Effective communication with doctors, nurses, pharmacists, and other health professionals is vital when actively participating in medical decisions. There are three goals to strive for during the process:
- Ask the right questions to get the information you and your parent need to make decisions.
- Give health professionals information they need about your parent to make informed judgments.
- Receive the information, services, and quality care your parent deserves.
Obstacles to Effective Communication
There are a number of obstacles to achieving these goals, and being aware of them is the first step to overcoming them:
Patient Attitudes − Older patients are less likely to ask their doctors and nurses questions, and they are more likely to follow the doctor’s orders without understanding the reasons behind them. They are more inclined to just rely on the doctor’s expertise rather than actively seeking health information. Their generation grew up not wanting to bother or insult the doctor, and they may not have embraced the many changes in the delivery of medical care that occurred over their lifetime.
Physical Training and Lack of Time − Doctors are not always comfortable counseling patients, and sometimes feel it does no good because the patients don’t heed their advise. Some physicians do provide information, but by using medical terms that the patients cannot understand. And communication takes time, and doctors are rarely reimbursed by insurance companies for as much time as is required.
Discrimination Against the Elderly − Society in general holds negative attitudes toward the elderly, and this discrimination, known as ageism, is often exhibited by health professionals. Older people are often expected to be frail, confused, depressed, needy, or quarrelsome, and as a result, may be ignored or treated condescendingly. Since most health professionals do not receive training specific to the geriatric population, they simply do not understand the elderly and are unaware of their needs.
What You Can Do to Improve Communication
Respect your parents’ wishes concerning how much they want to discuss with health professionals, and how much they want to tell you about their health.
Talk to your parents about the importance of having open communication with the doctor for safe, effectual care.
Ask for permission to communicate with your parents’ doctors and nurses yourself.
Offer suggestions to your parents to ensure they get the most out of their doctor visits:
Ask questions − Write questions down ahead of time, and take the list for reference during the doctor’s visit for reference. Read over our suggested questions under “Managing Medication.”
Give Information − Doctors need information about their patients to make proper diagnoses and to prescribe safe, effective treatment. Medical records don’t always provide all the facts a doctor needs to know, especially since elderly patients usually see more than one physician. It’s important that each doctor know everything about the patient’s health: all medications and supplements, side effects, hospitalizations, chronic illnesses, test results, allergies, lifestyle issues (alcohol consumption, smoking, sleeping problems), and mental issues (confusion, depression, memory problems).
Utilize the Entire Team of Health Professionals − Nurses are trained in patient education and counseling and may be better suited to explain a diagnosis or teach patients how to perform different aspects of their treatment plan. Pharmacists specialize in drugs and can provide more thorough counseling about medications. Dieticians can help with meal planning, and social workers can guide patients through the medical care and social service systems.
Do Your Own Research − A wealth of materials is available in libraries, bookstores, and over the internet. You and your parent can be well-informed partners in treatment.
Advocate for Your Parent's Care − Attentive service and quality care are not always attributes of the medical system and shouldn’t be assumed. You and your parent must take an active role to get the best service.
Ideas for being proactive:
Get a second opinion before choosing surgery or treatment for serious illnesses.
Consider changing physicians if he/she does not listen or explain things well.
Be persistent with managed care or specialist visits.
Don’t accept diagnoses or treatment options that could be based on ageism stereotypes.
Find out why the particular treatment has been chosen.
Keep asking until you are satisfied with the answer.
Use Legal Tools − Advance directives are a legally binding way to communicate a patient’s wishes to family members, health professionals, and hospitals. Options include living wills regarding life-sustaining medical care in end-of-life situations, durable medical powers of attorney (health care proxies) to give an appointed individual the power to make decisions on behalf of your parents, interpret written instructions from the patient, and respond to changing medical situations.
- Be a Team Player − Regardless of how frustrating the situation becomes, you are more likely to get what your parent needs if you remain polite, constructive, and involved.