Help Aging Parents: The Doctor Patient Relationship

I read the cover story, “What Doctors Wish Their Patients Knew,” in the March 11, 2011 Consumer Reports magazine with interest and an eye towards helping aging parents. It’s excerpted in the above link; the additional major points follow:

1. The  importance of the long-term doctor-patient relationship. Research suggests patients who frequently switch doctors have more health problems and spend more on care than patients who stay with one doctor.

2. The importance of following–and being able to follow–doctors’ advice or treatment recommendations. Patients need to feel comfortable doing this or asking questions if they can’t or don’t understand. They should be able to express any doubts or concerns about treatment, side effects or other health-related issues.

3.  The importance of keeping a diary or log of treatments, medications, tests, procedure, health issues. Interestingly, in this age of electronic medical records, we learn that 89% of the doctors interviewed in Consumer Reports want patients to know “that it pays to keep track of your medical history.”

4.  Two people remember things better than one. In addition, a person who isn’t feeling well may not have the best judgment, thus going to a doctor’s appointment with someone is recommended.  Can’t we conclude, then, that it’s helpful when an adult child (or a friend or relative) accompanies aging parents to doctors’ appointments (assuming parents don’t mind)?

5.  Time with the doctor is precious, so coming to the appointment with questions written down and prioritized makes the most of the time allotted.  I found faxing questions ahead of an appointment saved precious time after mother had her stroke and we went for follow-up appointments. You might ask if emailing is preferred.

There’s an additional piece connected to “What Doctors Wish Their Patients Knew“– “Finding Dr. Right,” copied in its entirety in the above link.

As we try to help parents age well, finding the right doctor can make all the difference. I continue to be an advocate of geriatricians for older people. Geriatricians, with advanced specialty training in geriatrics, treat patients 65 and older. They work with primary care physicians; An older person need not give up his/her primary care doctor.  If you’re unfamiliar with geriatricians, do read Karen’s comment about her 80+ year-old’s mothers first appointment by linking to https://helpparentsagewell.com/2010/09/13/update-on-best-hospitals-geriatric-division-visit/.

Robert Butler MD, 1927-2010: Helping Aging Parents–Yours and Mine

Every aging parent today and every child with an aging parent today has, I believe–whether aware of it or not–reaped benefits from Dr. Robert Butler’s work.  He brought the subject of “aging” and an awareness of our biased view (“old geezers”) to the forefront in the mid-1970’s and worked tirelessly throughout his life to research, impart information, and influence policy that ultimately changed attitudes and the way we support old age.

As we strive to help aging parents, we need to recognize that Dr. Butler pioneered the groundwork to help older people, then created, built and led organizations aimed at helping every senior to age better. To that end, let me share a personal experience as it pertained to helping my parents age well.

I remember, probably in the early 80’s, a friend telling me about a group who met at Mt. Sinai Hospital in NY, to talk about aging parents and family members.  I was asked if it interested me. Of course it did. I was acutely aware of living far from my parents who were aging and was also sensitive to aging parent/grandparent issues in my counselees’ families.  On the other hand, my Helping Children of Divorce book had been accepted for publication and my job at the high school plus family responsibilities made another commitment impossible. Never-the-less Mt. Sinai and “aging parents” remained on my radar.

In 1982 Dr. Butler founded the first department of geriatrics at a US medical school (Mt. Sinai’s). I heard Robert Butler’s name again and again…and the term “geriatrician” but couldn’t differentiate it from “gerontologist.” It wasn’t until the late 90’s when my mother suffered (and recovered from) a stroke, followed by a fall in an unlit movie theater and a difficult recovery, that I understood the difference.

After receiving a phone call that Mother was dying and making long-distance, ultimately successful efforts to change her doctor to a geriatrician at a research/medical school hospital in Oregon, Mother made a miraculous recovery. Reason: a geriatrician who, among other things arranged to have Mother’s catheter removed (the catheter made life easier for the caregivers), and rebalanced her medications (she was small and was taking doses probably appropriate for an NFL tackle). I was “sold” on having geriatricians as part of a team to help every medically-needy aging parent in the country.

I subscribed to a Tufts U. health newsletter in 2002 and read in an interview with Richard Bennett, MD, (a Johns Hopkins geriatrician and professor of geriatric medicine) that: “geriatricians have special training in diagnosing older people, whose disease symptoms may differ from those of younger adults…and that they may work harder to treat other problems often dismissed as inevitable (in older people) such as incontinence or memory loss” and that they are often part of a team.

Unfortunately, geriatricians are few in number compared to the aging population.

  • Reason: becoming a geriatrician requires additional years of training and not many medical schools offer this specialty; Mt. Sinai of course does.
  • Reason: $.  Geriatricians make far less than other specialists.

So while the need is great, the number of specialists is small.

The NY Times (July 7, 2010) obituary section published many tributes to Dr. Butler.  I quote from the end of the (Washington DC) Leadership Council of Aging Organizations’  tribute: “Dr. Butler did as much as any leader in our time to advance the cause of protecting and helping older people in America and throughout the world.  His gifts remain beyond his lifetime.”

As we try to help our parents age well, we recognize Dr. Butler’s gift–to our parents now; to you and me in the future.

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