8 steps to a better doctor’s appointment for patients and caregivers

If you are one of the estimated 53 million Americans who is providing care to an adult family member or friend, going to a doctor’s appointment with them can be challenging. But, sitting in on the visit will help the patient and you in the long run.

“Anybody who has memory issues or some kind of dementia should definitely come with company each visit,” said Arash Tadbiri, MD, a Cape Cod Healthcare specialist in family medicine and geriatrics who practices in Bourne.

In a 2020 report, the National Alliance for Caregiving and AARP estimate that one in five people in the U.S. provide unpaid care to an adult with health or functional needs. In addition to taking care of their loved one’s physical needs, they also oversee their medical needs. For many, that includes attending physician appointments.

At these appointments, caregivers end up taking on the dual roles of concerned family member and medical advocate. The key to successfully accompanying a parent or older family member or friend to the doctor is to prepare for the visit in the following ways, according to Dr. Tadbiri.

Call ahead to let the physician know you are coming.

“This call is much better if they list some concerns they have,” Dr. Tadbiri said. “That gives the physician something in mind before going into the room so the time that is spent with the patient becomes more effective and efficient.”

The caregiver (which is usually a daughter, according to Dr. Tadbiri) should let the provider know what their relationship is to the patient. It is also important for the person accompanying the patient to actually know the patient really well and be able to answer any questions the doctor asks that the patient is unable to answer.

That means that in some cases, such as when the patient has any issues with dementia, the best person to accompany the patient might be a paid caregiver rather than a family member, he said. Or, the family member could attend along with the paid caregiver if the doctor and patient are comfortable with that.

Gather information from outside sources to share with the doctor.

Just because you are the caregiver, don’t assume you have all of the information. Call other family members and ask them what their concerns are. Sometimes familiarity makes it hard to see the patient objectively.

“Other family members might have other concerns, such as a memory issue,” he said. “If someone is in another state where they are not talking to their mom more frequently, they may find the memory change more significant than somebody who lives with the patient.”

Make every visit a “brown bag visit.”

“Medication is very important,” Dr. Tadbiri said. “Any bottles they have at home – any prescriptions, supplements, vitamins or anything else should be put in a bag so we know exactly what the patient is taking.”

That not only helps the physician know what the patient is taking. It also helps them make sure the patient is taking the medications that they should be taking, including medications from any specialists. It also eliminates doubling up on prescriptions with the same ingredients but different names such as a generic medication and a name brand version. Many patients don’t realize that over-the-counter medications can interact with prescription medications in negative ways, so it is important to include them.

Fill out any paperwork in advance.

“It’s better to fill it out and send it in advance so I can sign it and don’t have to spend time in the office filling out that form during the encounter,” Dr. Tadbiri said.

Other paperwork that needs to be in order includes a form acknowledging that you are the patient’s healthcare proxy. That designates you as the person chosen to make decisions if the patient is unable to make decisions for themselves.

The patient should also have a MOLST form so that both the physician and the caregiver know about the patient’s wishes for the end of life. This form covers what interventions or life-saving treatments the patient wants the care team to provide or withhold. It covers things like CPR, intubation with a breathing tube or inserting a feeding tube.

Be respectful and don’t argue with the patient.

Dr. Tadbiri has seen arguments occur between family members and patients that end up wasting time during the visit and are counter-productive to a successful visit. Have a conversation with the patient before the appointment to make sure you are on the same page and that the patient’s wishes and concerns will be respected.

Also be aware that some subjects may be sensitive or embarrassing to the patient and they may not want to talk honestly about them in front of you. About halfway through each visit, Dr. Tadbiri asks the patient if they are comfortable with the subject being discussed in front of their caregiver or if the caregiver should go back to the waiting room for a few minutes before coming back in for the summary of the visit.

“They definitely should be very respectful towards the patient because, if they aren’t, the patient will become defensive. Then they may become unwilling to give information or do anything the doctor suggests.”

Take notes during the visit.

“Ask for a summary of the visit and the family member should take notes,” Dr. Tadbiri said. “Take notes of all instructions and all of the things talked about. They say a written thing is better than the best memories.”

Be the spokesperson for the rest of the family.

Dr. Tadbiri has had patients come in with a daughter only to have the out-of-state son or daughter call the next day for a summary of the visit or with new questions. Understand that even though it is hard to be the caregiver, it is also hard to be the person out of state. Sometimes those family members worry the most, Dr. Tadbiri said, so keep them in the loop.

Be realistic about what can be accomplished.

Each appointment is about 10 to 15 minutes long, so everything cannot be addressed in one visit. It might take multiple appointments to tackle all of the concerns, he said. That makes it even more essential to be organized so you can prioritize the most important health concerns first. By following the steps above, that 10 to 15 minutes becomes much more effective.

“It makes our life easier and it’s good for the patient,” Dr. Tadbiri said.