6/23/2011 3:46 PM ET|
Should you fire your parent's doctor?
Many older people think they're stuck with the doctor assigned to them. In most cases, that's not true. A daughter shares lessons from her father's decline and death.
Recently I dealt with the loss of my father and helping my mother cope with her loss.
As some of you know, it's an incredibly painful experience -- and it's even worse if you're dealing with an overstretched health-care system.
Like a lot of older folks, Dad faced a series of medical problems. First, he had knee surgery. Once back home, he fell, leading him to return to a rehabilitation facility. While there, he developed pneumonia.
What made it more challenging is that Mom didn't think the primary doctor was responsive or available, which caused a delay in treatment. Even the nurse said the doctor spread himself too thin.
Don't let this happen to you. There are things you can do to make sure your loved one gets better care.
Fire your doctor
What people don't realize is that they can fire doctors, Mom said.
True. Just because you've been assigned a doctor -- in a hospital emergency room, for example -- doesn't mean you have to stay with that physician.
"We should approach our relationship with our doctors like we do a relationship with anyone else," said my sister-in-law and long-term health care expert and consultant Christine Openshaw.
"Sometimes we spend more time interviewing a potential painter than a doctor, so talk to your physician early. Ask questions like: "What are your philosophies? What kind of care do you provide?" If you've had an issue and they're not responsive, they tell you it's all in your head, don't encourage you to get another opinion or don't offer multiple solutions, it may be time to change doctors."
There are times this might make sense, like when your loved one is taken to the emergency room. There, you might get assigned the doctor on call, who may now be the physician responsible for coordinating your loved one's care. But is the doctor right? Is he or she they available? And is there a doctor who's more familiar with the patient's history and needs?
Name your home-care provider
Just like lenders that rely on their preferred title companies, so too might a doctor recommend a particular in-home care provider when the time comes. But as with a doctor, if you don't like the first person or company sent to your home, you can usually request another.
In our case, my mother chose to use a home-care provider she had used before -- a company that continued to check in on Dad's health over the months. If you've had a good experience with one, it might be wise to stick with it, even if that means questioning your doctor's recommendation.
"The dignity they gave him made all the difference," Mom said of the hospice care.
Make your end-of-life plans now
My mother said she didn't want her children to go through with her what we had to with our father.
Let's face it: We put off the conversation. It's not easy. But it's really important -- for the sake of those around you -- that you discuss the many details that you'd typically never think about, from life support to feeding tubes. Dad's condition meant he had to be fed through a tube in his stomach to keep him going -- something Mom had never considered.
Hospitals often have nurse hotlines or social workers who can help. So ask for a discharge planner or social worker to educate you about options.
For help thinking through these important decisions now, Florida-based Aging With Dignity has a document titled "Five Wishes" that covers related concerns, issues and questions.
Shop your costs
This one's especially touchy, because everyone has different views about how to care for a loved one after death. And your friends and relatives may quickly impart their own opinions about how you should handle things, even suggesting that going the less-expensive route may be wrong. All the more reason to talk things through in advance.
Be mindful of costs: Companies know there are profits to be made amid your grief. My dad wanted his remains cremated, and the costs ranged from a high of $3,500 down to $700. You might just be paying for posh buildings. We found a place that was on the reasonable side, at $700, handled the services on its grounds and provided both pickup and delivery of the remains -- something few did.
Review long-term care insurance needs
Many people, my mother included, have paid a hefty price for long-term care insurance. "If there's one thing I would've changed there," she said, "it's the 90-day waiting period." (How much will long-term care cost? Check MSN Money's calculator.)
But shortening the waiting period so your coverage begins in, say, 30 days, comes with a much higher premium, as one insurance agent told me. If you have limited means, the best policy is usually the one with a 90-day waiting period and a lifetime benefit, but the waiting period can be a real trauma for some.
However, there are ways to make the waiting period start sooner. State Farm's insurance policies, for example, count even just one hour of care on one day as the beginning of your waiting period, so long as the patient cannot perform two of six daily living activities.
The loss of a loved one is hard enough. By planning ahead, you can focus more on your family and less on the logistics and financial aspects.
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So much info to pass along and so little space to provide it. First...I am a senior 69 years of age on medicare. I have a family practitioner, cardiologist, urologist, orthopedic surgeon and an ear, nose and throat doctor as well as a local hospital. I see all the physicians on an as needed basis except for my cardiologist which is three times a year. Had open heart surgery in 2006.
All medications I take (which are heart related) are forwarded to my family practitioner as well as info from all specialty physicians. This keeps everybody in the loop and on the same page. This list is readily available to my family with all phone numbers "in case of emergency". All of my physicians want to be kept up with all info of course however it is the info that changes they are most concerned about. My significant other is very aware of my doctors and knows all of them as well as I do.
When we get older, we really need an advocate to help us when receiving medical care. Maybe I am fortunate because all my doctors have been referred by my doctors. All my doctors call to remind me of my appointments and welcome my advocate to sit in when I am being examined. This is to listen, ask questions, write down info and to have first hand information and not second hand which is of no value if not remembered correctly.
If you have a senior that is in need of health care, be a part of that care and speak on their behalf if you feel the proper care, proper information or any reason you feel the care is not as expected.
I lost mine too in a similar way.
He even had Blue Cross insurance, but was treated like a transient homeless person.
He was denied the modern procedures that would have saved his life (MRI,ultrasound).
The bed was even so uncomfortable he could not lie in it. He slept in a chair for 2 weeks.
AVOID Medical Center of Plano,TX--- IF YOU DON'T HAVE A CADILLAC INSURANCE POLICY THEY WILL KILL YOU!!!
To JamesPA' comment: A good physician has the time to listen. I am 74 and I find that doctors of all disciplines and their PA's do not listen. I pay close attention to my body and when it tells me something is different I always used to mention it and question about it. Once I had started wheezing (new to my general health) and when I specifically made an appointment with my primary about it he told me, and I quote "You are just getting old". Nothing else, and I was dismissed. Needless to say I fired that doctor.
Doctors don't tell you about the serious side effects of what they do prescribe either.
I now make it my business to ask for the manufacturers insert on meds that I am prescribed so that I can read what the med is and what the side effects are. I am extremely susceptible to side effects and find that sometimes the meds side effects will cause the very thing it is supposed to treat. Doctors listening is a joke! I want a doctor that is a detective of symptoms, not one that throws tests and meds up against a wall to see what sticks! I have yet to find one. Especially on Medicare.
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