Many adult children of older people tell a familiar tale: They take a parent who has multiple health issues to an appointment, and suddenly, Mom brightens up and claims she's completely healthy and symptom-free. Or Dad, who fell twice last month, denies having any balance issues. They might report they take all their medications when they often forget. The physician only sees a patient who appears to be in good health, and your parents don't get the care they need. Then, when you confront your parent about this deception, they dig in and refuse to acknowledge your concerns. Now you're the bad guy. What can you do?
The way out of this stalemate is by making the physician your ally. By tactfully communicating and documenting your concerns, you can join forces with your parent's practitioners and position them as the ones who address the situation with your parent. Hopefully, the doctor can tactfully convince your parent to make the required changes, and you’ll have more peace in your relationship.
How to make the physician your ally? Try these strategies:
Understand why older people mislead their medical team.
Many older people have anxiety around doctor's appointments. They fear a life-changing diagnosis, which could lead to a loss of their precious independence. Your parent feels like there's a lot on the line regarding doctor appointments, and avoiding a negative outcome feels like the priority, even if it means being in denial. This denial leads to a phenomenon called "showtiming," in which an older person puts on a show of health for their doctor. Understanding how much is at stake for your parent can help you be more compassionate when the two of you are at odds about a health situation.
Position yourself as an ally before the visit
Ask them what they would like to get out of the visit. What concerns do they want to address, and what is their priority? For example, your mom might have high blood pressure, but insomnia is bothering her more. What does she hope to get out of this visit? Does she want medication, or would she agree to see a sleep specialist? Would she try lifestyle changes for better sleep? Discuss information the doctor might need from her (like a record of her sleep and waking times or her caffeine intake.) Offer to bring these notes to the visit.
If the physician needs to know something critical: ask for one-on-one communication before the visit.
Alert the staff that you'd like to let them know about some concerns before the appointment and ask for the best way to communicate. Written communications will become part of your parent's medical record, so an email is a good option.
Another way to communicate with your parent’s physician is to enroll in the office’s online patient portal. Most practices have an online patient portal so you can send questions to your practitioners. These portals often house your parent's lab reports, appointment summaries, medication lists, and bills.
Although written permission is necessary for the physician to contact you and discuss your parent’s situation, they will still review your email and find a discreet way to bring up your concerns during the consultation.
Keep meticulous notes.
If your parent struggles with daily life activities, their doctor should know. Keep track of medications, changes in behavior, pain levels, and sleep, and include them in your communication.
Don’t take over the appointment.
Let your parent be the center of the conversation with their doctor. Chime in occasionally with supporting information, but otherwise, stay quiet and take notes. Don't use this time to reveal that your mom is inconsistent about her medication or that your dad is still driving. Let the doctor work that topic into the conversation. Having autonomy about their healthcare decisions will make your parent more likely to follow the doctor's advice. If there are discrepancies or "fibs" during the appointment, follow up with a phone call on your own.
Befriend the rest of the team.
Ally yourself with the staff that supports your parent's doctor. Introduce yourself and thank everyone for their time and attention. A good relationship with the healthcare team will help your parent feel calmer and make your job as a caregiver easier too.