Talking to Your Parents’ Doctor
“Mom has been having dizzy spells and seems to be losing interest in her normal activities. She tells us “everything is fine”, but we’re worried would like to talk to her doctor about our concern. How should we do this?” This is a common dilemma for adult children who are worried about aging parents. When you see signs that cause concern, it is natural to wonder what is wrong. Often, the elderly parent will be “reassuring” or might try to dismiss your concerns. But your worries don’t go away easily. You would prefer to be reassured from the doctor. Have you tried calling the doctor, and been told that he/she won’t see you without your parent present? Maybe the doctor doesn’t return your call? Here are three things to consider if you want to talk to your parents’ doctor: Doctor-Patient Confidentiality This is the obligation of one person to preserve the secrecy of another’s personal information. A doctor’s guiding code of ethics requires them to maintain confidentiality. When physicians are licensed to practice, they take the Oath of Hippocrates and promise: “Whatever, in connection with my professional service, I see or hear, which ought not to be spoken of abroad, I will not divulge” (abridged). Confidentiality stems from the therapeutic relationship between patient and doctor. Patients want to trust that their personal information will be kept private. They want to be able to speak honestly, without worry that their condition or treatment could be revealed to others without their consent. Right To Privacy Privacy is the right of individuals to be left alone, and to determine when, how, and to what extent they share information about themselves with others. But you have the right to share your worry and concern with your parent, and ask if you can come to the next doctor’s visit. Explain what you want to do: for example “I want to help you remember the things you wanted to talk about.” Or “I want to ask the doctor about your dizziness.” Suggest that having a family member or friend with them can help your parent get the most out of a visit. Being Your Parent’s Advocate The doctor may appreciate learning more about your parent’s problem from your point of view. If you want to advocate for your parent, consider writing the doctor to express your concerns. But keep in mind that the doctor may still not be willing to share private information with you. A word of warning: tell your parent you are writing the letter. Don’t expect the doctor to keep it a secret! The first steps to opening the lines of communication are to help your parent(s) understand the benefits of this information exchange, and to get their consent. If you do meet with the doctor, or have a telephone conversation, be prepared. Be specific about your concerns and ask: What is wrong? What do I need to know? What can I do to help my parent? Whether your parent is at home or in hospital, and whether you live in the same city or across the country, establishing a relationship with your parent’s doctor can benefit all parties. Vol.3, No. 17 © ElderWise Inc. 2007. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise Publishing, a division of ElderWise Inc. We provide clear, concise and practical direction to Canadians with aging parents. Visit us at http://elderwise.memwebs.com/ and subscribe to our FREE e-newsletter ...
Read MoreDefinitions for POA and Health Care Directives
There are two types of “power of attorney”: one for finances and one for decisions about health and personal care. Both documents are drawn up by a person with “capacity”, i.e. the ability to make reasoned decisions, who wants to decide on his or her wishes for future medical care and treatment and personal care - in the event they are not able to give informed consent. This document is also known as a living will or health care directive may, and may contain or include: Appointment of a “proxy” who will assume responsibility for ensuring the person’s wishes are respected Health and personal care wishes that must be followed by health care providers, where the wishes are reasonable, possible, and legal. The first type is called a proxy directive. All provinces, the Yukon, and the Northwest Territories allow proxy directives.The second type is called an instructional directive. Several provinces allow this type of directive, as well as the proxy directive. Why have a directive? Manitoba Health provides this general suggestion for writing a health care directive, or “living will.” “Due to accident or illness, you may become unable to say or show what treatment you would like, and under what conditions. If you have signed a directive, those close to you and the health care professionals treating you are relieved of the burden of guessing what your wishes might be.” Each province has specific legislation regarding health care directives. The ElderWise Guide, “Decide For Yourself”, provides web links to the specific details for each Canadian province and territory. You must comply with the legislation in your parent’s province if the directive is being prepared for them. Here is a scenario that is all too common for families who do not have advance care planning in place (names changed to protect privacy): Clarence was 87 years old and had not named anyone to speak on his behalf. When his niece raised the topic, he said: “You’ll be there for me - and I know you will do the right thing.” But when Clarence had a stroke and was temporarily in a coma, his niece was unable to legally speak on his behalf because she had not been specifically named as Clarence’s personal representative. Research the information that applies to your province (“Decide for Yourself” includes web resources for all provinces and territories). Discuss medical treatments, such as a “Do Not Resuscitate” order, with your doctor. Decide who will speak on your behalf AND get their consent. Write the directive yourself - or get help from a lawyer. Provide copies of the directive to your family, your doctor, and the person(s) named in the directive. Get full details about the contents of “Decide for Yourself” Vol. 5, No. 8 © ElderWise Publishing 2009. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise, Canada’s go-to place for “age-smart” planning. Visit us at http://elderwise.memwebs.com/ and subscribe to our FREE e-newsletter. ...
Read MoreGeriatric Specialists in Short Supply
In a past ElderWise article, “Why Geriatrics and Gerontology Matter”, we discussed the importance of gerontology and of finding geriatric specialists for your aging parents. Now the bad news: there is currently a shortage of geriatric practitioners in Canada. Dr. Susan J. Torrible, author of a 2006 study into the reasons for this shortage, estimated that there were approximately 200 geriatricians practicing in Canada - but at least three times that number of geriatricians is needed to meet demand. The study surveyed current Canadian geriatricians, geriatric medicine trainees, internal medicine residents, and senior medical students. Medical students and residents stated downsides to working in geriatric medicine: level of income; working in long term care; and management of chronic illness. The study also highlighted factors that may help in recruiting geriatric medicine practitioners. Of the survey subjects who were considering a career in geriatrics, all but one reported a positive past experience working or volunteering with seniors. This exposure may be key to having medical students see the possible rewards of working with seniors. But, according to Dr. Janet Gordon, currently that interaction may not be part of a student’s medical school experience. Interviewed in the Calgary Herald, Dr. Gordon states, “Only half the (medical) schools have people do geriatrics even though all have them do pediatrics.” Mentoring programs may also help medical students see the possibilities for a life in geriatric medicine. The Canadian Institutes of Health Research has another suggestion: adjust provincial scheduling fees to accommodate the longer time required per visit to help manage seniors’ health problems Canadians are already taking a page from the book of some American organizations. The John A. Hartford Foundation is putting millions of dollars into training programs for geriatric nurses and social workers. Can you help? Yes - if you are a service provider, encourage medical students to volunteer in your agency. If you know a doctor who has specialized training or a special interest in geriatrics, thank him or her for their much-needed contribution to our aging population. Vol.4, No. 11 © ElderWise Publishing 2008. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise, Canada’s go-to place for “age-smart” planning. Visit us at http://elderwise.memwebs.com/ and subscribe to our FREE...
Read MoreAging Well: Top 10 Do’s and Don’ts
No known substance can extend life, but we can improve our chances of staying healthy and living a long time. First, what NOT to do: Here are ten common health care mistakes seniors make, according to the Institute for Health Care Advancement: 1. Driving when it is no longer safe 2. Fighting the aging process and its appearance 3. Failing to discuss intimate health problems with your health care provider 4. Not understanding what the doctor says about the problem or treatment plan 5. Disregarding the serious potential of a fall 6. Not having a system for managing medications 7. Not having a single primary care physician 8. Not seeking medication attention when warning signs occur 9. Not participating in prevention programs 10. Not asking loved ones for help The news isn’t all bad, though. The National Institute on Aging offers its own Top 10 Tips for healthy aging. We have reproduced this list below, and included in parentheses previous ElderWise Info articles covering related topics. Top Ten Tips for Healthy Aging 1. Eat a balanced diet, including five servings of fruits and vegetables a day. (Challenges to Healthy Eating) 2. Exercise regularly. (Osteoporosis and Bone Health, Exercise for Healthy Hearts) 3. Get regular health check-ups. (Why Geriatrics and Gerontology Matter) 4. Don’t smoke (it’s never too late to quit). 5. Practice safety habits at home to prevent falls and fractures. (Safety on the Stairs) Always wear your seatbelt in a car. 6. Keep up contact with family and friends. Stay active through work, play, and community. (Seniors Who Volunteer) 7. Avoid overexposure to the sun and the cold. (Heat Stroke) 8. If you drink, moderation is the key. When you drink, let someone else drive. (Are you a Safe Driver?) 9. Keep personal and financial records in order to simplify budgeting and investing. Plan long-term housing and money needs. (Long Term Care Planning and Long Term Care Terminology) 10. Keep a positive attitude toward life. Do things that make you happy. (Recording a Life Story, Keys to Enjoying Later Life) Both these lists are great “between the generations” conversation-starters, whether you are in mid-life or a senior. See the related ElderWise Infos for resources and suggestions to bring enhanced health and greater longevity into your life. Vol.3, No.16 © ElderWise Inc. 2007. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise, Canada’s go-to place for “age-smart” planning. Visit us at http://elderwise.memwebs.com/ and subscribe to our FREE...
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