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Hello! My 93 year old Mom has been in Memory Care for over 2 months and still struggles with settling in, even though the nurses and aides have been wonderful with her.
My problem is that she insisted she keeps her outside doctor. To make a long story short, it is rather difficult to get into her outside doctor, and even his nurse and her favorite nurse in Memory Care said it would make it easier to switch her to the doctor at her Memory Care so she could get attention to her constant issues that arise.
For instance, she is having delusions more and more often. Last time, it took days to get an order for a urinalysis from her outside doctor to get to Memory Care, who sent the results the next morning. But it took 5 days to hear back from her outside doctor and get the medicine she needed, while my Mom was miserable and calling me constantly for the results.
I know she won't like it, but I'm just thinking of switching her over to the doctor at her Memory Care, which should also help her anxiety from becoming more and more confused.
Any advice as to how to best handle it, or should I just gently say that this is how it's going to be? Thank you for your help!

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Imho, tell your mother that she will be seeing the house physician - "because that's the rules" or something akin to that.
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Both my parents went onto assisted living within days of each other. I immediately signed them up for the in house doc, meds, dental everything they offered. I think between them there were 6 different outside doctors.

I think I used the fib that their insurance covered more of the cost if they used in house services. At this point they both had some level of dementia, there was no way to reason with them about the simplest issues but they always were all in if they thought something was a bargain.

With assited living and in house services my life became 1000% easier.
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Time to let mother know she MUST use the doctor at the Memory Care now, that's just the way the cookie crumbles. Therapeutic fibs is what they're called, I believe. Using an outside doctor is insanity, pure and simple, when the MC doc is on site and your mother's issues will continue to mount daily, as my mother's do. Her favorite thing to do is to see the doctor who's now coming in on Tuesdays AND Thursdays, oh joy..........so mother invents a new issue TWICE a week now! The doctor can write new Rxs or change them, or order a urinalysis or xray or whatever, right on the spot, and the headaches are drastically reduced for all concerned. Part of the beauty of being in MC to begin with is to be able to use the facility as a one-stop shopping village for ALL of their needs.

If I had to use outside doctors and resources for my mother's continuous issues, I'd be bald from ripping my hair out by now! I even use the mobile dentist who comes in and does extractions in her ROOM!!!! Praise the Lord for all of it, that's my take on things!

Good luck!
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You don’t ask, you tell. Knowing she wants to be in control but is not making rational decisions, you use a therapeutic fib. You'll need to find one you are comfortable with using, but it's in her best interests to make the switch. Especially as she continues to decline.
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I simply told my mother that her current physician no longer accepts her medical insurance and that we had to be careful with her money. Being from the “frugal generation” she accepted the change without hesitation.
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Ease her in to it. When she needs to see the doctor, tell her that because of covid her doctor can't see her for several months, but he said that Dr Soandso could see her in the next few days to treat her quicker. Or if she needs a doctor, just tell the facility dr to see her and smooth it over with the same conversation - her dr not available right now and this dr can see you now.

You can put your foot down and say it's going to be that way because you said so, but you're just creating an argument/anxiety that doesn't have to happen. Just let her continue to think her own doctor is her 'real' doctor and this new guy is coming this time.
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I am sorry that your Mom will have to lose her doctor. Her insistence really is neither here nor there in the realities that are now faced with loss after loss. This is another sad loss for her, but it is real life, in which not everything can be fixed. Having lived long, she will have had many losses and this is but one more. Simply explain to her that her doctor doesn't serve the inner facility care and is as sorry to lose her as a patient as she is to lose him; then get her signed off with the kindest physician they have available to her. Be honest with her. That she can rant or she can cry or she can accept what is another sad adjustment you truly wish she didn't have to make, but whichever way she chooses the facts are really not changed. Wishing you good luck. It is so hard to witness all their losses.
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Tell her Dr. B( house Dr) is helping Dr A ( her regular doc) out for awhile due to Covid. That way she can get the help she needs sooner since Dr. A can't come into the facility. Then just do it. Much love to you.
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DILKimba Feb 2021
Excellent idea!
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It might be easier to "sell" the idea of switching doctors if your mom believes that her beloved "outside" doctor has referred her to the memory care doc. - - - a ? for you: have you asked her current doctor if he makes house calls?
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Is it possible to get a consult from the MC doctor so he/she can visit her briefly? It might not be a problem once she knows the person. She has had a lot of change lately.
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I really appreciate all of your advice and plan to get working on switching my Mom to the doctor at her Memory Care tomorrow. I'm trying to help her settle in, which I know will take a long time, but having an outside doctor just adds to her stress and delays timely results. Thank you all again, and best wishes to each of you!
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Once you do it, you’ll wonder why you didn’t do it sooner. My mom is in MC. What a difference it is to be able to have someone who sees her in the setting where she lives. The house doc visits her right in her room.

No show timing, no sitting in offices for hours. No having to go to the lab and waiting there, either. Entire mornings of additional stress for both of us, gone. Docs keep in great communication with me.
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In this case, I’d DO IT (no conversation about it) and if she asked after seeing the house doctor, I’d tell her the truth, that everyone thinks her previous doctor is great, but that the time factor for getting her services was making it too difficult for her to get care in a time frame she deserves and needs.

By the way, two months is not really a very long time to adjust to making such a significant life change.
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Harpcat Feb 2021
Agree! It takes at the minimum 3-6 months for the adjustment to new living arrangements. And with dementia it can take longer. Know that this is not unusual.
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Blame it on the insurance company, and say they don't cover her doctor any longer or that he stopped taking Medicare patients. (My mom's doctor did that, or rather, Medicare fired her. Good thing, too, as she was close to killing my mom with incompetence.)
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