Why Do Old People Not Go to the Doctor?
The Caring Generation® – Episode 142 June 15, 2022. Why Do Old People Not Go to The Doctor? Pamela D Wilson, Caregiving Expert shares thoughts about why elderly parents and loved ones avoid or delay seeking medical care. If you are a family caregiver, learn how you can help aging parents, spouses, and others get the care they need.
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Why do old people not go to the doctor? People avoid medical care due to many reasons including fear of a diagnosis, lack of time, embarrassment, use of too many medical words, technology, and uncertainty that doctors can make accurate diagnoses.
Let’s look at eight reasons why old people don’t go to the doctor
1 – Don’t See the Need
How many of you think, “oh, it will get better with time,” or “I’m not sick enough.” If you are young and generally healthy, both of these statements may be true.
However, if you have older parents with many health issues, waiting can have serious negative consequences. Don’t wait.
Waiting can mean a late diagnosis of a disease—which, if identified six months earlier, could have been treated but today may lead to the death of a parent or another loved one. Not going to the doctor until a person can’t get out of bed or is terribly sick can result in a life-ending diagnosis, a great deal of unnecessary suffering, or a trip to the emergency room.
2 Fear of Being Diagnosed with Severe Illness
Elderly parents and adults of all ages fear receiving bad news, not just about health but any bad news. Some caregivers and older adults say that going to the doctor makes them think of death or dying.
Others fear going to the doctor because receiving a diagnosis and participating in treatments may be painful. Here is an important insight, if your main fears are death and pain, seeing a doctor earlier rather than later can prevent both of these.
Uncertainty about anything can lead to worry, right? Worry about what might happen tomorrow, next week, next month, or next year.
Gaining certainty and receiving the facts, especially about a health problem, is the only way to reduce or manage worry and anxiety. So rather than waiting or saying, “oh, it will get better with time” or “I’m not sick enough to see a doctor,” make the appointment.
Learn about the health diagnosis. Ask questions about treatment and the consequences of how the health issue might progress.
3 Dislike the Healthcare System
Making doctor appointments, the wait time at appointments, the wait time to get an appointment, and trying to get anyone to answer the phone and then help you are all reasons caregivers, older adults, and others say that they have an unfavorable opinion of the healthcare system.
Many elderly feel ignored, which is part of why do old people not go to the doctor. If you’ve ever tried to make an appointment and have to leave a message, it can be days before anyone calls you back—if they do, call back. Right?
Long wait times
How many of you have been to a doctor’s appointment and had to wait hours because the doctor was late, delayed due to surgery, or other reasons? You may have taken off work and told your boss that you would be gone for 2 hours, and 2 hours have passed, and you haven’t seen the doctor yet.
These are all problems contributing to why do old people not go to the doctor. Many elderly do not have the physical stamina to sit in a doctor’s office for 4 hours to wait to be seen, especially if they aren’t feeling well.
If you don’t get the first appointment of the day or the first appointment after lunch, the likelihood that you will be waiting increases for every patient who is scheduled before you. This hassle factor of dealing with medical offices with staff who don’t seem to care is a deterrent that answers why do old people not go to the doctor. Add to this that your parents may feel guilty asking you to take time off work to take them to the doctor.
An alternative to all of this can be a doctor’s office that has an online portal where you can schedule appointments and communicate with the staff in your doctor’s office about the care of an elderly parent, assuming you have written permission.
Ask if the healthcare provider has an online portal. If so, using the portal can smooth out the challenges of scheduling appointments and coordinating care that relates to why do old people not go to the doctor.
Challenges with prescription or treatment approvals
How many of you have been written a prescription by your doctor only to have the pharmacist tell you that the medicine is not in your insurance formulary? Which simply means your insurance company isn’t going to approve the drug.
It can take days for your pharmacist to go back and forth with your doctor and the insurance company to figure out the medicine that your insurance company will pay for. In the meantime, if you’re really sick, this delay can be a significant problem that means you have to go to the emergency room for treatment.
For over twenty years, I managed the care of many older adults. My staff and I have spent hours on hold with doctor’s offices, insurance companies, and other healthcare providers. Honestly, it can be frustrating, and many times, you may want to give up. Don’t.
Don’t give up
Don’t give the healthcare system the satisfaction of not doing the right thing. In my experience, health insurance companies can make it difficult to receive care.
Health insurance companies, including Medicare and Medicaid, also called by the healthcare system term “payer,” hope that you’ll give up. Many consumers do.
But when you give up, the only person you are placing at risk of pain and suffering is you or an elderly parent.
You don’t want to look back, weeks, months, or years from now and say, if only I didn’t give up on that medication or treatment or if we continued to see the doctor, we wouldn’t be in this place with this illness, or diagnosis causing so many problems and the pain and suffering a parent is experiencing.
Managed healthcare programs
Health insurance companies seek to manage costs. This means that patients, especially older adults must learn to advocate for their care and establish positive relationships with physicians.
Healthcare plans can appear to decline treatments or restrict care. For the elderly who are less able to advocate for themselves, refusing to be treated by the healthcare system can be troublesome.
While declines and restrictions happen, sometimes the cause is not the health insurance company but a doctor’s office or another provider not submitting information correctly to the health insurance company also called the payor. Incorrect diagnosis or treatment codes can often cause problems.
Healthcare bias against the elderly exists. For more on this topic, listen to Episode 132 of The Caring Generation Podcasts, Is the Healthcare System Forgetting the Elderly, and my interview with Dr. Mary Wyman from the University of Wisconsin who shares her research.
Care may be declined or limited when the doctor writes a prescription for a medication that your health plan won’t approve, an incorrect treatment code, diagnosis code, or procedure code is listed on an office visit, or a request for treatment pre-approval for services.
Doctor’s office staff, pharmacists, and treatment centers fight the insurance approval battle every day.
Instead of treating or helping patients, their staff spends hours on the phone with insurance companies, chasing down approvals and updating paperwork to get consumers and patients the care they need.
So instead of giving up, ask your doctor’s office, the pharmacist, or the healthcare provider what the problem or delay might be and how you can help resolve issues, delays, or declines for healthcare treatments. You might be surprised to know that many local pharmacies lose money on processing your prescriptions, so many of them are going out of business.
Financial challenges are also why you see fewer independent medical clinics. Doctors have no other option but to join large healthcare systems because of the overwhelming amount of paperwork involved in trying to help patients.
Ask the right questions and be persistent
Until consumers and patients begin taking more responsibility for their care and learn what is going on behind the scenes, health insurance companies will continue to decline or limit care. Caregivers, the elderly, and others win by learning to ask the right questions and by being persistent to get the care you need.
Healthcare services are not a typical consumer good. All of the costs and pricing are hidden from consumers, so as a consumer asking for healthcare transparency is essential.
When you think of consumer goods like cereal or shampoo or other services like restaurants or any place, you feel that you receive good service like a beauty shop or a barber, and you compare these to the healthcare system, which do you feel like gives you a return for the money you spend?
Most people would probably NOT say that they feel that they get good value or good treatment from going to the doctor. This is another factor answering the question of why do old people not go to the doctor and why avoiding medical care is becoming increasingly common.
4 High Care Costs
The high cost of healthcare is the number four reason that explains why do old people not go to the doctor. Concerns about being able to afford co-pays or high health insurance deductibles are real.
If you don’t have the money to pay for these services, you are less likely to see the doctor. Many elderly persons are on fixed incomes that may be limited to monthly social security or retirement check.
After the year one retires, the cost of everything else continues to increase. Look at the price of a gallon of gasoline, groceries at the store, electricity, or rent payments.
When paying for daily necessities is a concern, everything else—including seeing a doctor for what you might believe is a minor problem—becomes a lower priority. Some older adults have to make choices between paying their rent and getting a prescription medical refilled.
Being old and sick or being elderly and having many medical conditions has stress factors that may be difficult for adult children—who are their caregivers—to understand. If you are in this situation, ask your doctor’s billing office about a payment plan. Unless you ask, you won’t know if it’s possible.
Being attentive to health and participating in healthy habits like attending regular doctor appointments can change life for the better. But, unless you are in a position where you are willing to be persistent and advocate for your needs, you may end up old and sick.
5 Embarrassment or Nagging
You might notice that there are similarities between persons of all ages when thinking about why people avoid medical care. It’s just not the elderly who struggle to navigate the healthcare system—it’s everyone.
Number five for, why do old people not go to the doctor is being embarrassed about health conditions or fear of the doctor’s nagging. Embarrassment includes things like finding out that your blood sugar readings aren’t as good as you imagined, your blood pressure is still sky-high, or that your cholesterol readings haven’t decreased despite you changing your diet for the past six months.
So things that may be out of your control or things that you are working on that haven’t improved to the level that we had hoped. Fear of needles could be another embarrassment or fear of telling the doctor that you are participating in unhealthy behaviors—maybe drinking or smoking.
Here’s the concern in withholding information from the doctor. Some concerns may be a little out of your control, like blood sugar or blood pressure, but only until you learn to do the things that you need to do to bring them to positive levels.
Joining a support group may offer solutions
On the other hand, if these are on your no list and you continue to do them like drinking and smoking—then you may need a little more support to make the change. In this case, ask your doctor for help. Maybe a smoking cessation program or attending a 12-step program. Sometimes it can take extraordinary effort to change longstanding behaviors, and you may need the help of others in a similar situation.
It’s no different for family caregivers experiencing stress and pressure. Find an in-person or online caregiver support group so that you can share and learn with others in similar situations.
Other embarrassing or nagging situations may include not following through with medical advice to take medications. This is obviously your choice. However, you should ask what happens to your health, body, and mind if you don’t take the medications.
It’s important to be fully informed about the consequences of not taking actions that might improve your health. So that when you become ill, you say, “oh, this is what the doctor told me might happen,” rather than, “no one told me this would happen.”
Become knowledgeable about your health and accountable for your actions. If you are caring for an elderly parent, you may see a lot of refusals or not following recommendations.
When this happens, providing information in a non-nagging manner can help parents make a more informed decision. Do your best to be empathetic and listen so that you don’t add to embarrassment and nagging for your loved ones.
6 Distrust of Doctors or the Healthcare System
If an elderly parent has ongoing health issues that seem to only get worse, distrust of doctors or the healthcare system may be a
Or maybe elderly parents followed the doctor’s recommendations that didn’t work out as expected. Either way, disappointment exists and feelings of “why keep trying when nothing works out” may be the issue.
Additionally, a lack of trust can relate back to difficulty receiving or understanding information that a doctor provides. Doctors who speak in a complicated language that patients can’t understand can create situations of mistrust.
If staff in a doctor’s office promised to follow up and did not, this can also lead to frustration about whether a doctor and his or her staff really care. These types of situations can result in low confidence in a doctor’s expertise.
There may be a feeling that the doctor doesn’t know what he or she is doing or can’t make the right diagnosis so there is no follow-up. There is also a feeling that some doctors care more about money than patients.
Perceptions exist that doctors are more interested in money than patients
What happens when the doctor prescribes a really expensive medication that a patient sees advertised on television and the patient finds out that a less expensive and equally effective option might be available? Or when unnecessary tests are prescribed by the doctor that makes the healthcare system money.
There is no shame in talking to doctors about medications or treatments that are the least expensive for patients. It’s also okay to ask if labs or treatment centers that they refer you to are owned by the doctor, his staff, or anyone in the system that provides care to you. In many cases, this happens and patients remain unaware.
When distrust exists and prevents elderly parents from seeking care it might be time to change doctors or make the effort to explain your concerns. Older adults place doctors on a pedestal which means that they don’t ask questions or aren’t honest about their opinions or feelings about treatment recommendations.
There is no way to get good care or have trusting relationships with healthcare providers if you don’t speak up.
7 Transportation Difficulties
Transportation difficulties are another reason why do old people not go to the doctor. When elderly people don’t have children or friends who are available to take them to the doctor, attending appointments can be difficult.
This challenge ties into the use of technology that we will talk about in a moment. While transportation may seem like a barrier to why do old people not go to the doctor, many cities have transportation services specifically for the elderly or the disabled to attend medical appointments.
More and more medical offices that serve seniors are doctor house-call services. These are doctors that visit the elderly who are homebound in their homes.
For older adults who have a lot of complicated health issues, palliative or hospice care may be an alternative. When pain management is a concern or if medical conditions have advanced to the point where aggressive treatment is not the goal it’s time to discuss these options with your doctor.
In addition to local transportation services and doctor house-call services, some senior community centers have an information and referral person on staff who may be able to answer transportation questions. Additionally, contact your local Area Agency on Aging to ask about ride services for seniors.
8 Lack of Confidence in Using Technology
Older adults who are not comfortable using technology may benefit from virtual medical appointments. If there has been any positive result of COVID, virtual doctor appointments are now commonplace
as long the appointment is for routine care or an ongoing diagnosis. The doctor does need to see patients to diagnose new concerns or investigate ongoing concerns that seem to be worsening.
Other uses of medical technology these days are apps that can help track exercise and nutrition and help monitor other medical conditions. For example, if a person has type 1 diabetes, monitoring can be done with a continuous glucose monitor, also called a CGM that takes and records blood sugar readings.
Insulin can be supplied by the use of an insulin pump—no more injections. Even though it can take training and an interest in learning how to use medical technology the benefits are amazing.
To learn more about healthcare technology listen to my interview with Dr. Joseph Cafazzo from the Centre for Global eHealth Innovation. Check out the Caring Generation Podcast Episode 87 called What is 24/7 Care for the Elderly?
Patients can feel ignored
For older adults who are not computer literate, many feel that the doctor talks to the computer, not to them when they attend in-office appointments. Healthcare systems are moving toward electronic health records so that providers can share information about patients.
On the other hand, consumers have valid concerns about privacy and confidentiality. Patients can be suspicious about having to sign up for healthcare information portals.
Others may not have cellular access to receive text messages about appointments. So, while health technology can be beneficial, there may be a learning curve and if you don’t live in an area with fast Internet, trying to use the technology may be frustrating.
Consumer, Caregiver, and Patient Involvement
To overcome issues of why don’t people—including old people—go to the doctor, more consumer, family caregiver, and patient involvement are necessary. The provision of medical care has typically been one-sided—the healthcare system to the patient—for so long that changing longstanding beliefs about how healthcare works can take consistent effort.
As a caregiver for an elderly parent or if you are caring for yourself, it is essential to participate in all education about your health diagnosis so that you can be more proactive. This means identifying incorrect beliefs you have about health and aging.
For example; all old people will be old and sick. This isn’t true – lifestyle habits contribute to health and well-being when older.
Most of all, don’t give up seeking the health or medical care you or a loved one needs. Seek out others in similar situations who can inspire you to make changes that will help you improve or manage your health.
Why Seek Out Health Information
And last but not least, let’s look at why people are proactive to seek information about health and take consistent action. One reason is a decline in physical or mental health—which should not be a surprise.
Health that gets worse is motivation to seek solutions. The second reason is to set an example for your children or family members.
Adults, especially parents want to set good examples for their children. These examples include not being fearful of seeing doctors and participating in preventative health measures like vaccinations.
And last, elderly parents become more proactive about health when they are curious or hesitant. They ask their children or others to investigate information.
So becoming comfortable about seeing doctors and engaging with the healthcare system is supported by researching information, asking questions, and seeking help from loved ones and others in similar situations.
Interested in Better Care for Aging Parents or Yourself? Check Out Pamela’s Online Courses and Programs.
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