I have recently heard a number of folks express frustration with doctor appointments, particularly with loved ones with dementia. Just getting to the appointment can be a challenge, and then often times, you leave more confused than when you went in. I have put together a list of suggestions that may help you get more out of those visits, whether you are seeing your own MD or bringing a loved one to see theirs.

First, be prepared. Always bring a current list of medications and your schedule for taking them. Many of you see multiple physicians…the primary care, the cardiologist, the neurologist, the rheumatologist… These doctors may not communicate with one another and would therefore have no knowledge of the medicine another may have prescribed. It is important for the doctor you are seeing to know exactly what you are taking (name and dosage) and when. Include over the counter and herbal remedies as well, as these can often interact with prescription medicines or have adverse side effects.

In addition to a list of medications, have a list of questions ready. It is helpful to keep a running list on the fridge and add to it when something comes up, as opposed to trying to brainstorm all of your questions ten minutes before the appointment. Before the appointment, you may want to rearrange the list, putting your top concerns at the top of the list in case time runs short. Be sure to ask your questions early in the appointment; don’t wait until the doctor is going out the door. Bring a pen to write down answers or ideas that are new or ask the doctor if he has a print out with the new information. Many offices now provide written information about new diagnoses or plans of care.

Bringing a person with dementia to the doctor poses an additional set of challenges. It may be very difficult for you to speak openly with the doctor while your loved one is in the room. Additionally, your loved one may be very skilled at putting on a good show to prove to the doctor that there is nothing wrong with them (making you look like the confused one!). I have heard so many of you say that your loved one, who is fairly impaired day to day, answers all of the doctors questions, and then some, exhibiting few signs of dementia in that ten minute time span.

Prepare a list of the things that you observe about your loved one, particularly new or different behaviors or trends. Notice and keep track of changes in eating, sleep, or bathroom habits, changes in weight or mood, new behaviors (good and bad), and any correlation you observe to time of day, caregiver, activity, medication, etc. This list will help you convey accurate information to the doctor, and if your loved one being present inhibits you from talking freely, you could simply hand the doctor the list.

You may try calling your doctor’s office in advance. When you schedule the appointment, explain to the receptionist that you are concerned that you may not be able to speak openly with the doctor with your loved one present. Ask the receptionist if it would be possible for you to speak with the doctor by phone ahead of time, or if there is some other way you could have an opportunity to talk to the doctor in private prior to the exam. Every practice is different, so you need to inquire about how your doctor would like to handle this type of situation.

It is an unfortunate reality that doctors are pressed for time. Because of insurance requirements and office management practices, they have many people to see in a short period of time. Respect your doctor’s constraints by preparing yourself ahead of time and being efficient while you are there.

Christina Forbes, LGSW from the Daybreak Newsletter 6/2009