Whether at a Doctor Visit or a Family Gathering, Include Elders in Conversation
I know it can be hard. Your siblings are in town. You visit the nursing home with them so you can all be together with your mom who is living in a care center. The adult children are all jabbering, trying to catch up on each other's lives. Sure, you are physically in the room with your parent. But there's a good chance that your mom is completely left out of the conversation.
Her hearing isn't bad, but the noise of several voices at once is too much. Her worsening dementia makes a lot of commotion confusing. She doesn't complain, and she really does enjoy seeing everyone. Yet, after you all leave feeling satisfied that you visited with mom, she doesn't feel "visited."
Doctor appointments present similar situations. I accompanied each of my seven elders when they had doctor appointments. I found it interesting to observe the doctors and their different personalities. Some tried very hard to talk with my love ones, even when - as was the case with my dad - dementia made true conversation with him impossible. I respected that approach and was grateful. I was aware it took more of the doctor's time, since eventually I had to answer the health questions for Dad, but I was impressed when a doctor included my dad in the conversation.
My friend, Joe, for whom I was a primary caregiver, had been profoundly deaf since his 30s. As I cared for him during the last five years of his life, I took him to several doctors for different ailments. Each time, I'd bring along our ever-present pad of paper, and a pen, so Joe and I could converse. I would tell the doctors Joe could not hear anything and I would ask them to write the questions on the pad. Few bothered, and one doctor yelled loudly at Joe trying to get Joe to hear. The simple task of writing down the phrases and handing Joe the notes seemed too difficult for these doctors to understand.
I don't mean to imply that Joe could have handled the visit alone and the doctor didn't need to do anything but write to Joe. However, this is about respect and dignity. If a doctor doesn't get it, who will?
There needs to be a balance between efficiency and respect, and that balance isn't always easy to find. For medical appointments, doctors should be given written information about the elder ahead of time and they should have their questions answered by the person most likely to give appropriate responses. However, the doctor needs to direct conversation, written or spoken, to the elder as well, and he needs to use eye contact so the elder doesn't feel dehumanized and ignored.
For family and friends, I recommend that you keep the visiting groups small. If a couple of different families come to visit during the holidays, it may be more appropriate to have each group separately visit Mom in the care center. There's nothing wrong with asking the care center to provide a place where the whole family can get together, as well. Many centers are accommodating and the gathering can provide Mom with the pleasure of seeing the whole family together.
However, Mom should be monitored closely during these gatherings and not ignored because of all the excitement. If she is showing signs of confusion, agitation or exhaustion, then it's time to move her to a quieter area or take her back to her room for a nap. The rest of the family can continue to visit or go home, but someone needs to be appointed to act as Mom's advocate so she doesn't accidently get ignored.
Include Mom, by all means, if she will enjoy being with a large group. But be aware that real communication with her is probably going to be more effective if people visit when they can focus just on Mom.
And the next time you accompany your mom to the doctor, make a point of watching for interaction with your mom. If it's not there, then you can look at her, instead of the doctor, while you answer his questions. He will likely follow your eyes and get the hint that your mom needs to be included in the conversation that centers on her own health. This approach is a form of advocacy for your mom, and should work with the family, as well.