Get Help In Talking To Your Healthcare Provider

Most people do not have difficulty expressing to others, especially friends and family members, what they think.  Still, the same person who shares his or her observations and complaints regularly with acquaintances can freeze when dealing with medical professionals, doctors, nurses, diagnosticians, and therapists.

Sometimes the patient does not know what to ask or thinks of the question after the interview.  Sometimes he or she is embarrassed or feeling so poorly that he cannot frame the issue and feels helpless.  When caregivers have to ask the questions for their family member, a spouse or adult daughter or son may not understand what is happening and also be unable to express it.

In our office, Diana Chryst, our Elder Care Coordinator, follows a detailed listing of questions in appropriate cases, to arrive at a picture of what is going on and also, where helpful, attends care plan meetings at assisted living and nursing home facilities.  When Diana came on board with us somewhat less than 1 ½ years ago, I had no idea how valuable her background as a former director of admissions at a nearby nursing home would be.   Dealing with seniors means we, of necessity, consider physical concerns and opinions regarding care and capacities.  A clearer picture helps us to know whether it is more likely that a spouse or parent can safely stay at home or in the home of a family member, what supports might be needed to stay at home, and whether a move may be necessary.  My friend and fellow life care planning attorney, Tim Takacs, refers to this as determining where a person is on the continuum of care.   Regardless where a person is on the continuum of care, suggestions can be made for improvement.

Early on after Diana began working with us, we learned that a nursing facility discontinued physical therapy for one of our clients who was still on Medicare on the basis that our client failed to cooperate with the therapy.  After discussing issues with the family and learning more details,  Diana was able to express, along with family members, at the next care plan meeting that one reason for “failure to cooperate” was that the patient’s hearing aid had been lost.  He was unable to hear the instructions.

In some cases, patient’s medications cause problems.  A person who seems incoherent might, for instance, be overmedicated.

Our purpose in all of this is not to criticize but to suggest ways in which care might be improved.  We listen to the family and convey these thoughts.  Care plan meetings, the times scheduled by caseworkers at facilities to meet with families,   are ideal times to share this information with providers.  In short, we do what attorneys have always done, we advocate for the client and the family.  The process actually begins with the first call in to Terri Jarrell who takes initial information.  As a result, usually the facility and providers, our client patient, his family, and those of us who are working on the case feel we are all working together toward a common goal.

Communication problems affect everyone.  For average persons not dealing with long term care, there is a readable plain language book available free from National Institute on Aging under the National Institutes of Health, called “Talking With Your Doctor:  A Guide for Older People.”   It can be ordered to be mailed or downloaded immediately at www.niapublications.org/pubs/talking/index.asp.   Here is a preview of some of its recommendations.

First, choose a doctor you can talk to.  This book tells you how.  Next get ready for an appointment.  Make a list of your concerns and prioritize them.  Take information with you including a list of your prescription and non-prescription drugs, vitamins, and herbal supplements, insurance cards, names, and telephone numbers of any other doctors you see, and medical records that your doctor does not have.

Make sure you can see and hear as well as possible. Consider bringing a family member or close friend if needed.  Plan what you are going to say and stick to the point.  Ask why a medication is being prescribed or a test ordered. The worksheets at the back of the book are wonderful and should be copied to help you organize your thoughts so both you and your family know your medications, symptoms, and concerns.  The better you are at sharing your thoughts, the more likely it is that your needs will be handled promptly and well.

About the Author Janet Colliton

Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.

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