Nervous about meeting new geriatric specialist

LittleVolcano

Hi All, I'm looking for feedback/advice on the following scenario (and also just getting my thoughts down):

I have a video call with Mom's new geriatric specialist this week to discuss possible SSRIs for helping mom with her general anxiety (Mom's probably in stage 5 and doesn't recognize Dad most of the time which causes her great anxiety, plus we're a pretty anxious family in general). Kaiser didn't want to schedule a separate appointment for me to talk to the geri alone first (Kaiser is a walled fortress) so I'll be pretending that "I" have an appointment with "my" doctor first, then I'll bring Mom into the video call when I'm done giving an overview to the geri doc. I'll take the call in my parents' office, door closed, and hopefully Mom won't be listening (she still knows me and I feel/hope she would be respectful of my privacy). 

I was thinking of holding up a sign for the doc to see saying "I'm going to refer to myself in the first person, but I'm talking about Mom, in case she's listening in" so that I can freely communicate while also not risking triggering Mom. I'm also working on getting a caregiver account with Kaiser so I can hopefully email her doctors (I have to call Member Services to hopefully get permission to do this. Years ago I signed documents with Mom at Kaiser saying I have permission to make health decisions for her, so I'm trying to stay positive that they'll honor that document without too much fuss.)

(1) What do you think of my plan? Any other tips for communicating with a doc with your LO potentially listening in?

(2) What should I tell my Mom that this appointment is for? I think she would be ok with a gentle ribbing (she still has a good sense of humor) that this is an appointment with a geriatric specialist that just wants to make sure that she's healthy and happy (and absolutely no talk about anti-anxiety/depression meds. And the geri doc better have been told by the scheduling nurse that Mom doesn't know she has ALZ, therefore don't bring it up!).

(3) What should I ask/tell the doc in my 1-on-1, before Mom comes on the call? I've got a running list of things to mention (anxiety cuz she doesn't know Dad anymore, calling me up to 60 times a day when she's really upset, list of medications, ask for recommendations like low-dose SSRIs, vitamin-deficiency testing, etc.), but I'm afraid I'll miss something important out of naivete.

(4) How do I stay calm before and during this appointment? The medical stuff drives me crazy, but Dad can't do any of this (Mom hovers him constantly). I just set a reminder to meditate before I head up to my parents' house before the appointment, but feel free to add your tried and true methods of dealing with this stuff calmly.

Anyway, I'm just really worked up about this, so feel free to just jump in with your experiences. I feel a bit scattered. Thanks in advance!!! 

SusanB-dil

Hi LittleVolcano - First calm down, you'll be fine. Looks like you have everything together and already practicing what to say, as if it is public speaking class (like we had in school).

Make sure they honor your paperwork, that they know you are speaking of your mom, and they understand and answer your questions.  For mom - whatever works... some ribbing, making sure she is healthy/happy, or that they need to go over some 'stuff' for insurance purposes, maybe. Might want to speak in the 'we' instead of 'first person', just to mitigate any confusion.

LittleVolcano

Thanks Susan! Instead of first person, I think I'll refer to "A dear friend of mine..." as in "A dear friend of mine doesn't recognize her husband and that makes her anxious." I already feel like I live in Bizarro World with all the fibbing, and I'm not sure my lizard brain could separate what I was saying from reality (as in, it would believe that I don't recognize my own husband anymore, and I just don't need to confuse my brain more than I already do).

And, yes, I'll be fine (I do forget that often, so thanks for the reminder). The calm part? Eh, I give myself an A for effot.

LittleVolcano

Thanks Susan! Instead of first person, I think I'll refer to "A dear friend of mine..." as in "A dear friend of mine doesn't recognize her husband and that makes her anxious." I already feel like I live in Bizarro World with all the fibbing, and I'm not sure my lizard brain could separate what I was saying from reality (as in, it would believe that I don't recognize my own husband anymore, and I just don't need to confuse my brain more than I already do).

And, yes, I'll be fine (I do forget that often, so thanks for the reminder). The calm part? Eh, I give myself an A for effort.

LaurenB

I love and use the phrase "we" a lot of the time.  I also like the idea of referring to a "friend of mine."  I'm sure that the doctor will pick up on this.  As for getting an appointment with just you, but billing it under another's insurance...I can't bill for therapy services if the patient isn't present in my line of work.  Maybe it's the same for the doctors?

LittleVolcano

Hi Lauren,

Mom's PCP (this is at Kaiser) will usually make an appointment with just me if I need to talk to her. As for the new geri specialist, it might just be a case that the first meeting must have Mom present for evaluation. I believe we'll be assigned a social worker as well during the meeting, so I may be able to freely convey messages through her. And I'm still hoping to set up a caregiver account with them in the hopes that I'll be able to email her docs, which appears to be the best way to get hold of them (we can't call the docs directly--we have to send messages through the Kaiser operator--so it's literally a game of telephone and the messages always get screwed up in the process).

I'm feeling a bit calmer this morning (yesterday was a caregiving chaos day), so I'm more optimistic (or at the very least, more relaxed about the whole thing). It's just hard tip-toeing around Mom while also trying to get her the care she needs. The system isn't set up for our situation, and there's so much fear over lawsuits and swindlers that honest people like myself struggle to get what we need.

Anyway, rant over. At 11:30 on Friday, this portion of ongoing stress will be over.

In good news, I'm listening to Atul Gawande's Being Mortal: Medicine and What Matters In the End and it's been really good at helping me refocus my efforts towards Mom's happiness (and Dad's as well, since he's her other co-primary). I just hope that there's something out there that can make her less fearful of Dad ("the stranger"), for both their sake.