How to help the doctor better help your aging parent.
If you’re taking your aging parents to doctor visits or even doing tele-health appointments with them, you want to make the most of the time you have and get issues properly addressed. There may even be concerns you want to bring up that are hard to do in front of your parent. So what do we do?
Kim & Mike Barnes of Parenting Aging Parents wanted to get the perspective of a doctor to find out what we can do to help the doctor provide the best care possible. Dr. David Murdy is a Geriatrician at Baylor Scott & White Health and specializes in taking care of older adults.
Dr. Murdy shares what you can do ahead of time to prepare for a doctor visit, how to advocate for your parents and what questions to ask for the most effective visits.
Read the full transcript
Transcript of Interview: “Tips from a Doctor: Doctor Visits with Elderly Parents”
Mike Barnes:
As we get more involved in the medical care of our aging parents, we may be going to doctor’s offices, coordinating doctor’s appointments, and trying to keep track of things. It can be tricky.
Kim Barnes:
Yeah, you made a lot of doctor’s visits with your mom.
Mike Barnes:
Yeah, another one with my dad coming up pretty soon and with my mom.
Kim Barnes:
So, it’s just hard figuring out what we’re supposed to do and how to make things easier on the doctor. Let’s bring in a doctor and ask him. Dr. David Murdy is a geriatrician. Thank you, because we, as the adult children, potentially have full-time work, children at home, and are trying to manage and help our parents. What are the things that, from a doctor’s perspective, we can do as the adult children that really help you help our parents?
Dr. David Murdy:
Well, I think it’s important to empower your aging parents to seek medical attention, and often you’re the one bringing them, like you said. I also think it’s appropriate that people plan and organize a little bit ahead of time about what their concerns are so that we can go through those lists, however long they may be, and make sure your questions are answered. That helps us not miss things, like a needed flu shot or a COVID booster, something that might seem to slip our attention if we’re busy talking about high blood pressure, dizziness, or falls.
Mike Barnes:
Those are the basic things. One of the hard parts, I think, for us as the adult children is that we have such a wide range of personalities that we’re dealing with, whether our moms or dads are hypochondriacs and they’re coming up with all kinds of different diseases they may have or they just never want to go to the doctor and everything in between. So, it’s hard to say “do this” because we’re dealing with so many different personalities.
Dr. David Murdy:
You’ll obviously know the personality of who you’re dealing with, and you can try to put into perspective how serious or unserious their concerns are. Are these chronic things they comment on each day? Perhaps they can be set aside if we’re trying to evaluate progress in mobility, safety, eating, and basic activities of daily living. It’s wonderful to have information from family members about what mom or dad is able to do and what areas they’re having trouble doing because sometimes those things don’t necessarily come out in a conversation in a doctor’s office.
Kim Barnes:
We often start with “How are you feeling?” and they may say, “I feel great, I don’t know why I’m here,” and we’re worried about that new blood pressure medicine we started. Is it working? Are the home blood pressure readings safe? Collecting information like that is important. Has there been a weight change? Any adverse effects of a medication? Are they taking their medicines regularly? It’s amazing the number of times when the question comes up and we find out they’re not really taking their medicines regularly, making it very hard to assess whether they work properly or not.
Kim Barnes:
When you are going with them or doing telemedicine with my mom, what are the things that we can share to help make it easier for you?
Dr. David Murdy:
If you have a principal concern, like since last time mom has a problem with this or dad has fallen three times, it is appropriate to make sure those concerns are out front and center so they get addressed. Not at the end of the visit, but considered upfront, even if there are other things being checked on during that visit. You want to know that your concern and your aging parent’s concern have been answered. Are you satisfied with that or do you have other questions? If a specialist is needed or a diagnostic test, ask the question. Do we need an x-ray? Maybe we don’t, but you’ll need an explanation so you feel confident in that advice.
Mike Barnes:
It’s just sometimes hard for us as the kids if we’re there in the room with the parents and the doctor says, like it happened to me with my mom who has Alzheimer’s, a couple of years ago, the doctor said, “Jane, are you doing okay?” and my mom’s like, “Doing fine, never been better.” And I’m in the back going, “No, she’s not, she doesn’t remember anything!” Which kind of riles up my mom. So there’s a fine line we have to deal with as kids.
Dr. David Murdy:
It’s very appropriate if you know that and you don’t want to start a fight to provide some information in a note. Communication can easily be done through portals like the one we have here at Baylor Scott and White. Emphasize, “Hey, we’ve seen these problems, this is not what we expected from our last visit, we wanted you to know,” so that when we’re visiting, you can ask and check on these things and make sure we’re not missing anything important.
Kim Barnes:
We can almost plant, not plant, but we can make because a lot of times if we’re the ones bringing it up, they may perceive it differently than if the doctor brings it up. One example that I hear a lot about is driving. If the doctor were to ask more about, “So how’s driving going?” and things like that, it would probably be better received by them than if I’m the one bringing it up. So really use that portal as a way to communicate with the doctor.
Dr. David Murdy:
Right, and it depends on the situation and the relationship, whether it’s okay for the doctor to acknowledge that these concerns have come from the kids or whether it’s inappropriate, and you’d rather they not bring that up. That depends on the situation with each parent. Everyone has a different personality. When family members bring up important information and the elderly patient is concerned about that, I often point out that the elderly patient trained these children, so it is appropriate that they bring up concerns, just as when they were parenting you as a small child, they paid attention to these things.
Kim Barnes:
I love that. It’s a great reminder because it is such a reversal in many cases. It makes it even more challenging because these are our parents who we want to show respect to, but we also want to make sure they aren’t downplaying something serious or just not wanting to acknowledge it. Or if there is a dementia issue, just not able to acknowledge it.
Mike Barnes:
Do you and other doctors mind being the proverbial bad guy when we say, “No, Mom, the doctor says”?
Dr. David Murdy:
No, I mean, our goal as physicians is to provide accurate, meaningful information in a way that people can use it to be healthier. Our goal is also to respect their wishes and not to impose our wishes upon people. That may mean we fulfill a diagnostic test, do a procedure to get a biopsy, or understand the pros and cons of a therapy. If it leads to a serious diagnosis, we may need to talk about and plan end-of-life concerns. We try to elicit people’s understanding of their situation and their willingness to pursue tests or therapies. Sometimes their opinions may differ from yours as a child. For example, a 90-something-year-old may not want to go through diagnostic tests and treatments, believing the burden of potential treatment exceeds the benefit. They may prefer to work with their doctor to live their life with quality, hopefully pain-free, without pursuing everything that might be expected if someone was 30 or 40 years younger.
Kim Barnes:
So how do you know when to push and when to step back?
Dr. David Murdy:
They call it practicing medicine for a reason because there’s no perfect answer for that. It’s not uncommon that I’ve had a visit with a family member in tow with a patient, and we thought we had it resolved. Then they come back and say, “We’ve thought about it, we’ve talked about this some more, and we now think we’d like to do this.” Or sometimes they were gung-ho for a diagnostic test and specialist visit to nail down a diagnosis, and later say, “We’re okay with what you said and don’t want to pursue that right now.” That’s okay because it’s part of working together, making sure all sides are heard, and realizing continuity of care often provides the best value and confidence in the help they’d like to have.
Mike Barnes:
Such great tips, suggestions, and advice. We really appreciate your time, Dr. Murdy. Thank you.
Dr. David Murdy:
You’re welcome. Thank you for helping provide good information for people caring for their aging parents.
Kim Barnes:
So many great things to think about because we want to be advocates for our parents. We want them to see things a certain way, but we have to be respectful of their choices. Hearing from a doctor, it’s good to know they are okay with us reaching out and having conversations. I love thinking about how they were parents to us, and now we’ve got to treat them the same way.
Mike Barnes:
Absolutely. If you have other suggestions of topics you’d like us to cover, just let us know on Parenting Aging Parents.
*This transcript is auto-generated. Please excuse any typos or mistakes.
