by Dio - Changing PCP to MCF's visiting doctor

Dio

Just wondering if after placement whether I should sign up with the visiting doctor at the facility. On the one hand, it'll definitely save us the hassle of hauling DH out of the facility to go to his current PCP's office, which is quite far from the facility. Plus, the visiting doctor is closer in proximity and will be more accessible. But our PCP is the best doctor one can ever ask for and has all of DH's medical history. And what about our neurologist and psychiatrist...do they still play a role after placement?

If anyone has experience with this situation, please help shed some light into this. Thanks.

Mint

these are all very good questions. I do not know the answers. Hopefully others with experience in this area will be along. I’m interested in the answers too.

me it's just me

I don't have personal experience with this, but I work at a facility that houses independent living, assisted living, memory care, and skilled nursing residents. What I've observed is that the great majority of people eventually switch to the docs available on-site, and they're happy with them. Are you able to interview any other residents' family members about their opinions of the doctors there? Ask about how often the doctors are there, which hospitals they use, and how easy or difficult it is to get an appointment with the doc when needed. Good luck!

M1

Dio we've done it and it has been fine. But im a doc too, so I have some comfort in overseeing what is going on. My partner has a very complex medical history with a lot of different problems and was formerly seeing an internist, rheumatologist, oncologist, and dermatologist on a regular basis. She no longer sees any of them and would not handle leaving the facility easily. Fortunately her medications are pretty stable. As her dementia has progressed, it's been pretty clear that palliative care is in order. You can always talk about this with his doc that you like so much and see what he thinks, i would encourage you to do that.

harshedbuzz

Dad went into a MCF around stage 6. While he had some significant health conditions- COPD, mild pulmonary fibrosis, T2D, prostate cancer and behavior issues- we decided to try the doctor affiliated with the MCF. It turned out to be the right decision for us. The MCF doc was a geriatric specialist and very familiar with PWD; dad thought highly of him. We also made a decision to move towards a more palliative model of care for the most part.

The MCF also had an affiliated geripsych who took over dad's care. She was initially my first choice for him but wasn't taking private patients at the time. She was great.

The only appointment we went out for was dad's urologist for the twice yearly shots intended to slow down the progression of his prostate cancer. It had been a recurrence and dad was all-in on treatment prior to his diagnosis; mom felt she needed to honor that. I was hoping to avoid fractures caused by bone metastases and that the androgen deprivation therapy would calm down some of his hypersexual talk. We hired medical transport for these appointments because we initially thought he might not cooperate with returning to the MCF.

HB

Beachfan

Prior to placement, DH only saw his PCP every 6 months for a “checkup”. He is physically very healthy, and presently takes no medication. I decided to engage the facility Doctor as our PCP was retiring and the one way hour- long trip for visits wasn’t practical anyway. The facility Doctor visits once a month, which, at DH’s level of progression and physical health, seemed like overkill. I have requested only an annual physical visit and have not scheduled eye or dental appointments since placement; DH is too compromised at this point to participate meaningfully in any appointments or treatments. The nurses at the facility have handled any medical issues that have arisen. DH’s health and non-medicated status made these decisions easier; YMMV. Best of luck going forward.

storycrafter

Great advice and helpful sharing above. Where your loved one is in the journey, and his particular needs, have a bearing on your decision.

The on-site clinic and doctors at my dad's facility were great and worked out well for him. It's worth trying out for sure. You might want to ask about how they handle referrals if the need comes up; how open are they to making them. In my father's case I took note that they were good about referrals to specialists when needed. For a while his eyes needed extra care and he also needed to see a cardiologist/pulmonologist at some point.

The retirement facility had a reliable transportation service and a few times I chose to meet my dad at the specialist's office, or went to his facility and rode along with him to the office, simplifying my having to find and drive my dad to it myself.