In the last few days 2 people have come to me for advice about an aging parent with memory issues who is not telling their doctor what is really going on. I had a similar experience with my 90 year old father. The doctor would ask him questions about how he was functioning and he said he was fine. I knew he wasn’t and was standing behind my dad signaling the correct information to his physician. It was quickly apparent when my dad took off his shirt and was wearing a watch on his wrist and by his elbow that something was wrong. My father thanked me for helping him find the watches. A doctor recommended trip directly to the hospital emergency room confirmed he had a brain hemorrhage.
This scenario can occur for several reasons. In my dad’s case he genuinely did not remember having problems with his memory or his ability to walk. Some people are in denial about what they can and cannot do and err on the side of maximizing their medical status. Medical issues can impact a person’s ability to accurately self assess their day to day function. Many people are afraid they will have to leave their home or get additional help they don’t want if it is apparent that they are unsafe or unable to do self care activities independently.
So what can we do to support our loved ones when we know their physicians are not aware of their true status?
- Try to get a release of information from your loved one so that you can have an honest discussion with their doctor about what is going on in terms of their health status. This also allows you to bring medical records from other doctors or hospitalizations. This will help ensure that the current doctor has accurate and comprehensive information to make the correct diagnosis and treatment plan.
- Have a talk with your loved one prior to the appointment about what things should be discussed at the appointment. It will help you gage how realistic or open they are about honestly assessing their situation. Do this as a collaboration, not a confrontation. Make suggestions about areas that might be covered during the doctor visit and explain why it is important the doctor be made aware of these problem areas. Remind them their safety and quality of life is your priority.
- Contact the doctor ahead of the appointment and share your concerns and observations. If the doctor knows what to look for it can be explored during the examination in more detail. Sometimes loved ones will listen to a doctor and follow their recommendations more readily than a family member.
- Advocate for your loved one. Be prepared with a list of all medications that are being taken. Someone with a memory problem may forget to include a drug that can have a bad reaction when taken with another medication. Also some people like to doctor shop and have different doctors give them medications and don’t reveal this. It is critical that a physician has all the correct information regarding the daily medications and dosage regime of their patients.
- Take notes or record the doctor visit so you and your loved one can refer back to it if there is some confusion about what was said. A lot of information can be exchanged during a doctor’s appointment and this eliminates potential problems. This is especially important in cases where memory or cognitive impairments are present in the patient.
Iris Waichler, MSW, LCSW is the author of Role Reversal How to Take Care of Yourself and Your Aging Parents. Role Reversal is the winner of 5 major book awards. Ms. Waichler has been a medical social worker and patient advocate for 40 years. She has done freelance writing, counseling, and workshops on patient advocacy and healthcare related issues for 17 years. Find out more at her website http://iriswaichler.wpengine.com