By Susan Collins-Smith
MSU Ag Communications
RAYMOND, Miss. — The stress of managing personal health can be physically and emotionally draining for senior citizens and their families, but proper preparation for routine doctor visits can help older adults stay active and robust.
A few basic steps are essential for communicating effectively with the physician and staff, said David Buys, health specialist with the Mississippi State University Extension Service.
Each senior should create a notebook that includes all of his or her conditions, treatments for those conditions and medications with dosages. This record is especially important if a senior has more than one physician.
“Taking too many medications or the wrong amount can cause anything from disorientation to falls,” said Buys, who is also a researcher with the Mississippi Agricultural and Forestry Experiment Station. “That can happen if multiple health care providers are unaware of what each other are treating and with what medications. This is still an important step if a patient has only one physician. Medication mistakes can happen on the part of the doctor, pharmacy or patient.”
A good strategy is to use a single pharmacy and ask the pharmacist to print out a list of current medications each time a new prescription is added or a refill is purchased. Compare that list to what the patient is taking, and share it with the patient’s health care providers. If there are any discrepancies, Buys suggests telling the doctor or nurse.
If a patient has more than one doctor, he or she should list all of them in the notebook and take it along on every doctor visit. The notebook is also a good place to write down questions for the doctor, their recommendations, notes about treatment response and any changes in symptoms.
“It is a good idea to write down questions you have for your doctor as you think of them,” Buys said. “Don’t think that you will remember, because you likely won’t once you are at the appointment.”
Mary Smith, a nurse practitioner with Starkville Orthopedic Clinic and education director for the Mississippi Rural Health Association, said patients should try to schedule appointments early.
“Schedule appointments first thing in the morning or right after lunch,” said Smith, who is also an assistant professor and assistant program director for South University Online College of Nursing and Public Health. “Appointments later in the morning and later in the day might not be as productive if the provider is running behind.”
Patients also can ask specialists to send updates to their primary care physician, Smith said. Having this information before a patient’s visit helps the primary provider understand any changes in health and prepare for the appointment.
Seniors can benefit from advocates who attends doctor appointments with them and know their everyday habits. However, the patient must sign a form giving permission for the advocate to attend visits and talk with the doctor and other health care staff, Smith said.
“I highly recommend that the patient sign required forms to give informed consent for specific individuals they wish to have access to their medical records and also be able to discuss concerns with the provider,” Smith said. “A family member or individual can always express concerns to the provider at any time, but without the patient giving consent for medical information to be released to that individual, the provider can’t discuss anything with them.”
Seniors also should make proper legal arrangements for someone they trust to act on their behalf if they become incapacitated and unable to express their wishes. A living will, which is also called an advanced health care directive, and a durable power of attorney are especially important for elderly individuals, Smith said.
“A living will details an individual’s desires about medical treatment in situations where they are no longer able to express informed consent,” she said. “Power of attorney grants another person the ability to make medical and financial decisions for the individual. They can choose whomever they like. It doesn’t have to be a family member.”
If a senior is reluctant or refuses to allow another individual to attend their doctor appointments, a family member or friend can contact the health care provider to express concern and ask that the provider discuss these options with the patient.
“The provider will not be able to tell you anything about the patient or their care, but you can share your concerns and ask that the provider discuss these legal documents with the patient and their importance,” Buys said. “Doctors and nurses know how to engage family members in these situations and have strategies to help their patients.”
Buys also recommends seniors prepare for emergency situations by displaying a list of their doctors, conditions, medications and any allergies on their refrigerators or in other obvious places in case they are unable to communicate with emergency medical responders. This document should also contain at least three emergency contacts. A copy of the document also can be kept in the patient’s vehicle, purse or wallet.
For more information about advance care planning, refer to Extension Publication 2220, “Declaring Your Wishes Through an Advance Healthcare Directive” at http://www.msucares.com. The Centers for Disease Control also has information and links to helpful resources at http://www.cdc.gov/aging/advancecareplanning/index.htm.