Selecting a PCP

AConcernedSon

One more question if anyone has ideas. I am trying to find a new geriatric specialist for my LO with dementia to serve as a primary care doc. He is in a memory care facility, but has a variety of medical issues. Just wondering:

1. What KIND of doctors do people use for PCPs 

2. If anyone's in the area South of Boston and knows of a good one, open to recommendations.

John2.0.1

I live about 15-20 miles south of Boston and mom is 5 minutes away at a AL in the memory care unit. (Roughly the Canton area) I can't suggest any specific PCP but have you asked the facility if they have a visiting PCP? While not guaranteed, I'd think that a PCP that makes the rounds at an assisted living/MC would have more than average experience with the health problems of the elderly. Have you asked about that with the facility?

I need to call and talk to the PCP that my mom's place uses. It's close to the top of a long to-do list. If acceptable we will probably make the switch. We recently had what's likely her visit with her long-time PCP in Wellsley and he agrees it probably makes sense.

Thisis just PCP stuff. She still has a neurologist for her Parkinson's. But neurologists are not keen on serving as PCPs and they don't make appointments except for months in advance.

Is your dad (I'm guessing) in the Canton area? If so it might be the same place and we could talk privately.

AConcernedSon

Thanks. He's not in Canton, but further south. The facility he's in has a PCP that visits--that worked for a bit to get him set up there, but I'm just not thrilled with them--spend way too much time trying to get information from the office or nurse. So just looking to make a switch. Like you, it's just one of the things on our long list of things to take care of.

harshedbuzz

ACS-

We went with the affiliated PCP at the MCF.

YMMV, but by the time we placed dad, we were using a mostly palliative approach to care. If dad had been in an earlier stage of dementia when he went to MC, I might have kept his regular doctor. But his PCP was fairly new to him as I moved my parents nearer to me when dad was diagnosed so it wasn't as if he had a long relationship there. 

Getting dad out to see his doctors had become challenging- getting him up and ready, in and out of the car, dealing with falls and him having to wait to be seen became onerous. We did still see his urologist for twice yearly ADT in-office which required hiring medical transport towards the end. 

TBH, I didn't love the way the MCF PCP, set up worked. He didn't have set appointments- per se- so it wasn't like you could be certain you could be there when he showed up. He worked 2 mornings a week at dad's facility, but would circle back in the afternoon if there was an emerging issue for someone. I never met him in person, but my dad liked him. He was a board certified gerontologist. 

HB

MN Chickadee

We switched my mom to the doc who does rounds at her memory care facility and have immensely enjoyed this arrangement. The person has changed once since mom moved there a few years ago but both have been great. The nursing staff has constant communication with the PCP then, they can talk to the doctor each week and she can be seen as often as necessary without having to take her out. When something is going on sometimes she is seen weekly. They do her labs and therapy and everything on site. The first doc was a family practice doc from a local clinic. The one we have now is a Physicians Assistant with extensive experience in elder care. She is with a firm in the metro who specializes in geriatric care and nursing homes. Earlier in the disease I would not have wanted just a family practice doc, but after the move to memory care we got more into the palliative care model as well. This PA who has cared for the elderly in long term care her whole career has been wonderful and the whole thing is so much easier on my mother. While she doesn't have set appointments, I know the morning she comes each week so if my mom is on her schedule I just go during that window and ask if she can be seen first. Sometimes for minor things I don't go since it's all handled. If you don't like the visiting PCP, perhaps find someone else. My experience is it was harder to get in touch with a regular clinic - a constant game of telephone.  It's important to find someone who you can work with and you operate on the same wavelength, whatever that is.

Rescue mom

My mom in a facility used the doc who served that facility. They made regular weekly visits, were in touch with staff regularly and as needed, and were  on board with the special situations presented by patients with dementia serious enough for a facility. What Harshedbuzz and chickadee said.

Stuck in the middle

I used the house doctor with my mother. I didn't like his personality all that much, but he knew his job.

A doctor who is very familiar with the needs of nursing home patients and makes house calls.   What's not to like?

Beats the tar out of taking off work, getting Mama dressed, into a wheelchair, into a car, into a wheelchair, cool heels in waiting room, talk to doctor, into car, into wheelchair, back to room in NH where she would have preferred to stay the whole time.  Not to mention Depends changes.  All to see a gerontologist who told me to not bring her back because he couldn't do any more than the NH house doctor.

AConcernedSon

Thanks all. Appreciate the input, super helpful. Finding these message boards more and more valuable every time I ask a question--sort of feeling less "hung out on my own" little by little. Wish I had gotten on these a long time ago!