One of the services I provide to my clients is coaching them on managing their parents’ appointments with their respective doctors. I use the word “managing” intentionally, because for best results, the accompanying adult child needs to play an active role in ensuring that the meetings are as productive and stress-free as possible.
Not only do my clients and I spend time preparing a formal written agenda that outlines the objectives of the meeting (the subject of a future newsletter!), I also spend quite a bit of time talking about the subtle, often nonverbal elements that need to be taken into account when an older adult meets with a physician.
A new experience
For most adults, the only experience we have in accompanying another person into a doctor’s exam room is with our own child. Under these circumstances, and for the first five or even ten years of a child’s life, we’re the point person in the discussion. The doctor examines our child, of course, but the meaningful verbal interaction is with us.
That’s fine and appropriate with a toddler; it’s not the best way, however, with your parent. In this case, there are some very specific things I do and instruct other adult children to do on behalf of their parents, to help these older individuals maintain a direct, adult relationship with their own physician.
Here are three ideas for making your parent’s next visit go as well as possible:
- Pay attention to introductions.
Be sure that all the people you encounter introduce themselves to both you and your parent. It’s not uncommon for office staff and/or the physician, in the interest of time, to begin to bypass an older adult who may be slow to move or respond. Encourage direct communication by asking your parent to answer the questions being asked and by repeating them: “Mom, the assistant is asking about your medications, would you like to share your list?”In addition, if you meet someone whose role you don’t understand, ask them: “And your role is?” If you don’t know who they are, your parent doesn’t either and may be hesitant to ask. Distinguishing between a medical assistant, a nurse and a physician can make a difference and help you and your parent know to whom you should address issues and questions.
Introductions are also an appropriate time to point out if the older adult is hard of hearing and to provide tips on how best to communicate. You might say, “My mom is hard of hearing but she does well if you position yourself right in front of her so she can read your lips. Just go slow, lower your tone and ask her to repeat things you want to be sure she understands. You can usually tell by her face if she understands you or not.”
- Pay attention to body language.
It’s important to position your parent in the line of vision of the physician. Many exam rooms are designed with a chair facing a computer (for the physician) and another chair beside it, facing out. Position the older adult in that chair for initial conversation.You, as the second person, can sit to the side of your parent so that the physician can make eye contact with both of you. If your parent is in a wheelchair, simply remove the chair and position your parent in its place.
Often, upon entering the exam room, the patient will be asked to undress, put on a hospital gown and sit on the examination table until the physician arrives. Unfortunately, this puts the older adult in a vulnerable position and makes it even harder for him or her to maintain an equal relationship with the doctor.
Instead, I recommend deferring changing until after you’ve both met with the doctor. I simply say, “My mother prefers to remain dressed as she has never met this physician before.” Or, “My father prefers to discuss his medical status before changing his clothes.” If the medical assistant insists, I state: “We prefer to wait, thank you.”
- Avoid the temptation to take over the meeting.
In many instances, of course, it’s more efficient for you to answer the questions and speak on behalf of your parent. Try to avoid this unless absolutely necessary.If I find the physician talking only to me, I look down to take notes or stare at the older adult to gently let the physician know that he/she should be speaking to the patient. If that still doesn’t work, I interrupt and ask that the conversation be directed toward the older adult or I ask the older adult if they understood what the physician said.
Again, the idea is to assist, not take the place of your parent as patient.
These three suggestions are subtle, but I think you’ll find that they make a big difference in the tone and nature of your parents’ appointments.
Above all, the most important thing to keep in mind is that your role as adult child is to build and enhance the relationship between your parent and his or her physician. The extra steps described above can be uncomfortable at times, I understand. Being assertive sometimes is.
But reassure yourself with the knowledge that while keeping your parent front and center in discussions of their health may take a little more time and effort, in the long run, it’s better for everyone involved, all of whom share the goal of keeping your parent as healthy as possible for as long as possible!
P.S. Although these suggestions are focused on attending an appointment with an older adult, the concept of enhancing our relationship with our respective physicians is universal and must be considered during every interaction. We’ll continue to address this in future newsletters.