By MARY JACOBS
MARY JACOBS The Dallas Morning NewsSpecial Contributor
The patient and the doctor are in one city, and the adult children or other caregivers live in another. Dr. Mitch Carroll, director of the Senior Medical Center at Texas Health Presbyterian Hospital Dallas, frequently faces that situation, and it makes communicating complicated.
“It’s very common for an older person to be stoic, not want to be a burden, and not tell the child about problems,” he says. “Many times, I’ve had conversations with an out-of-town child whose mother never told her she’s been in poor health.”
Like most doctors, he’s too pressed for time to repeat every conversation from every appointment with out-of-town caregivers.
For those who can afford it, he says geriatric case managers can be a huge help. A case manager can accompany the patient to appointments and convey information to the family as needed. Case managers “are a wonderful resource, but unfortunately, it’s something that Medicare does not cover,” he says. When that’s not an option, Carroll offers these tips:
1. Meet the doctor. “If it’s at all possible, try to accompany your loved one on a doctor visit, even if it’s just to meet the doctor,” he says. He has patients who make appointments solely for this purpose when a child is visiting, and that’s something he heartily encourages. “It helps the doctor do a better job.” If a neighbor or friend is involved in keeping an eye on your loved one, bring them along, too.
2. Be sure your loved one has a complete list of relatives and friends on the HIPAA consent list. “Some patients will only list a spouse, so if I’m calling in an emergency, and their phone line is busy, I have nothing to do but sit there and wait,” Carroll says.
3. Send a list of questions before the appointment directly to the doctor or with your loved one.
4. Ask for an extra copy of a visit summary, and have your loved one mail it to you. Many practices provide these written summaries, which typically include all the related diagnoses, tests performed during the visit and an updated list of medications the patient is taking. Check the list of medications to make sure it matches what the patient is actually taking; if not, call the doctor.
5. Use the speakerphone. Have your loved one bring a cellphone to the appointment so that you can listen and ask questions.
6. Discuss communication. Talk to your loved one’s doctor and ask for the best way to reach him or her in urgent but nonemergency situations. The key is to find out in advance.