NP wants mom in there every 3 mos. Is this normal?

She has a B12 deficiency he is watching. As long as there is a REASON, then I think you should get the bloodwork. I don't think the actual appointment to see the doctor should be necessary. Speak to the doctor. B12 may need to be administered SQ if patient not taking it by mouth, and in all truth by mouth may not be enough.
Discuss with the NP.
Now to drawing a clock. It is one of the most common Dementia tests. Inability to draw a clock set at a particular time indicates there is dementia. Has Mom been diagnosed with same? If not, it is time to see a neurologist, yes, so you can get information and know what stage you are on.
It is now crucial you have done paperwork for POA and etc? If not, time to do it before you have a diagnosis. She likely has not entered any stage where she cannot understand POA; She should do that, because once you have diagnosis of dementia it is unlikely you can get any of this done. You need advanced directives, posts, POA, make certain you know her wishes now.

Until this past year, my mom saw her primary every three months to monitor her thyroid levels, since she is taking levothyroxine. Since she entered hospice, however, she isn't seeing her primary anymore.

You know, it's ok to ask the NP if you can stretch out the visits to every 4 months, especially with the pandemic still rearing it's ugly head. The worst he can do is say no - and then you can absolutely ask why are the 3 month visits necessary? It can be done without being accusatory.

One of the biggest things I have had to learn in this caregiving journey is that, as the primary caregiver, I feel I am entitled to know everything that might have an impact on how I manage my mother's care. Sometimes we're a little intimidated by those in the medical profession, but a GOOD doctor should be willing to address and answer ANY concerns or questions you might have. Because, if you don't ask, chances are they won't explain. And, when it comes to caregiving what YOU don't know *might* hurt your LO.
Best wishes!!

Older people are often asked to come in every 3 months. That's not unusual. Things can crop up relatively quickly and can be found when the patient is seen every 3 months.

However, if you feel it's excessive, cut back to 6 months apart. After all, the dr is YOUR employee!

Hand raised, I am also part of the every 3 month doctor thing, which for us seems unnecessary as our health issues are under control [we are in our 70's]. So when a new appointment is scheduled for 3 months down the road we later call up and reschedule for 4 or 5 months later.

Also deficient in vitamin B12 and D. As for vitamin D, we are spending too much time inside compared to when we were young. I remember seeing in the middle of winter, my parents [in their 90's] would have their sliding patio door open with the screen in place, wearing their winter coats, gloves, and hats, but had their pant legs rolled up to get some sunshine :)

My mom's doctor told me liked to see all her older people every three months in order to become familiar with them and keep on top of any little issues or changes that might signal something major. She made sure we complied by not renewing any medications without an office visit 🙄

In my experience, if she is not sick she doesn't need to go.

Thyroid, my Mom went to a specialist. In the beginning I think we went every 3 months with testing being done before the next appt. Once her levels were stable we went to once a year with a test at 6 months. That way he could adjust what was needed.

When I started doing Moms finances (Dementia involved) I found she was going to her PCP every 2 months and questioned her. She said thats when he wanted to see her. I told myself if he asks her why she is there, I am cutting down on those visits. I even had one of his nurses, a family friend, ask why we were there. I told her I had no idea but if he asks why she is there, we won't be coming every 2 months unless she is sick. He asked, I walked out without making another appt at that time. Yes, he isn't actually defrauding Medicare because they probably allow for so many visits a year but he is taking advantage. I cut back visits with a couple of Moms Drs. once she was stable. A yearly visit with labs in between if needed is enough.

Where I live a NP works with/for a Dr. Even though my RN nurse says with the training they go thru they might as well go for an MD, they are not MDs. They are limited in what they can do. Sometimes the Dr. needs to intervene. I would not trust a NP to handle my Moms thyroid. Some medications can cause damage to the liver. Liver enzymes need to be looked at. Mom had to go off cholesterol and couldn't take Tylenol. Both effect the liver. In my state, you need to see a doctor every 6 months for renewal of certain perscriptions. The Medicare checkup is not a have to. Its just the basic labs and checking vitals.

So no, if Mom is healthy in other ways, other than Thyroid, I think 3 months is a little too much. I would say maybe 6 with you getting her labs done before the appt. If he gives u the order at the appt, then he can have you come into the office for the results. This is also something I find doctors are doing. If labs are good, no need coming back in. I do think they are milking Medicare.

If you plan on continuing with the NP for her Thyroid I would learn to understand what is involved. In the beginning, yes the dosage of the pills will need to be adjusted till her numbers are normal. Once Normal for a while, the dosage may be reduced. I would research what she is taking. Like I said, the one Mom was on effected the liver so her enzymes should be part of your mothers labs. Once Mom reached normal numbers her dosage was reduced and she eventually only took it every other day.

We have to be advocates for our parents as they age. We need to be there with them and question, question, question. We need to research everything they take. The Thyroid gives off hormones. Without these hormones doing their jobs, health problems form. With my Mom she had Graves diseases and it effected her heart rate.

I know, you feel if you go against the NPs recommendations something will happen. If it does, deal with it then. The NP is not dealing with a person with Dementia. He is not the one having to make sure she is ready and driving her there. Some people have to take off work and some employers don't appreciate that. I looked at it as, its now my responsibility, so its done in my time sort of thing.

Dosmo, I do think you'll get more responses by creating your own thread.  You have valid concerns, and they're similar to those that many others have and for whom advice has previously been requested.    The time factor is also relevant to your situation.

As to transportation, are you located near a city which has public transportation, and provides what is variously known as "small bus", or something else depending on the system?   These aren't the full size buses, they're smaller, about the size of an ambulance.

The purpose is to provide transportation for people who don't have it, and can't access full sized buses with established routes.

Some Senior Centers have these buses, through arrangements with the local transit  company.

When I shopped around for transportation to a surgery center for my cataract surgery, I called a lot of companies, but found that most were expensive, charging $3 or more per mile, plus a flat fee.    The local transit company provided small bus service, with pick up, delivery, and pick up after surgery.  The cost was either $1 or 2 each way.    Can't beat that!

I also learned that some ambulance services have nonemergency vans also providing service.  It wasn't cheap, but it worked for me.  

Your profile doesn't indicate where you live, so I can't do any research for you.   But you might want to read these threads and posts on point to point transportation and do some research on your own.

https://www.agingcare.com/search?term=small+bus+transportation

Another group of similar threads:
https://www.agingcare.com/search?term=point+to+point+transportation

Anyone who wants to criticize me for redirecting the tenor of this thread can feel free to do so.    I felt that Dosmo needed some support, regardless of this not being "her" thread.

Here in Canada is is routine for seniors who take medication to be seen every three months. At least in my experience as a MOA.

Doctors will often only do three month Rxs, to ensure the patient comes in.

B12 is not something to mess around with. The under the tongue tablets are easy to take, if they do not boost her levels, then she likely needs B12 injections. Often these are done weekly, for a month, then labs are done, if the levels are up monthly shots may be prescribed.

Lack of B12 can lead to odd behaviours, including dementia like symptoms.

FYI: Medicare offers a yearly Wellness visit - however this is NOT really like a yearly checkup visit.

A "Wellness" visit is primarily to "develop or update a personalized prevention plan to help prevent disease and disability, based on your current health and risk factors. Your provider may also perform a cognitive impairment assessment."

That's not the same as getting a yearly exam. I had to specify to the doc office I wanted a REAL checkup, along with the usual lab work. No clue what Medicare covers on that - I have an advantage plan, so the only thing I really have to pay is copay for the lab work.

https://www.medicare.gov/coverage/yearly-wellness-visits

This page does list more "coverage", but I don't see lab work on it:

"What it is
The cognitive impairment assessment is performed to look for signs of Alzheimer's disease or dementia.

The personalized prevention plan is designed to help prevent disease and disability based on your current health and risk factors. Your provider will ask you to fill out a questionnaire, called a “Health Risk Assessment,” as part of this visit. Answering these questions can help you and your provider develop a personalized prevention plan to help you stay healthy and get the most out of your visit. It can also include (**my note = this says "CAN"**):

*A review of your medical and family history.
*Developing or updating a list of current providers and prescriptions.
*Height, weight, blood pressure, and other routine measurements.
*Detection of any cognitive impairment.
*Personalized health advice.
*A list of risk factors and treatment options for you.
*A screening schedule (like a checklist) for appropriate preventive services. Get details about coverage for screenings, shots, and other preventive services.
*Advance care planning"

A link under that is "Preventative". That shows:
"Medicare Part B (Medical Insurance) covers a “Welcome to Medicare” preventive visit once within the first 12 months you have Part B."

SO, you get this ONCE, after you start Medicare, but with CAVEAT - if doc orders additional tests/services or items not covered, you could pay deductible or all for the not covered items.

See the link above and follow other links from there for more info.

I laugh when the chant Medicare For All is going on... I don't think they understand that
1) Medicare ISN'T FREE (Part A is),
2) plain old vanilla Medicare A only covers inpatient hospital stays, skilled nursing care, hospice care, and limited home health-care services. You typically pay a deductible and coinsurance and/or copayments,
3) Part B isn't free and covers more but not everything,
4) even with gap or advantage plans you could have high co-pays and/or deductibles,
5) there are any number of not covered medical issues and
6) you have to sign up for a medication plan (often included in advantage plans), but there is still the issue of the "Donut" hole you might fall into and also non-covered medications.

I understand somewhat the desire for Universal Health Care, but it will NEVER be "free" - you either pay for coverage or you pay higher taxes, or both.

Comparing other countries is not the way either. GB's NHS really covers basics - many people buy medicals plans/insurance so that they can get better care and go to private doctors. So, UHC isn't always a better way. Granted, our way is awful! The last year I was on company retirement insurance, it cost me almost 12k and all I got was a lousy checkup. That plan added that we had to cover the first $700 of ANYTHING. One ophthalmologist appt and one tick bite appt didn't even cover that, so almost $12,000 to get a lousy check up!!!

I am thankful to be on Medicare now, as it is a LOT less, but dread to know what might happen if I get *really* hurt or ill....

I would definitely do the follow up to ensure that she is getting her b12 levels up.

I would then ask if she really needs to come in every 3 months if nothing has changed and her labs have stabilized. Every 6 to 12 months may be just fine.

I honestly think that it is ingrained, see you in 3 months, whether there is a need or not. I just saw a dermatologist and I was told all is well, come back in 6 months. Why? Nothing noted to keep an eye on, no issues, just wrote to get patients on a rotation of 3, 6 or ?? in my opinion.