In your caregiver role it is important to support and encourage your relative to effectively communicate with treating physicians and other health professionals. Always respect how much your relative is willing to share with you about their health condition.

Common communication barriers between older patients and physicians include:

Older persons are less likely to ask questions and more likely to “follow doctor’s orders” even if they don’t totally understand the purpose of treatments or tests recommended or the medications prescribed.
Effective communication takes time and insurance companies rarely pay for as much time with the doctor as older patients may want and need.
Sometimes when a caregiver is present at a medical visit, the doctor or doctor’s staff may be inclined to speak solely to the caregiver and not the older person. This may make the older person feel invisible and powerless over decisions about their own health care.
Attitudes about “aging” may also prevent successful communication. Physical problems affect persons of any age. Both your relative and the health professional should believe that ill health is not something to expect as part of growing older.

CREATING A PARTNERSHIP Speak to your relative about viewing the relationship with the physician as a “partnership” where both partners must share information to achieve the best possible care. Being a good partner means to:

Take good care of yourself
Practice medical self-care at home
At the first sign of a health problem write down the symptoms
Play an active role in the medical visit by asking questions, stating your preferences for care and taking responsibility for your own health. This includes asking questions if the doctor’s explanations or instructions are unclear, bringing up problems even if the doctor doesn’t ask and letting the doctor know if a treatment isn’t working. Many older persons bring a tape recorder to medical visits to make sure they can correctly recall what was said.
Suggest that your relative ask the physician the following questions: What illness do I have? What are my treatment options (drugs or alternative approaches)? What should I expect to happen with or without treatment? Will my insurance cover the entire cost of the treatment? Is there written information about the illness, suggested treatments and medications? What is the best way to contact the physician (phone, e-mail, etc.)?
If the doctor prescribes a medication, your relative should ask the following: What is the name of the medication? Is a generic form of the prescribed

medication available? How often and how long should the drug be taken? What might happen if the medication is not taken as prescribed? What foods, other medications, or activities should be avoided while taking it? What are the possible side effects of taking the medication as prescribed (drowsiness, constipation, etc.)?

SHARING INFORMATION

Before the visit, you may want to discuss with your relative the following tips about sharing information:

Being honest – Suggest that your relative try not to say what the doctor might want to hear; for example, that he/she is exercising regularly and eating less fatty food. While this may be natural, it is not in your relative’s best interest. The doctor can provide the best treatment only if your relative says what is really going on both emotionally and physically.
Sticking to the point – Routinely, each patient is scheduled for a specified amount of time. Make sure your relative has requested enough time to discuss their concerns and conditions. Your relative can make the best use of their time by giving the doctor a brief description of the symptom, when it started, how often it happens, and if it is getting worse or better. Your relative should not leave until they have a clear understanding of diagnosis, treatment and what is needed to recover and stay healthy.

Asking about options to conventional treatment – Many common conditions, if not very serious, can be treated without medications. The doctor may recommend that your relative first consider trying exercise, good nutrition, stress reduction methods, herb supplements and vitamins as well as other non-drug physical or manual therapies to alleviate the symptoms.
Learning more about medical tests and other procedures – Your relative should ask the doctor to explain why the test or procedure is important, what it will cost and how to prepare for the test (not eating or taking prescribed medications for a period of time prior to the test). Suggest that your relative ask the doctor for any written information that describes the test or procedure. Remind your relative to find out when to expect (and how to obtain) test results, if the doctor will be available to answer any questions that may arise, and if a follow-up visit will be needed. Your relative may request a written copy of the test results. If the test is performed by a specialist, your relative should ask that test results be sent to their primary physician.
Asking the doctor about the diagnosis and what to expect – Your relative may want to ask the doctor the following questions: What may have caused the condition? Will it be permanent? How is the condition treated or managed? What will be the long term effects on my life? How can I learn more about my illness/condition?

Communicating with Physicians and Other Health Professionals Communicating with Physicians and Other Health Professionals

• Understanding what the physician has said – If your relative does not understand something, then ask the doctor to explain it again. Repeating what was said may help your relative make sure they heard it correctly.

PHYSICIAN BACKGROUND

Your relative may want to know about a physician’s training and experience including whether or not the doctor is Board Certified and in what field. Doctors who are Board Certified have had additional training specializing in a certain field/area of medicine. Board Certification is one way for your relative to tell about a doctor’s expertise but it does not guarantee availability when needed nor does it measure ability to communicate effectively. For information about a physician’s credentials, education and training, disciplinary history and malpractice/criminal information contact:

Arizona Medical Board, 9545 E. Doubletree Ranch Rd, Scottsdale, AZ 85258-5539; Phone: (480) 551-2700; or toll free (877)255-2212; www.bomex.org Click on: AZDOCInfo: Physician, Resident & PA Search

• Pima County Medical Society, 5199 E. Farness Dr., Tucson, AZ 85712; Phone:

(520) 795-7985;

www.pimamedicalsociety.org For information about Board Certified Medical Specialists including a description of the medical specialty, the medical specialist’s credentials, education and training as well as access to a directory of certified specialists, contact:

• American Board of Medical Specialties, 1007 Church St., Suite 404, Evanston, IL 60201-5913; Phone: (847)491-9091; www.abms.org Click on: Which medical specialist is for you?

EVALUATING THE PARTNERSHIP Begin by asking your relative this question, “Can you and the doctor communicate with each other?” This is one of the most important aspects of any partnership. Other qualities that are vital in building a positive partnership are: Does the doctor care about your relative, listen carefully to their concerns and explain things clearly and fully? Does the doctor reassure your relative, when appropriate? Does the doctor or doctor’s staff return your relative’s telephone calls in a timely manner? Do your relative and the doctor work together as a team to plan for your relative’s current and future care? Good health is dependent upon good communication especially for obtaining information, services and the best care possible.

RESOURCES

• Pima Council on Aging 8467 E. Broadway Blvd. Tucson, AZ 85710-4009 Phone: (520) 790-7262 www.pcoa.org

• Caregiver Consortium; www.arizonacaregivers.org

• Talking with Your Doctor: A Guide for Older People. National Institute on Aging. www.nia.nih.gov/health/pubs/talking/ talkwithdoc.pdf

• Caregiving: Communicating with Health Professionals; AARP. www.aarp.org/confacts/caregive/ healthprof.html

• Communicating with Your Aging Parent’s Physician. CareGuide. www.coordinatedcare.com/Careguide/ index.jsp Click on: Care for Caregivers; Go to: Featured Topics

Choosing a Doctor. Age Page. www.nia.nih.gov/health/agepages/ choose.htm
Communicating with Health Care Professionals. Beth Israel Medical Center. www.stoppain.org/caregivers/ communicating.html

• Frequently Asked Questions About Medical Ethics. American Medical Association, 515 N. State St., Chicago, IL 60610; Phone: (312)464-5000; www.ama-assn.org Click on: Medical Ethics-Frequently Asked Questions

Pima Council on Aging

PATHFINDER: A Guide for

PHYSICIAN BACKGROUND

RESOURCES

Family Caregiving