blood tests and even an echo cardiogram she ordered recently. Ask the ALF what the doc's credentials are; normally they are geriatric care specialists, and go from there.
I felt that the choices NOT to use my current LO’s previous geriatric group outweighed the use of the staff physician, based solely on the logistics of getting her back and forth to an office, rather than having her seen onsite.
I have NEVER had a single regret for my decision. The staff doctor is wonderful. His decisions when she became Covid positive were what saved her life.
Ask the staff physician any questions you feel are pertinent.
My Moms AL was small, 39 residents, so they had no doctor affilated with it. I continued to take Mom to her PCP. Any orders or new prescriptions went to the RN at be AL. The AL had there own pharmacy they worked with.
When Mom entered the NH there were about 3 doctors affilated with it. One of them was the backup for her PCP for hospital visits and vacations. Since he had seen Mom before, I went with him.
Use their doctor. He's likely a geriatrician, and that accounts for a lot when deciding what is realistic to treat and what is less important. Throwing pills and endless tests at incurable conditions is pointless.
A geriatrician will focus on what will ensure the best quality of life within the boundaries of each person's existing health.
Definitely use the ALF primary care physician. They are on-site and don't require a "trip to the doctor's" which gets harder and harder to do. They will make time to see your LO whenever the nurse thinks it may be necessary whereas if you use an off-site physician you may have to wait on an appointment. All labs blood draws are done quickly and on-site, usually in my dad's own apartment. I've found great continuity of care by using the on-site physician, much better than my father's longstanding primary care doctor from before he moved to the ALF. The on-site physician is used to dealing with families and I've found great communication.
I was in the nursing home for approximately 2.5 months this past summer. I have several pre existing conditions that my PCP coordinated my medications with my specialists. The nursing home did not accept my PCP's input. The nursing home used only their two doctors, both of them made switches to my meds including my diabetic medication resulting in problems. one of the doctors called the drivers license bureau and told them I should not have a license because of diabetic retinopathy and macular degeneration that I should be declared legally blind. I ended up having to get statements from both of my eye specialists, having repeat testing at the license bureau. The NH docs put me on high blood pressure med and I don't have high blood pressure. My husband is a doctor and they refused to discuss with him.
I was well treated by the rehab therapists and the staff at the nursing home. but the doctors were horrible. I would check out the staff doctors before making a decision to not have your own PCP.
The is everyone for your responses. There are so helpful and personal experiences. Thank you for sharing. Mom is starting next week and we will start with keeping her PCP and go from there. Will look more closely at the ALF doctors and credentials.
I would recommend keeping her current Internist because he/she knows your parent. This will keep your parent calmer because he/she is familiar with him/her. A new doctor doesn’t know your parent & most importantly didn’t know your parent as a mentally well person. An unfamiliar doctor can cause your parent extreme & unnecessary added anxiety. Best to you.
Ask to meet with their physician. Prepare a list of questions you will have about care for Mom. Provide a list of Mom’s medical concerns, eating habits, behaviors, recent changes etc. If a Nurse Practitioner will also be seeing your Mom, ask to meet as well. It is helpful to have in house care available for your Mom, but ultimately it is your Mom’s and your choice. With current CO-VID numbers on the rise, having in house care is a very effective way to keep Mom’s health in check. As a side note, transitioning into assisted-living can be difficult for people. There are services that are available that are paid through Medicare and supplemental insurance is to assist your mom with her transition. There is physical therapy, occupational therapy, speech therapy, psych nursing and social services available through the insurances. The majority of physicians will write an order for the services, and this can help mom get acclimated into a community. You will also wanna make sure that if you decide to go with the in-house position, that they would be willing to do this, if this is something you wish for your mom The choice of home health organization is patient’s choice, not the physicians. You need to remember this and know which home health service would best suit your mom. I always recommend to families to research any organization that their loved one wants to work with, as well as to get some opinions from others that have worked with the services, the physicians or any other healthcare professionals in your area. I hope this answer is helpful to you. I am a certified dementia practitioner and memory care advisor I have been in the senior living industry for almost 20 years. And many times I find that the transition is harder on the family when they have their loved one make a move to assisted-living or memory care than it is on the person moving in. You will also want to know what plan the community has in place to help your mom have a smooth transition into this next chapter of her life. I wish you all the best. Schelle’y Cunningham CDP Senior Memory Care Advisor Promedica Senior Health Service Arden Courts Memory Care
Oh I hope you don't mind me asking you a question. My parents are 86 and 90 both now with dementia. My mom that can't do anything for herself absolutely refuses to go to Assisted Living. I have POA but can't force them. I've had a few people tell me lately that moving them now to assisted living would make them more confused and disoriented. Do you find that to be the case? My mom has vascular dementia but knows what's going on around her. My dad has presented memory loss starting about 4 months ago. His sister has been diagnosed with Alzheimers disease and is in a memory care facility. I'm scared at 90 that this may be his diagnosis. Just wondering what affect a move would make on their mental status, that is if I could ever get them to go! Thanks a bunch for hearing me out!!!
Your mom's doctor knows her conditions and her care well. If your mom's doctor is a geriatric specialist or a general medicine internist, you might be better off keeping her doctor. If your mom's doctor is a general practitioner or family medicine doctor, either her doctor or the ALF doctor would have about the same qualifications.
Jarkitect8: Imho, the first time that I'm able to view your post is four days later and I do see your update from September 11, wherein you stated that you'll still be using your mother's PCP for starters. Best of luck.
Check to see if her dr will make calls to the ALF. Mom's PCP had a nurse practitioner who made monthly calls to multiple facilities, then we would schedule an annual exam or sooner if she thought mom needed to see the dr.
I would check out the specific dr who does the visit and see what his record is, maybe schedule a one on one visit to meet him/her and gauge your response. One advantage is that those staff drs at least have more experience seeing elderly than a typical GP. And since that dr will see your Mom on a regular basis they might spot problems sooner. Also, the dr may delegate to a nurse practitioner to do well-care visits so verify who will be seeing your mom if that is an issue for you.
And as the person who had to wrangle Mom, her walker, her purse and everything she "needed" for a 15 minute dr visit that ultimately took 3 hours I LOVED having her see the in-house dr.
When mom was in AL during COVID and because of change of insurance coverage after dad's death, I transferred mom's care to the facility's dr. While I felt the move was necessary, the Dr used by the facility was NOT a good dr. The doc she saw pre COVID was an excellent caring dr.
I'd check the facility's doc out. I'm sure there are a lot of facility docs that are good. But don't get stuck with one like mom had. She has since moved from AL to IL and has new DRs.
I really hope my mom's experience was an aberration and not the norm. Best of luck.
Good luck!
I have NEVER had a single regret for my decision. The staff doctor is wonderful. His decisions when she became Covid positive were what saved her life.
Ask the staff physician any questions you feel are pertinent.
When Mom entered the NH there were about 3 doctors affilated with it. One of them was the backup for her PCP for hospital visits and vacations. Since he had seen Mom before, I went with him.
I liked where the Dr. came to her.
A geriatrician will focus on what will ensure the best quality of life within the boundaries of each person's existing health.
Some PCPs also make the choice easy, since being in an AL, NH, they're not going to visit, as to not "step on the toes" of the in house doc.
I was well treated by the rehab therapists and the staff at the nursing home. but the doctors were horrible. I would check out the staff doctors before making a decision to not have your own PCP.
It is helpful to have in house care available for your Mom, but ultimately it is your Mom’s and your choice. With current CO-VID numbers on the rise, having in house care is a very effective way to keep Mom’s health in check. As a side note, transitioning into assisted-living can be difficult for people. There are services that are available that are paid through Medicare and supplemental insurance is to assist your mom with her transition. There is physical therapy, occupational therapy, speech therapy, psych nursing and social services available through the insurances. The majority of physicians will write an order for the services, and this can help mom get acclimated into a community. You will also wanna make sure that if you decide to go with the in-house position, that they would be willing to do this, if this is something you wish for your mom The choice of home health organization is patient’s choice, not the physicians. You need to remember this and know which home health service would best suit your mom. I always recommend to families to research any organization that their loved one wants to work with, as well as to get some opinions from others that have worked with the services, the physicians or any other healthcare professionals in your area. I hope this answer is helpful to you. I am a certified dementia practitioner and memory care advisor I have been in the senior living industry for almost 20 years. And many times I find that the transition is harder on the family when they have their loved one make a move to assisted-living or memory care than it is on the person moving in. You will also want to know what plan the community has in place to help your mom have a smooth transition into this next chapter of her life. I wish you all the best.
Schelle’y Cunningham CDP
Senior Memory Care Advisor
Promedica Senior Health Service Arden Courts Memory Care
Just wondering what affect a move would make on their mental status, that is if I could ever get them to go! Thanks a bunch for hearing me out!!!
The VA offers home based care services ,so his PCP will continue to see him at the ALF.
Your Dr can also give all info to the other Dr.
I would check out the specific dr who does the visit and see what his record is, maybe schedule a one on one visit to meet him/her and gauge your response. One advantage is that those staff drs at least have more experience seeing elderly than a typical GP. And since that dr will see your Mom on a regular basis they might spot problems sooner. Also, the dr may delegate to a nurse practitioner to do well-care visits so verify who will be seeing your mom if that is an issue for you.
And as the person who had to wrangle Mom, her walker, her purse and everything she "needed" for a 15 minute dr visit that ultimately took 3 hours I LOVED having her see the in-house dr.
Accordingly, the doctors may not be as qualified.
I'd check the facility's doc out. I'm sure there are a lot of facility docs that are good. But don't get stuck with one like mom had. She has since moved from AL to IL and has new DRs.
I really hope my mom's experience was an aberration and not the norm. Best of luck.