Caregiving Blog: Aging Adults Get the Results You Want From a 15-Minute Medical Appointment

Aging adults find it difficult to get results from a 15-minute medical appointment. The time limitation makes it difficult to thoroughly discuss health concerns. After age 50, the likelihood of having multiple chronic diseases increases. More time is needed to receive and understand information and to ask questions.

Having a family caregiver attend appointments helps ensure that concerns are identified, questions are asked, and follow ups occur. A process of pre-appointment preparation, discussion with the doctor, and after the appointment follow up helps achieve expected results.  

Aging adults attending medical appointments may feel like they join an assembly line upon arriving at the doctor’s office. Medical office staff seem more concerned about patients being on time than the doctor running late. Sign in, provide insurance card, update and sign medical office forms, make the co-pay and then wait, and wait, and wait to receive your doctor’s undivided attention.

Rules and Regulations for No Nonsense Medical Appointments are Posted on Medical Practice Websites

I purposely searched medical office websites (1) to see if there was information about attending appointments. This is the information I found that is an example of the small print on many of the forms we sign to receive medical care that may not be read in detail. If everyone read this information it might make the assembly line at the doctor’s office more efficient. 

Please arrive 15 minutes prior to your appointment so that we may update your account and confirm billing and insurance information without delaying your visit. As we strive to respect our patients’ scheduled appointment times, if you are more than 15 minutes late you could be requested to reschedule your appointment. We are legally required by your insurance company to view your insurance card and collect co-payment at the time of service. If there is a balance on your account you will be required to pay at the time of your appointment.”

Seeing the Doctor

After passing approval by the reception desk, the second step is being invited into a treatment room. Being in the treatment room allows a medical assistant or nurse to take vital signs, verify medications, and ask about any changes in health or concerns.

The doctor enters the room. The 15-minute appointment clock starts. Pleasantries are exchanged. Unaccompanied aging adults may feel like they see the doctor and are escorted out the door before having the opportunity to state a real concern. Having a caregiving advocate, like an adult child or friend, attend medical appointments is very helpful.

Medical appointments are more difficult for aging adults because it takes longer to think about information provided by the doctor and to think of questions that should be asked. A failing memory may result in prescriptions going unfilled or being lost.

For aging adults, a 15-minute appointment may not provide answers to a long list of concerns. Doctors, who are not geriatricians, may become impatient with aging patients who fail to or who forget to follow instructions. In most circumstances, family members are welcome at medical appointments.

Aging Adults Benefit from Caregiving Support at Medical Appointments

If you are a family caregiver, attending a medical appointment with a spouse, aging parent, or loved one is beneficial. Receiving information directly from the doctor and asking questions improves the healthcare process. The benefit for the doctor of having a caregiver attend the medical appointment is the ability for the doctor to receive information about daily life and routines, observations, and concerns that may not be reported by the aging adult.

A shocking and unknown concern for aging adults is the high rate of undiagnosed dementia. A lack of diagnosis results from poor self-reporting at medical appointments. Aging adults do not remember to report information they are unable to remember.

Aging adults and family caregivers are also unlikely to be aware of the signs of dementia which makes reporting symptoms to a doctor impossible.Statistics confirm that 50% of aging adults have dementia but are undiagnosed. Physicians knowledgeable about dementia are able to ask questions to identify potential concerns related to the diagnosis. Additional testing may be ordered to confirm the diagnosis. 

Here is my 5-5-5 process to help aging adults get results from a 15-minute medical appointment

1 At the appointment use a watch or cellphone clock to track the time

Allow 5 minutes for the doctor to make an introduction and ask questions. During the next 5 minutes, express concerns concisely and in order of importance (more on this in a moment). The last 5 minutes should be recommendations from the doctor for treatment, prescription writing, orders for tests, follow-ups, and confirmation of the timing of the next appointment.

2 Before the doctor appointment write or type a list of all medications and supplements you take

If you have difficulty making the list, ask an adult child or friend who may also be your caregiver to assist. Ask the check-in staff at the doctor’s office to make a copy for you. Give the copy to the medical assistant or nurse who takes your vitals to place in your chart so that your 15 minute appointment is not further interrupted.

3 Before the doctor appointment, write or type a list of health concerns 

Write a list of health concerns in the order of priority as there may only be time to discuss 1 or 2 concerns. If the list is longer, a second appointment will have to be made. Be as specific about the concerns as possible. At what time of day and how often does the condition occur? How does this condition make you feel? Have you had any changes in activity or health that might have caused the concerns? Are family members able to offer any helpful observations or information?

What action do you expect or want the doctor to take? Prescribe a medication, run testing, or make another recommendation? The idea is to receive responses to concerns before the doctor rushes to see the next patient. Do the same with this list. Have the check-in staff make you a copy. When the doctor asks what he or she can do for you hand over the list to begin the discussion about health concerns.

4 Ask questions to support treatment recommendations 

If you struggle to think of questions to ask during the 15 minute appointment, ask if you can call the nurse to ask questions after the appointment. If a family caregiver accompanied you have this person assist with asking questions during the appointment.

Typical questions should relate to identification of health concerns, recommended follow-ups, prescription medications, side effects, treatment options etc. For more information on questions to ask your doctor, read” “How to Know When You Should (Or Shouldn’t) Be Concerned About Side Effects of Medication.”

5 Before leaving the office, make a list of follow ups

Write down information about the doctor’s responses to your questions and recommendations before you leave the treatment room or the medical office. If all of your questions were not answered about treatment suggestions, ask the front desk staff for the the name and number of your doctor’s nurse so that you can call to follow up.

Make the nurse your new best friend. Nurses can be extremely helpful in communicating information with the doctor and responding to you with suggestions. If your questions were answered make your regular follow up appointment before . Add the date into your calendar immediately when you return home.

After the appointment, monitor changes in how you feel. Did the suggestions or treatment resolve the concern discussed at the appointment? Do you have a list of follow-ups like taking your blood pressure daily or writing down how you feel based on taking a new medication. The more information and details you to document the smoother the appointment process will be the next time.

A bonus tip

Use the 5-5-5 process to be more effective in conversations where others may be time pressured and you want assistance. Write out questions or concerns. Open the conversation by asking for help. Give the other person time to ask questions and make suggestions.  Agree that the last 5 minutes will be spent identifying solutions and next steps.

Source:

(1) SCL Physicians Appointment information. https://www.sclhealth.org/patients-visitors/appointment-information/

Pamela D. Wilson, MS, BS/BA, CG, CSA, is a national caregiving thought leader, caregiving expert, advocate, and speaker helping family caregivers solve common caregiving problems and healthcare issues. Pamela’s book, The Caregiving Trap: Solutions for Life’s Unexpected Changes offers practical tips and solutions for common caregiving problems. .

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