Make the best senior care decision
Taking on a more active caregiving role often means becoming more involved in a parent’s doctor visits. You may wonder if they’re accurately reporting symptoms or leaving out crucial information. Attending doctor visits with your parent might also give you a better understanding of their current health, what they need, and how you can help.
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Talking to your parent’s doctor can be difficult at first, but it is worthwhile to be part of this conversation.
“I as a physician can have the best care plan in the world and have the best intentions for my patient, but it will not come to fruition or light unless there is this great partnership between the patient, their caregiver, and us as physicians,” says Cleveland Clinic’s Center for Geriatric Medicine Section Chief Dr. Ardeshir Hashmi.
Use these tips to incorporate Hashmi’s team mindset the next time you talk to your parent’s doctor.
Set aside time before your parent’s doctor appointment to define expectations, and make sure you have everything you need for a successful consultation.
Let your parent know that you’d like to attend doctor visits with them, and tell them why. If you’re helping to care for your parent, having information on their health and medications can be crucial. Be up front about your role as a caregiver — you are there to support your parent, not to take over their life.
Let your parent act as the CEO of their care and what matters most to them — their goals and how they want to meet them should remain the priority.
“Our senior patients are experts not only at defining [their] destination, but how they want to get there,” says Hashmi.
Before the appointment, you and your parent should discuss the questions or concerns you want to address with the doctor. You may also want to collect input from other family members or in-home caregivers, if applicable.
You should also discuss whether your parent wants to have a one-on-one conversation with their doctor. If so, leave the room to give your parent privacy. If you want to speak to the doctor privately without your loved one, ask your parent if this is okay before the appointment.
If your parent has agreed to let you speak to their doctor, it’s a good idea for them to fill out a Health Insurance Portability and Accountability Act (HIPAA) form. This form is available for your parent to complete at their doctor’s office. Once your parent signs a HIPAA waiver, you can access your parent’s records and personal health information, which will help as you become more involved in your parent’s care.
Hashmi recommends having a designated point person who has a medical power of attorney. This can be especially helpful if multiple people are involved in a loved one’s care. Requirements for establishing a medical power of attorney vary by state. Most states require that you provide the doctor’s office with a form that includes a notarized signature.
“We do this mostly for safety and privacy reasons,” Hashmi explains. For example, even if your parent doesn’t require you to make medical decisions for them, a medical power of attorney will enable you to always speak to your parent’s doctor about their health. If your parent does become cognitively or physically unable to make decisions, a medical power of attorney allows you to make health care decisions on behalf of your parent.
If your parent declines to sign the HIPAA form or designate a medical power of attorney, you probably won’t be able to discuss your parent’s health with their doctor, even if you accompany them to their appointment. If this happens, you can voice your concerns by writing a letter or email to your parent’s doctor. Hashmi also stresses that you should bring your concerns to your parent directly, as well.
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It’s all right if you can’t address every concern in your first visit. In fact, your parent may feel uncomfortable if things move too quickly.
Hashmi says many patients come to an appointment with the assumption that their child or doctor wants to put them in a nursing home, even though this is often not the case. You may even want to ask your parent directly if they have any concerns about losing their independence. Taking the time to build trust is crucial.
Through multiple visits, you can establish the team that Hashmi advocates and make sure everyone has a clearly defined role. Your parent should understand that everyone on this team works for them and in their best interests.
Your role as a caregiver involves implementing the doctor’s suggested care plan, so paying attention to details during visits is key. Take notes if you need to, and ask clarifying questions if anything is unclear. Communicate to your parent that you are on their side.
A good relationship with your parent’s doctor will also allow you as a caregiver to discuss any early warning signs you find concerning. Hashmi says you should speak up if you have serious safety concerns or believe your parent is avoiding a topic — for example, driving — because they’re in denial. Even if you’re not the medical power of attorney, your parent’s doctor can listen to your concerns.
Hashmi says that in his own practice, patients are required to attend appointments with their medical power of attorney — to address any concerns and hear both sides of the story. Hashmi recommends separate interviews with the doctor to see how your account differs from your parent’s, in order to address any safety concerns.
Be sure to discuss how follow up questions or communications between you and your parent’s doctor can take place. It’s important to make sure your parent is okay with these decisions and doesn’t feel like you’re talking to the doctor behind their back.
Your parent’s doctor can work as a co-advocate from a medical perspective and will ideally introduce you to new resources.
Many seniors see several doctors and caregivers. While your parent’s doctor likely receives records and updates from other physicians, it’s important to confirm relevant changes in your parent’s care plan with specialists, therapists, pharmacists, or other caregivers. Doing this will keep everyone on your parent’s care team up to date. For instance, a pharmacist may be able to spot harmful drug interactions if your parent is filling a new medication for the first time.
Depending on your parent’s needs, you may decide to add other resources to make life easier for your parent. Think broadly, and ask yourself where your parent needs the most help and what they would appreciate. In this increasingly convenient and service-oriented world, the options are many:
Dr. Hashmi recommends that patients adopt a different mindset if possible: Accepting help — whether that means letting a loved one drive them to the store, schedule appointments for them, or something more — will enable them to live a fuller life.
Your parent can spend time on what matters most to them while delegating important tasks to members of their care team. This approach helps patients not only get more years out of their life, but allows them a richer experience across their retirement years. When your parent has a team they can trust, they can use that to their advantage and build the lifestyle they want.
“It’s actually empowering [them] to stay independent for much longer,” explains Hashmi.
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This article was developed in conversation with Ardeshir Hashmi, MD, section chief of the Cleveland Clinic’s Center for Geriatric Medicine, as part of a series of articles featuring expert advice from Cleveland Clinic geriatricians.
Interview conducted with Hashmi, A. Cleveland Clinic. September 13, 2021.
Interview conducted with Hashmi, A. Cleveland Clinic. July 26, 2021.
U.S Department of Health and Human Services. “Does the HIPAA Privacy Rule permit a doctor, laboratory, or other health care provider to share patient health information for treatment purposes by fax, e-mail, or over the phone?”
National Institute on Aging. “Doctor’s Appointments: Tips for Caregivers.”
Jacobs, B. AARP. “Who’s in Charge at the Doctor Visit?”
National Institute on Aging. “How to Prepare for a Doctor’s Appointment.”
Silveira, M. UptoDate. “Advance Care Planning and Advance Directives.”
Ward, K. Reuben, D. UptoDate. “Comprehensive Geriatric Assessment.”
Visiting Nurse Service of New York. “Doctor Visits with Elderly Parents.”
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