INITIAL MEDICAL VISITS

Prior to the medical visit, suggest that your relative prepare the following information:

• Bring a list of names, addresses and telephone numbers of all treating health professionals along with dates of service that are most significant to your relative’s medical history.

Questions about sensitive subjects that

your relative may want to discuss such as: sexuality, depression, incontinence, memory problems, etc. Be aware that your relative may be uncomfortable about openly discussing these topics with you as well as the doctor. If you are your relative’s designated health care agent (health care power of attorney) you may want to inform the physician about your relative’s concerns prior to the visit.

Copies of advance directives. Your relative’s primary physician, specialist and hospital should have a copy of any advance directives.
Lifestyle factors that may affect treatment options such as: cigarette smoking, alcohol consumption, problems sleeping, appetite changes, poor concentration and driving difficulties.

OFFICE PROTOCOL AND ROUTINE

Your relative may consider asking the office manager or other administrative staff the following questions:

• Will the physician accept my type of health insurance? Will my insurance cover the entire cost of the visit?

Are walk-ins seen? If I need urgent care can I be seen within 24 hours? If it is a routine visit, can I be seen within a week? Is there a penalty fee for no shows or cancellation of visits less than 24 hours in advance? What is the typical length of time reserved for a routine office visit?

What is the best time to make routine, non-urgent phone calls?
If 911 has been called in a medical emergency, how is the physician notified of the emergency situation?
Who should I call if I have questions about a treatment, procedure or side effects from a prescribed medication?
Who has a current copy of my medical file?

HELPING ON THE DAY OF THE VISIT

Make sure your relative is as relaxed as possible and feels “in control.” If you will be accompanying your relative, arrive at your relative’s home at least one hour early. This extra time will give both you and your relative a chance to review the reasons for the visit, talk about expectations and prioritize the 3 most important concerns to be addressed. Ask how you can be of most help during the medical visit, i.e., what your relative would like and not like you to do. Make sure you arrive at the medical office on time or come early if requested. Allow for extra time if you are unfamiliar with the location and/or if your relative has a physical impairment that makes transferring or maneuverability difficult.

CONFIDENTIALTY OF HEALTH INFORMATION

Your relative must specify who is authorized to have access to his or her medical information. An individual has certain rights under federal privacy standards about how medical information may be used and made known to others, including:

the right to request restrictions on the use and disclosure of your protected health information,
the right to receive confidential communications concerning your medical conditions and treatments,
the right to inspect and copy your protected health information, and
the right to an accounting of how and to whom your protected health information has been disclosed.

If you are the designated health care agent for your relative, then you have authorization to discuss your relative’s health condition with treating physicians and other health care practitioners. If you are not the designated health care agent, your relative must tell treating physicians and other health practitioners that you may talk to them about your relative’s health.

WHEN TO TALK WITH THE PHYSICIAN

Your relative may not always need to talk to the physician directly about basic questions. Health professionals who assist the doctor can spend more time answering questions. However, your relative should consider speaking directly with the physician or designated staff member to discuss:

Diagnoses or a change in treatment.
Concerns about a new symptom.
How to use a new medication, i.e., how often and how long should the drug be taken, and what might happen if the medication is not taken as prescribed.
Potential negative side effects from prescribed medications and adverse

Medical Visits: Scheduling, Preparation and Support Medical Visits: Scheduling, Preparation and Support

drug interactions (if any) when taken with other medications.

If an urgent refill of a current medication is needed. Otherwise, your relative’s pharmacy will contact the prescribing doctor as necessary to refill current medications.

• Test results.

If your relative chooses to leave a message, it should state the number to call and the best times to be reached.

• Ask if it is possible to communicate with the physician by sending e-mails about non-urgent health concerns.

GUIDELINES FOR CALLING

Some general guidelines that your relative should follow when calling the physician about a health concern are:

Be prepared before calling. Have ready a short description of the problem, a short symptom list and no more than three questions to ask the physician.
Be concise and stick to the issues.
If your relative does not understand something, ask the doctor to explain it again.
Have in hand the telephone number and location of the pharmacy that will be used. Call during regular office hours and before there is only one pill left.

NOT ANSWERING PATIENT CALLS

Misunderstandings arise in any relationship, including between patient and doctor. If your relative has formed a trusting and long-standing relationship with the doctor, working out the problem may be more useful than looking for a new doctor. Suggest that your relative be direct when speaking to the doctor or the doctor’s staff about the problem, such as: “I realize that you are very busy and take care of a lot of patients, but I get upset and frustrated when I have to wait for days for you to return my call. How can we solve this problem?” If the doctor or doctor’s staff continues to brush off your relative’s concerns, then it may be in your relative’s best interest to look for another doctor. Remember no matter how frustrating a situation becomes, your relative will be more likely to obtain the care that is needed by clearly stating the problems, being persistent and sincere.

RESOURCES

• Pima Council on Aging 8467 E. Broadway Blvd. Tucson, Arizona 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

Family Caregiving

helping older relatives or friends to become active
participants in their own health care

Prepared for Pima Council on Aging by the Arizona
Center on Aging, the University of Arizona^®