With doctor visits getting shorter and shorter, what are the key questions seniors should ask their doctors?
By Deborah Jeanne Sergeant
With electronic medical records, tighter margins for medical practices and a shortage of providers, most doctors cannot offer their patients much time to talk during visits. To get the most out of your visit, plan ahead the questions you should ask and concerns you should bring up.
Local experts offered a few ideas.
• “The big thing I notice that seniors don’t mention is balance issues and falls. If they’ve fallen at home, elderly patients tend to hide it. How long they were on the floor is important. The longer they’re on the floor increases the chances they’ll be in the hospital. If we detect it early on and assess risks, we can lower chance of hip fracture and hospitalization. A big component is they don’t want to lose their independence so they won’t say they’ve fallen. We agree that they should stay as long as they can in their own home. We can identify their balance issues early on to work on core strength and balance exercises. We can work with visiting nurses who can help them do balance training at home.
• “Seniors should talk about any issues with confusion and memory. That leads to their advanced directives. What we don’t do well is talk about what they wish to accomplish toward the end of life. Do they want to be resuscitated? That decision-making should start early on. If they have issues with cognition, they might be losing their ability to make decisions financially and medically. They need to make those decisions before they are unable to. If you do it early on, you can get the family onboard with what their issues are. It helps them avoid family strife.
• “Older adults tend to not talk about skin issues. They try to hide those things, as they often occur in the buttocks.”
Ju Joh, family medicine physician and associate chief medical officer with Primary Mobile Healthcare Partners, Buffalo
• “A lot of older adults take medication for pain. They’re not always open if they cannot afford their medication. Some [medications] they must have, some medication is nice to have and others they can skip if they cannot afford it. We need to know if they cannot afford it. It’s rare for them to say they cannot afford it.
• “Older adults are more stoic about their medical situations. We have to coax them to tell us this information. A part of it is how their parents handled chronic disease.
• “Asking about how their disease will progress in five years and 10 years will make a difference. If you don’t ask you won’t know.
• “I would like my patients to be more open about their incontinence. Older adults don’t bring it up. It is very hard to discuss a topic when the patient doesn’t want to talk about it. It causes major impact on quality of life. It’s very common. The patients — and particularly male patients — are not open about those types of problems. They’re happy to talk about bowels, breathing and chest pain. But incontinence they don’t want to talk about. They probably feel it’s part of getting old and there’s nothing that can be done. Downplaying the problem is a major issue.
• “They also may not want to talk about depression or isolation for the same reason. They’re not willing to seek treatment for it. When they start losing weight, someone else might say, ‘They’re not doing well; what can we do?’ but we can start treatment for depression so much sooner.
Physician Geria Furtuna, who works as geriatrician at University of Rochester Medical Center