Doctor’s appointments with my mother could be problematic. When she was suffering from Mild Cognitive Impairment (MCI), Mom wouldn’t allow either Dad or I to go with her into the examination room. And when she emerged after the appointment, she’d always say, “The doctor said I was fine.”
Finally, I managed to get Mom to agree to let me come into an appointment she had with her pulmonologist. (Mom also suffered from Chronic Obstructive Pulmonary Disease brought on by smoking.) Once in the examination room, the nurse came in to take Mom’s vital signs. I can still see the nurse’s reaction when she called out Mom’s blood pressure at 80/40. When the doctor came in, he told Mom that she needed to start thinking about assisted living and also should stop driving. Yet a couple of hours later, Mom told me that the doctor had said her health was fine. A few days later, she wanted to drive. That’s when I realized that Mom’s memory loss meant that she had no concept of what the doctor had said to her and was unwittingly sabotaging her health. Furthermore, she could have been a threat to her own safety as well as that of others.
Since that eventful day, I attended every one of Mom’s doctor’s appointments until she died. The following list encompasses tips that I wanted to share for handling doctor’s visits as the loved one’s MCI or Alzheimer’s progresses.
- Make the doctor aware of the loved one’s memory loss prior to the appointment. We didn’t do that with the pulmonologist and other doctors prior to that eventful day. I understand about patient’s rights; however, I would hope that if doctors knew that their patient suffered from memory loss, they would provides notes for the patient and would work with the family to figure out how to communicate what the loved one’s medical issues are.
- Make sure you’re able to be in the room when the doctor sees your loved one. This suggestion comes from that experience with the pulmonologist. As a caregiver, you may have to figure out how to get your foot in the door of these appointments. Even as her memory increasingly failed, my mom liked to be in charge of her health, so I started talking several days before the appointment about the possibility that I could join her; this time period was most often when she was receptive to my attending. When we got to the day of the appointment, I made her feel in charge by asking if she still wanted me to go in with her (instead of demanding to go in, which would cause her to balk). Using this tactic worked really well and she always said “yes” and I gained valuable information about what was going on.
- Brainstorm a list of questions that you want to ask the doctor prior to getting to the appointment. You’ll have limited time with the doctor during the appointment so brainstorm with your loved one and others what questions need to be addressed. Write these down and take a list into the appointment.
- Keep a list of all medications (including dosages) that the loved one is on and take it to the appointment. My mom had several doctors who prescribed different medications. Fortunately, my dad was able to remember these off the top of his head. However, I found myself alone with Mom in the emergency room and had no idea what drugs she was taking. From then on, I had a list that I kept in my billfold. Because Mom saw several different doctors, her medical history was never centralized. Eventually (hopefully), the necessity of keeping a list with you will end when the U.S. medical system has a technology system that enables doctors to access up-to-date information. But until that day, I’d strongly encourage you to make that list and check it often.
- Encourage the doctor to include the loved one in discussions. I still remember Mom’s first doctor’s appointment after her diagnosis with Alzheimer’s. Both my brother and I were there, and the allergist knew that Mom had Alzheimer’s. The doctor directed the whole conversation toward me and my brother, leaving my mom totally out. Needless to say, Mom was one very angry customer because she wanted to be included in discussions about her health. Therefore, I’d encourage you to make sure the conversation with the doctor is inclusive of your loved one, instead of treating him/her as if she is no longer mentally present.
- Share what other doctors might have said or prescribed. I learned that the medical system is not set up so that doctors talk to each other about common patients. Therefore, I had to become the conduit. If your loved one sees several doctors like my mother did, you’ll need to serve as the hub of communication.
- Take notes of what the doctor says. You’ll need these to remind your loved one what was said, as well as to share with family members and other doctors. Plus, when the next doctor’s appointment comes up, you’ll have a record of what your loved one’s health status previously was so that you can identify any changes and prepare yourself for the next appointment.
These strategies helped me stay organized and eased my stress as I tried to navigate the medical system with a loved one with Alzheimer’s. By taking a proactive and organized stance that started prior to the appointment and continued through the period afterwards, I could be ready for Mom’s reactions, the doctor’s examination diagnosis, and family members’ questions. And that preparation provided peace of mind for everyone involved.
Published On: May 05, 2009