Patient Education & Engagement

The Caring Generation® – Episode 16 November 13, 2019, On this caregiving radio program Pamela D. Wilson, caregiving expert, answers the question Why Is Patient Education & Engagement So Important for working caregivers and aging adults? Health strategies to improve patient care are discussed with guest Dr. Mayer Davidson, Professor of Medicine at both Charles Drew University and the David Geffen School of Medicine at UCLA, and the past President of the American Diabetes Association who talks about Diabetes Prevention and Management.

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Why Is Patient Education & Engagement So Important? Radio Show Transcript

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00:05 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life, but the good news is, that it doesn’t have to be that way. The Caring Generation with host Pamela D. Wilson is here to focus on the conversation of caring. You’re not alone, in fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.

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00:48 Pamela D. Wilson: This is Pamela D. Wilson caregiving expert, I am your host, you’re listening to The Caring Generation radio program coming to you live from the BBM Global Network Channel 100 and Tune In Radio. The Caring Generation focuses on the conversation of caring, giving us permission to talk and laugh–we must be able to laugh–about aging, the challenges of caregiving, health, well-being, work, life, family balance, and everything in between, all the important things we should know about life. Please invite your family, friends, co-workers, and others to join us each week on The Caring Generation, where we talk about how to be proactive to avoid surprises about health, well-being, caring for ourselves, and loved ones. Helpful information for caregivers and aging adults are on my website at pameladwilson.com. You can also listen to all of the podcasts on your favorite sites, Apple Podcasts, Google Podcasts, Spreaker, Spotify, Pandora, iHeart Radio, Stitcher, Castbox, SoundCloud, and more.

01:55 Pamela D. Wilson: The Caring Generation is wherever you are. Today, we’ll be talking about the importance of taking action to take care of ourselves, elderly parents, and loved ones. In medical speak terms, this means participating in patient education and patient engagement programs that the medical system talks about a lot, but patients probably haven’t even heard these terms. You might wonder why patient education and engagement are so important. Patient education and engagement are essential when we think of the long-term perspective of our health and our well-being. If you are a caregiver for an elderly parent or if you are an aging adult with health issues you probably have come into contact with the healthcare system. Meaning that you have visited a doctor’s office, gone to the pharmacy, had a medical test, maybe a blood test.

02:52 Pamela D. Wilson: I’m curious, what has your experience been like? Positive, just okay, not so great? In the past 20 years that I have been a caregiving advocate, I’ve experienced all of the above. In the second segment of our show, an extraordinary guest, Dr. Mayer Davidson joins us from California, where he is Professor of Medicine at Charles Drew University and the David Geffen School of Medicine at UCLA plus, he is the past president of the American Diabetes Association. He joins us to talk about diabetes prevention and management. I want to say a special hello to all of our listeners in California and everybody at the Venice Family Clinic. I lived in Venice Beach on Ocean Avenue near the clinic in the 1990s. Dr. Davidson founded the Venice Family Clinic in 1970. It became the largest free medical clinic in the United States, and he continues to serve as a member of the Board of Directors, Chairman of the Medical Practice Committee, and he volunteers supervising a diabetes program and seeing patients once a week. Stay with me for a great interview and easy-to-understand information about diabetes prevention and treatment. Let’s talk more about being an engaged and educated patient.

04:17 Pamela D. Wilson: If we have been to a doctor’s office, then we have been or currently are considered a patient. As a patient and as a caregiver, we make a lot of important decisions about many aspects of life, including our health, the health of elderly parents, spouses, and maybe our young children. These decisions might involve deciding about health insurance, scheduling a routine health exam, taking medications, or even scheduling a medical procedure. Depending on how complicated we see these tasks, we might struggle to complete the task, delay the task, or decide we’re not going to do it at all. Why is this? In many cases, it’s because we don’t understand the process or the information provided. Medical terms, may not mean a thing to us even though the information provided is vital to our health today and in the years to come. These complications in following instructions might be more difficult because we lack confidence in asking questions, and we don’t follow through. How many of you have found yourself in a situation where you really didn’t know what to do or didn’t know why you should do it, so you did nothing, or you delayed. The medical system can become frustrated with us when we don’t follow directions.

05:40 Pamela D. Wilson: So the question is, what would make taking action easier? Would it be somebody to explain information in a very simple manner? Someone to ask you what was challenging about following through? Somebody to give us a step-by-step explanation verbally or even on paper. It’s likely that one or all of the above would be helpful to help us complete the tasks of following through with a medical appointment, taking medications correctly, or scheduling a procedure. Patient education in all of these areas and beyond can help engage and move caregivers and patients to identify reasons why we should be more proactive about our health and our well-being. Throughout the show tonight, we’ll talk about the challenges of becoming an engaged and educated patient, and I’ll share tips for how we can be more successful at managing our health and being a caregiver for elderly parents, and also helping our parents to maintain their health because they have the same problems that we do.

06:49 Pamela D. Wilson: A complicating factor that affects what is called patient health literacy is that all of these events, this information, it’s not really relevant to us. It doesn’t have any meaning or any importance to grab our attention. Here’s an example, an elderly woman asked me a few weeks ago, why someone would need one of those, “I fall, and I can’t get up buttons?” She was in excellent physical condition. She walked every single day, and she couldn’t imagine how anyone might fall and not be able to get back up. Happens all the time. Sometimes it’s difficult for us to understand what another person experiences with health issues when we don’t experience the same health issues ourselves. How many times have any of us said, “Ah, I wish someone told me that,” when an unexpected event happens only to be told by somebody else that we were told. The problem is, we may have been overwhelmed, received too much information, we didn’t pay any attention, or the information didn’t make any sense to us. Or we were rushed or distracted. When it comes to our health and our well-being, what does get our attention? Does it take a heart attack, an elderly parent falling and breaking a hip, or some other tragedy? I hope not.

08:03 Pamela D. Wilson: I do know that for some people, it does take this type of wake-up call to make health and well-being a priority. Coming up after the break, we will be talking about being proactive to prevent health concerns in particular diabetes, which affects 30 million persons who are diagnosed, seven million who are undiagnosed, and 84 million adults out there who have pre-diabetes and don’t even know it, according to the American Diabetes Association, and the Centers for Disease Control. Diabetes is the seventh leading cause of death in the United States. Dr. Mayer Davidson joins us to talk about diabetes prevention and management. If you haven’t checked out all episodes of The Caring Generation, you are missing out. Visit my website at PamelaDWilson.com, go to the media tab, and then The Caring Generation radio show where you can listen, download, read and share all of the past programs. You can also listen to them on your favorite sites. You are listening to The Caring Generation radio program live on the BBM Global Network and Tune In Radio. We’ll be right back.

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11:31 Pamela D. Wilson: This is Pamela D. Wilson caregiving expert, I’m your host, you’re listening to The Caring Generation coming to you live from the BBM Global Network Channel 100 and Tune In Radio. We are back to visit with Dr. Mayer Davidson. Dr. Davidson welcome.

11:46 Dr. Mayer Davidson: Thank you, Pamela.

11:48 Pamela D. Wilson: So, I have a list of questions for you. Diabetes is a disease that is undiagnosed in so many people. What signs might indicate to a person that there is a concern and that maybe they should go see a doctor?

12:02 Dr. Mayer Davidson: Well, as far as the signs are concerned a very few people will have the signs of urinating a lot, being very thirsty, maybe weight loss, and blurring of vision. But unfortunately, for most people, there are no signs, and people have what we call asymptomatic hyperglycemia, which is a high blood sugar for many years before they’re diagnosed. So what has to be done is to have access to the medical care system and to get evaluated with the appropriate tests on an ongoing basis, especially if you’re over the age of 45.

12:39 Pamela D. Wilson: What are the best tests to confirm if somebody has diabetes beyond a fasting blood sugar reading?

12:46 Dr Mayer Davidson: Alright, well, the fasting blood sugar is one. There are two others, one of which is something called an oral glucose tolerance test, which very few physicians do anymore because it’s very inconvenient for patients. The test is used in addition to the fasting glucose is one called the hemoglobin A1c. This is a test that tells you what the average glucose has been over the past three to four months, and if that test is above 6.5% or the fasting glucose is over 126 milligrams per deciliter, that is diagnostic of diabetes.

13:26 Pamela D. Wilson: You know, we are all told by the healthcare system to maintain a healthy way, eat good foods, and to exercise. And I think that we get tired of hearing that because there are no health consequences. So for diabetes, what should people know about the short-term consequences and then the longer-term consequences?

13:46 Dr. Mayer Davidson: Well, in terms of whether you’re going to get diabetes or not, obesity is a very strong warning system. Unfortunately, 40% of our population is obese nowadays, and that is a tremendous risk factor for diabetes. In addition, if you have a family member with diabetes, what we call a first-degree relative, it’s a mother, father, siblings, or a child that really increases your risk. Now, once you get diabetes, then the complications are related to three things. One is high glucose over a long period of time, and the hemoglobin A1c is the test that tells you how bad you are, or how good you are in that regard. Blood pressure is another one, and the third one is something called bad cholesterol, the low-density lipoprotein, so it’s LDL cholesterol. So A1c, blood pressure, and LDL cholesterol are the three things we need to follow and to reduce down toward normal in order to avoid the complications of diabetes.

15:00 Pamela D. Wilson: And to your point a lot of people have diabetes and they don’t know it. But if they don’t go to the doctor regularly to get these blood tests, that’s probably why they never find out, is that, do you find that to be very common?

15:13 Dr. Mayer Davidson: Unfortunately, yes. And as the glucoses are high over those years before they find out, it causes the damage that when they’re first diagnosed, they’re at tremendous increased risk for those complications.

15:29 Pamela D. Wilson: And so, somebody comes they have the A1c, their blood pressure’s high, they have that cholesterol, they may think that “Oh my gosh, I’m eating too much sugar.” [chuckle] What are the most common misperceptions people have about why they get diabetes?

15:44 Dr. Mayer Davidson: Well, that’s one of them. It turns out, sugar itself doesn’t cause diabetes. What happens is that when you eat sugar, your brain does not tell you that you’re eating too much food, So that you keep on eating other food and that sugar has extra calories. The problem within diabetes is obesity and eating sugar then allows the patient to eat more and more of other stuff, which causes the obesity. The other perception is or misperception is, “Well, I feel fine. Why do I have to worry about taking all of this medicine or doing anything about it?” And that is a bad, bad misperception because even though there are no symptoms if your blood pressure is high, your cholesterol is high, and especially if your glucose is high, it’s causing damage in tremendous amounts of organs in the body that eventually will start to fail. And then you’re really in trouble.

16:46 Pamela D. Wilson: You mentioned medication, so if somebody has diabetes, is it normally a pill first, or where does the insulin come in?

16:53 Dr. Mayer Davidson: It’s usually a pill first. So what happens is this, about 5% of people have what we call Type 1 Diabetes, and they have to have insulin. About 90% have something called Type 2 diabetes, and when they are first diagnosed, they’ve already lost about 50% of their ability to secrete insulin. And over time unfortunately that goes down and down and down regardless of what we do. So initially, one pill is fine, and then subsequent to that we need two pills and then maybe even three pills or four pills and eventually there is not enough insulin being produced by the pancreas so patients need insulin and currently about 30% of people with diabetes needs insulin.

17:41 Pamela D. Wilson: And to your point, and I’ve heard this so many times, “Well, I feel good, so I don’t need to take the pills.” It’s so important to do that so that you don’t need to take, right, the second pill, the third pill, and then end up on insulin.

17:52 Dr. Mayer Davidson: Well, you hit the nail on the head. If one pill’s not doing it and you don’t take another pill or a third bill, and your sugar stays very high, you’re going to be in trouble eventually.

18:04 Pamela D. Wilson: Okay, we are going to continue our conversation with Dr. Mayer Davidson and the topic of diabetes prevention and management after this break. Please share The Caring Generation with family, friends, co-workers, and everybody that you know so that we can become more informed to avoid surprises about health like we are talking about tonight about diabetes and all the consequences. I’m Pamela D. Wilson, your host, you are listening live, on The Caring Generation on the BBM Global Network Channel 100 and TuneIn Radio. Remember to tune to your favorite podcast sites Apple, Google, Spreaker, Spotify, Pandora, iHeart Radio, Stitcher, Castbox, SoundCloud, and more to listen to replays of this show and all the other past shows. We’ll be right back after the break.

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21:10 Pamela D. Wilson: This is Pamela D Wilson caregiving expert, I’m your host, we’re back to continue our conversation about diabetes prevention and management, with Dr. Mayer Davidson. Dr. Mayer Davidson before the break, we were talking about the measures — the A1c the blood pressure, the bad cholesterol. If somebody has that and is diagnosed and they’re taking pills, how often would they need to come to see you or another doctor to maintain checkups?

21:36 Dr. Mayer Davidson: It depends on what those levels are. Assuming that those levels are in target, they could come every three months, but until they become in target, then they may need to come more frequently, especially in terms of the glucose depending on what the medication is, they may have to come every couple of weeks initially, after that, they can come every month, or two, and eventually, once they get towards the target, they can come every three months.

22:04 Pamela D. Wilson: Does everybody have to do finger sticks? I know people don’t like to be sticking their fingers, but is that an important part of managing diabetes?

22:13 Dr. Mayer Davidson: It’s an extremely important part if a patient is on insulin. The evidence that people who are not on insulin and stick their fingers that that makes much of a difference, it’s not very strong very frankly. But if a patient is on insulin, they have to test their sugars, and they have to do it two to four times a day if they’re on insulin depending on how much insulin they’re taking.

22:37 Pamela D. Wilson: Okay, and I know that people talk about diet a lot as being important in managing diabetes because, as you say, people are overweight. Does insurance cover a meeting with a dietitian or somebody who can help with food recommendations or is that really up to consumers?

22:53 Dr. Mayer Davidson: No, most insurances if you have diabetes, most insurances, will cover it. If you don’t have diabetes, Medicare will cover it and only certain other insurances will–but once diabetes is diagnosed that usually is covered.

23:09 Pamela D. Wilson: Are there foods in particular that are bad for people who have diabetes.

23:15 Dr. Mayer Davidson: There’s been a lot of studies done on which foods are good and which foods are bad? And very frankly it doesn’t make too much difference. The key is, if you’re overweight, or obese, which most people are, you’ve got to eat less calories than you are using up so that you can lose weight. But the amount of protein or the amount of carbohydrate or fat, in the long run, doesn’t really make that much difference. If you have bad cholesterol then eating saturated fat is not so good, but other than that, as long as you’re eating less calories than you’re using up that’s the best thing, as long as you’re overweight, or obese.

23:54 Pamela D. Wilson: And you mentioned that bad cholesterol and blood pressure can be part of this. Is diabetes linked to any other health conditions that listeners should know about?

24:06 Dr. Mayer Davidson: No, not particularly. Once you get diabetes those are the three things you have to worry about more than anything else.

24:17 Pamela D. Wilson: So one thing that I see and that we’ve talked about is consumers a lot of times don’t know what questions they should ask, and sometimes I call it medical speak, it’s just too confusing. What questions should consumers be asking their doctors to learn more about diabetes, to become more educated, and make sure that they follow through with all these treatment recommendations?

24:39 Dr. Mayer Davidson: That’s a good question. I would divide that into two answers. Very importantly, the patient needs to know, and they should ask their doctor about what is my A1c level, what is my blood pressure, and what is my LDL or bad cholesterol, and the doctor telling them what it is and they know that it’s above where it should be. Then that will motivate them to do something about it. The other education part is usually done by nurses – CDEs–there’s something called certified diabetes educators, or nurses because very frankly, doctors are so busy, they don’t have time to sit and spend a lot of time doing the education for diabetes.

25:25 Pamela D. Wilson: You mentioned knowing the blood pressure number. So my common sense would say, “Okay, I need to get a blood pressure cuff and be taking my blood pressure.” But if somebody’s on diabetes medication, do they also need then perhaps blood pressure medication?

25:41 Dr. Mayer Davidson: Yes, definitely. As a matter of fact, about 60 to 80% of people with diabetes have high blood pressure, so they are connected together, and you’ve got to get that blood pressure down to under 140 over 90.

25:57 Pamela D. Wilson: And so then you also mentioned LDL, so I’m assuming then the blood pressure medication doesn’t take care of the cholesterol or they may need something for that too?

26:05 Dr. Mayer Davidson: You’ve got it. Then you’ve got to get that bad cholesterol down, under 100 if you have diabetes, and if you had a heart attack, and have diabetes, you should have to get that bad cholesterol down to less than 70.

26:17 Pamela D. Wilson: So can a primary care doctor manage all this? Or do they need someone like you? Someone with an endocrinology background?

26:25 Dr. Mayer Davidson: Well, the reality is that there are many, many too few, endocrinologists who do this. Ninety percent of patients who have diabetes are taken care of by their primary care doctors. So if the patient will ask for those three things, the A1c the LDL, and the blood pressure that will sort of motivate or encourage the doctor to do something about it, to keep that at the target level.

26:50 Pamela D. Wilson: Okay, and then we got the last problem, which is obesity. What do we do about that?

26:54 Dr. Mayer Davidson: That’s a problem.

26:57 Pamela D. Wilson: Yeah, what do we do about that?

27:00 Dr. Mayer Davidson: Well, I can give you the easy answer, and it’s an accurate answer, but it’s not easy to do. Patients have to eat less calories than they use up, and unfortunately, the quantitative numbers are that you have got to eat 3500 calories less than you use up, and that will lead to one pound of fat being lost, but over time that leads to a lot of weight loss. If people can maintain that 3500 calorie deficit–is what a patient who is overweight or obese needs to eat in order to lose weight.

27:38 Pamela D. Wilson: And probably exercise falls into that equation?

27:42 Dr, Mayer Davidson: Exercise is helpful, but exercise in and of itself has not been associated with much weight loss.

27:48 Pamela D. Wilson: Dr. Mayer Davidson, I thank you so much for joining us tonight… You’ve been awesome. This has been a great discussion. We are going to continue our show after this next break. You are listening to The Caring Generation radio program for caregivers, and aging adults coming to you live from the BBM Global Network Channel 100 and Tune In radio. Please visit my website PamelaDWilson.com for more information for caregivers about all aspects of caregiving including health, well-being. My caregiving library is there. Videos are there for you to watch and a lot of other helpful information. Stay with me and also a reminder, check out podcasts of the show on all of the favorite sites Apple Podcasts, Google Podcasts, Spreaker Spotify, Pandora, iHeart Radio, Stitcher, Castbox Sound Cloud, and more, we will be right back after this break.

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30:56 Pamela D. Wilson: This is Pamela D Wilson caregiving expert, I’m your host for The Caring Generation radio program for caregivers and aging adults coming to you live from the BBM Global Network Channel 100 and Tune In radio, Help, hope and support for caregivers are available on my website, PamelaDWilson.com, in addition to the podcast replays of The Caring Generation, for you to listen to download share and read. When we left off from our first segment, we were talking about what it takes to get our attention so that we are proactive and engaged patients. I know that many of us don’t even consider ourselves as a patient or even caregivers. We simply take care of ourselves, elderly parents, children, and spouses who may have health issues. If you watch the news or read the newspaper, you probably see constant concerns about how expensive healthcare has become about how unaffordable healthcare has become. Do you know why? In part, and I do say in part because there are so many reasons. But one reason is a lack of patient education and engagement. So the conversation that we just had with Dr. Mayer Davidson about diabetes and all the aspects of diabetes–a lot of times all of that information is not discussed. As consumers, we’re responsible for our health and our well-being. We can make a difference in the cost of healthcare by being proactive and asking questions.

32:24 Pamela D. Wilson: It is up to us. A lot of us don’t realize the positive impact that we can have. Because like the subject of caregiving, we really don’t talk about our health until after there is a problem. So many people with diabetes are out there walking around. They don’t even know they have it. It’s much better for us to talk about health and well-being before problems begin rather than after. And as we talk, part of the problem is that the healthcare system doesn’t speak to us in the ways that we understand so that we follow their recommendations. A lot of us will, as Dr. Mayer Davidson said, “Not take the pills because we feel good.” Well, if we don’t follow the recommendations to take care of our health and well-being–our health, the health of an elderly parent, it may get worse. And I can tell you that watching the health of an elderly parent decline results in a lot of stress and a lot of worries plus care costs might increase with more doctor appointments, more medications, hospitalizations, accidents. These are all the things that we want to avoid if we possibly can because honestly, who needs more stress in the life of working and time-stretched caregiver?

33:37 Pamela D. Wilson: How many of you are presently in this situation? Are you wondering what can be done to make it easier, less stressful, and less worrisome? We’re going to continue to talk about these tips to become more engaged and educated patients. If you missed The Caring Generation Radio Program called, “Why Caregiving Takes More than Love,” I suggest going to my website, PamelaDWilson.com, and checking it out. We talked with Dr. Mayer Davidson about the fact that a lot of people with diabetes also have high blood pressure. The show, “Why Caregiving Takes More than Love,” features cardiologist, Dr. Melissa Walton-Shirley. She talks about heart disease prevention and management in very simple terms. It’s another great show to help you be proactive about health and well-being.

34:24 Pamela D. Wilson: So let’s talk about attending regular doctor appointments, and the importance of doing so. If you have diabetes, you have to go to the regular appointments, maybe initially, weekly, every month, every three months. It doesn’t matter if we are young, middle-aged, or elderly, regular checkups are one of the best ways we have to stay healthy, to avoid health problems, and to identify health problems before they get worse. Here’s how to make this easier. If your doctor’s office has a health portal and those are medical terms for a website for the doctor’s practice, where you can sign up, do this. Go online. You can see your medical history, make appointments, communicate with your doctor and the staff in the doctor’s office by email through that portal. There’s usually a program name associated with the portal, it could be MyChart, Advanced MD, NextGen, Chart Perfect. If you don’t know if your doctor has a system, next time you go, ask or pick up the phone and ask, they can send you the login information.

35:25 Pamela D. Wilson: And I know you’re probably thinking, “Ah, one more website where I have to enroll.” This is a good one, though. It can save you time in the long run, and here’s how. So some of these portals allow you to schedule medical appointments online. How many of you hate to call the doctor’s office? You’re put on a long hold, and even worse, you’ve been on hold for two or three minutes, and what happens? You get disconnected and then, you have to call back, and then you’re more frustrated. The same experience might have happened to you if you called the doctor’s office to ask a question, you leave a message on voicemail, nobody ever calls you back. This patient portal online allows you to send emails through this system. You usually get responses in 24 to 48 hours. By enrolling in that portal, you actually spend less time calling your doctor’s office and more time getting the answers that you want.

36:20 Pamela D. Wilson: Another benefit, that portal has all of your medical records, and I know that may not make a lot of sense right now, but you can also go there to request medication refills, another way to avoid more wasted time on the phone, on hold, trading phone calls back and forth. And by having your medical records online, you can choose to make progress in your health, to learn more about your medical diagnosis, to be proactive because as we talked with Dr. Davidson, the only way that we are going to be more proactive about our health is to learn more about our health. The doctors do their part. The rest really is up to us to become engaged and educated. Taking this one step further, what does that mean with regards to a health diagnosis, like heart disease, diabetes, breathing issues, or arthritis, that are common diagnoses that elderly parents have? Which is one of the reasons that we are caregivers today.

37:20 Pamela D. Wilson: As caregivers, we can learn so much by taking care of our elderly parents, our spouses, and our loved ones. What we learn by caring for them, by participating in their health and their care decisions, can really change our lives and our health, and have such a positive impact. But only if we’re willing to learn, engage, become more educated, go to those doctor appointments for ourselves, and for our aging parents, we will have this wonderful opportunity to live a healthier and more active life.

37:54 Pamela D. Wilson: We talked about the benefits of enrolling in that electronic medical portal, what else can be done to make caregiving for elderly parents and helping with healthcare decisions easier? Stay with me, we’ll be talking more about this subject after the break. Please share The Caring Generation Radio Show with family, friends, co-workers, your employers, and everybody that you know. The past show podcasts and the transcripts are on my website at PamelaDWilson.com. You can go to the Media tab and then The Caring Generation Radio Show, and you’ll see all the past programs. There are over 40 million caregivers out there looking for hope, help, and support, and it is all right here on my website, PamelaDWilson.com, and on The Caring Generation every week. This is Pamela D. Wilson, caregiving expert. I’m your host. You’re listening to The Caring Generation live from the BBM Global Network, Channel 100, and Tune In Radio, we’ll be right back after this break.

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41:17 Pamela D. Wilson: This is Pamela D Wilson caregiving expert. I’m your host. You’re listening to The Caring Generation coming to you live from the BBM Global Network Channel, 100 and Tune In radio. We’re back to continue our conversation about what else can be done to make being a caregiver easier when we’re caring for elderly parents, spouses, and loved ones? How many of you have had a bad experience with a doctor or a healthcare provider who seemed not to care? Was impatient with you, was rushed, or didn’t explain information well enough for you to understand the recommendations and the follow-ups? It’s difficult to be engaged when we feel like healthcare providers really don’t care about us. This is where printed information, like parking maps, patient education materials, and other information can be really helpful. Caregivers tell me that sometimes trying to find a doctor’s office that they have never visited can be time-consuming. It can be a hassle. Some doctor’s offices now have parking maps that you can pull off of their website. I know it might sound silly, but how many times have you driven in circles? Trying to find a medical office or even a store, and sometimes you just want to drive away because you’re so frustrated.

42:38 Pamela D. Wilson: A simple map, just as a simple medical brochure, can make all the difference. Some medical offices have patient education brochures about diabetes, about heart disease in the office, or online on the website that you can actually print. Let’s say that you take an elderly parent to a heart doctor, a cardiologist, for a check-up, and you’re having medications reviewed so that you can fill those meds at the pharmacy. What steps can you take to make that appointment go smoother on the day of the appointment? The first step is to make sure your elderly parent is dressed and ready to go when you arrive because you’re probably taking time off work. Backing up that might mean that you call the day before to remind your parent. You might call the day of–two hours before you are picking up your parent. You might even call again when you’re on your way. I know it seems like a lot of steps, but those precautions and planning are better than arriving late and finding your parent, not ready. You’re late for the appointment, and the doctor’s office cancels the appointment on you. Medical offices now have schedules to keep, so that they are more respectful of all patients, even though we wait for hours. If you arrive late, there’s no guarantee that you’ll be seen. Instead, most practices now tell you that you have to reschedule. Let’s think on the bright side. You got to your parents’ home. Mom or dad were ready, you got to the appointment early and you’re sitting in the waiting room.

44:02 Pamela D. Wilson: Information that you want to have with you is a current list of all of mom and dad’s medications and everything that they’re taking over the counter because some supplements react poorly with prescription medications. By having that list in writing, you actually make the time of the medical assistant, who is the person that takes you back to the room more efficient, because they enter this into the computer. Also, if you haven’t prepared a list of questions, the waiting room is a great time to write a list, knowing that probably all you’re going to get is 15 minutes with that doctor. Prioritize the most important questions, the issues, so that if you do run out of time, you have accomplished the reason for the purpose of that visit. Even more important, if you don’t understand a diagnosis like high blood pressure and what that means, diabetes and what that means, high cholesterol, or why a medication is prescribed ask. The medical appointment is the time to ask these questions. If you run out of time, ask who can help you. It might be a nurse in the office. There may be written education materials that you can take with you. There also might be a support group for diabetes, heart disease, high cholesterol, in that medical building, or at another location that you can attend to get additional information.

45:25 Pamela D. Wilson: Remember, the goal here is to become more engaged and more educated so that you can take care of yourself, your elderly parents, and stay more healthy outside of the medical clinic or the doctor’s office. There may be other issues that the healthcare practice might not be able to answer. Caregivers tell me that managing the day-to-day lives of elderly parents is time-consuming and that there are so many other questions. I’ll provide a few suggestions for the other common questions. If you or a parent, are considering moving to a care community — that would be independent living, assisted living, nursing homes, and so on. There is a great Caring Generation program, that aired a couple of weeks ago, it’s called, “What is Assisted Living?” If you’re worried about the cost of paying for care, including costs for doctor appointments, copays, another show called, “The Costs of Caring for Elderly Parents,” is a great show. Both of those are on my website. They’re also on your favorite podcast site. On my website, go to the Media tab and then, the drop-down for The Caring Generation Radio Program, you’ll find the information there.

46:35 Pamela D. Wilson: Care costs are often a worry for family caregivers and for elderly parents. To avoid worry, it’s essential to talk about costs early, before needs arise, so that your family can have a discussion, a non-emotional discussion, and be prepared. None of us like surprises, whether the surprise is a health diagnosis or an unexpected bill. We only like good surprises. Another concern that I hear from family caregivers and elderly adults is about healthcare costs. Like appointment copays, the costs of medical tests, and treatments. You want to know what they are before you have that appointment or test. In many cases, you can call the billing office of your doctor’s office, or contact your insurance company who can tell you. A surprise to so many patients is that the costs of medical treatment differ by treatment location, so one hospital versus another, even by the county where you live. I know it’s probably a surprise. These treatment costs are another reason to become a more engaged and educated patient because maybe you can go to a different clinic and have lower costs. So when in doubt about costs, make sure that you are asking questions. Ask about health diagnosis and preventative actions that you can take to avoid more expensive and unnecessary healthcare needs and treatments in the future. By taking these steps, you take more control over health and well-being, and you leave less up to chance, and less up to the medical system.

48:11 Pamela D. Wilson: Next week, I have another great show for you. Caregivers have asked me to talk about the subject, “what to do when families don’t get along,” and the challenges that caregivers face in relationships with brothers and sisters who may not help with the care of an elderly parent, or other family members who are simply just disagreeable. Attorney, Spencer Crona, joins us on the program to talk about what happens when families disagree and the only remedy is going to court. Mark your calendar and set an alarm on your cellphone to join me live for the program. After this break, I’ll share more practical concerns to mention to healthcare providers that can prevent you or an elderly parent from not receiving the best care possible. Follow me on my Facebook page. It’s PamelaDWilson.page. You are listening to The Caring Generation live from the BBM Global Network, Channel 100, and Tune In radio. We’ll be right back after this break.

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51:28 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host. You’re listening to The Caring Generation radio program for caregivers and aging adults, coming to you live from the BBM Global Network, Channel 100, and Tune In radio. We are back, talking about what event it might take to get our attention so that we pay attention to our care and our well-being? Now, we’re going to talk about what if that might happen — that we need to get help and attention from the healthcare system. We all know that caregivers hesitate to ask for help because, as caregivers, we want to do it all by ourselves. But there are times when we really must ask for help because we don’t have the skills, or we don’t have the information to make a good decision. There might be other complicating factors that we may be too embarrassed to mention. Let me share some of the reasons that family caregivers and elderly adults who are patients, fail to follow through with taking medications, scheduling doctor appointments, or scheduling treatments. These issues are nothing to be embarrassed about. They have to be mentioned so that a solution to the concern can be identified. There are times when two heads are better than one.

52:48 Pamela D. Wilson: Language barriers are a common issue that results in healthcare recommendations not being followed. Let’s say that you or a loved one, don’t speak English as your first language, maybe you speak Spanish, Russian, Chinese, Arabic or another language. If so, trying to understand instructions from a medical provider who speaks English, might feel like it’s an impossible task. Please tell that provider that you don’t understand because your English is not proficient enough so that they can find another way to help you.

53:24 Pamela D. Wilson: Another common concern among working caregivers are you’re worried about job security. You might worry about having to take time off work to care for an elderly parent, to take a parent to a doctor’s appointment, or to even attend a doctor appointment for yourself. Make sure that the doctor knows this is a concern, and that it’s not that you don’t want to attend the appointment, but that you have to talk to your employer to arrange to take time off for that appointment. We have talked before about the additional stress that working caregivers face, more on this subject is discussed in another radio program, it is called Managing Work-Life Balance for Working Caregivers, listen and share the program with your company human resources department or your manager so that there’s a better understanding of the day-to-day challenges that you are facing as a working caregiver.

54:23 Pamela D. Wilson: Many times, we don’t talk about this in the workplace because we’re worried about job security. Worries about being a caregiver and having a job security is a subject that we must be able to talk about. Other concerns to discuss with healthcare providers include issues with transportation and getting to appointments. Maybe your parent doesn’t have transportation. Maybe you don’t have a reliable car. A lack of understanding about a medical condition is another concern. Sometimes we need written instructions that are easy to follow. We talked about before, maps, anything that might make it easier for you as a caregiver of an elderly parent or spouse. It’s important to speak up with the healthcare system, with your doctors, and to make your needs known.

55:15 Pamela D. Wilson: For all caregivers including professional caregivers who work in doctor’s offices, care communities, hospitals, if nobody has told you that you are amazing, or hasn’t thanked you this week for everything that you do or in helping others, I want to  say, thank you. I know that you have such a difficult job out there with the work that you do every day. I’m Pamela D. Wilson, Caregiving Expert. I’m your host. Thank you for joining me on the Caring Generation Radio Program for Caregivers and Aging Adults this week. I look forward to being with you again next Wednesday evening. God bless you all, sleep well tonight and have a fabulous day tomorrow.

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55:55 Announcer: Tune in each week for The Caring Generation with host, Pamela D. Wilson. Come join the conversation and see how Pamela can provide solutions and peace of mind for everyone, here on Pamela D. Wilson’s, The Caring Generation.

Looking For More Help Managing Care for Yourself or Elderly Parents? You’ll find what you are looking for in The Caring Generation® library in the Section called Planning and Prevention.

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