Upcoming Geriatrician Appt; questions to ask?

clever_bear · February 24

My mom has her appt w/ the geriatrician coming up on Wednesday. The day before, I'm scheduled for a phone appointment with a social worker.

I have some general questions, but am wondering either what questions you wish you had asked or what are good questions to ask at a first geriatrician appt? I know primarily the appt with me is to gain information from family to aid in diagnosis, or this is what I'm assuming. I guess I'll find out Tuesday.

1. What is your primary role and how do you fit into my mother's healthcare team?
2. Given her history of depression and anxiety and now possibility dimentia of some kind, should we be looking for a geriatric psychiatrist?
3. It is difficult to travel here as we have no transportation of our own. Is there someone closer who can provide on-going treatment/consultation etc? Or are services available via tele-health even though we are living across state lines?
4. Do you have resources to provide to caregivers?

These are general questions as I know at an initial appt, they are trying to gather information from us and may not have very much specific info to impart about my mom's situation immediately. Please, any advice welcome.

Thanks,

C_B

jfkoc · February 24

Are you going to this new Dr for the possible dementia? If so please google the diagnosis protocol and compare it with what role this Dr has.

Smilescountry · February 24

I think that these are some good questions to get started. Knowing what the geriatrician can do will be helpful information. And I like your question about psychiatric care because that is very difficult to get in many locations. The doctor could do televisits, so that is another good question. Getting resources might be a little more difficult. Hopefully, the social worker can help you with that. If not, it is possible to put together your own care team. Just take it one step at a time. One more idea that might help is to list your concerns on a sheet of paper and give it to the doctor's office a little ahead of time. That way, you won't upset your mother by talking about things in front of the doctor. I do that with both of my parents. I send a concise note of concerns and observations to the doctor through the patient portal, then the doctor discreetly addresses them with my parents. It is so much better than bringing up something in front of them then being chided about it afterwards.

Jeanne C. · February 25

One of the things I like about the practice my husband goes to is that they have geriatric specialists, neurologists, psychiatrists, and social workers. He saw neuro and psych during diagnosis. The social worker provided information on resources available. The geriatric NP is his "day-to-day" provider (and she's amazing).

I would be sure to include resources in the conversation with the social worker. They should be able to pull together good information on what's available for your mom as well as support for you and your family.

I'm glad to hear you have a broad set of providers to access for your mom. Good luck with the appointments.

clever_bear · February 25

https://alzconnected.org/discussion/comment/199550#Comment_199550

clever_bear · February 25

Hi Jeanne C,

I believe that this practice is similar to what you describe. It is a memory specialist clinic that is part of a major state university medical school health system in the midwest. Given that my parents have accessed care via the hospital in our city that is part of that medical school, I believe they received the referral as part of efforts to keep them in the health system instead of considering long-term access to care for them.

Access to services like these makes me lucky indeed. There are many people in the more rural parts of our state that will never see a geriatrician and may never even know that geriatric psychiatrists exist. And even if all we get is information from the appointment, I'm hoping it'll be more than that. Perhaps they are familiar with some of the patches we can use to create our own care team here in our city. Even information will make this appointment a net gain though.

Take care,

C_B

clever_bear · February 25

https://alzconnected.org/discussion/comment/199469#Comment_199469

Based on my own knowledge and previous research alone, I can guess what tests they'll do to diagnose but that doesn't really help answer my bigger questions. Google confirms they will likely do some or all of the following:

-- neuropsych exam

-- physical exam

-- labs: blood work, imaging

-- maybe others

That does not answer what role he takes in her care team. Does he become like primary care, or more of a specialist? Does there clinic actively interface with primary care to aid in treating the whole patient? Generally my understanding is that most geriatrician's are primary care, but there's no way I'm having my mom see a primary care 1.5 hours away when we have no way of getting there regularly. Additionally, everything I'm seeing indicates this may be more of a specialty clinic which certainly is better for our situation. I just want to understand for certain. I hope that helps clarify my question a little more.

clever_bear · February 25

https://alzconnected.org/discussion/comment/199533#Comment_199533

I really like that you've found a way to address concerns with doctor so that he can be st care for your parents. I have parents that are the "don't ask the smart doctors questions" and it's maddening to me. I see doctors as humans who are also fallible.

Also anything to minimize friction between LO and caregiver is a win, especially when it also benefits all involved including the doctor who likely feels good knowing that your parents have someone else also looking out for them.

H1235 · February 27

I’m not sure where you are at with the diagnosis, but here is what I’m thinking. What level of care does the doctor recommend? If she is still driving what do they think of that? How does the doctor feel about the medications she is on and are they being taken at the correct time of day. If she is living with you can she be left alone while you run errands? Is she showering often enough, should she be getting reminders? My mom sees a neurologist that specializes in dementia twice a year and these are the kind of questions we have asked. My mom responds better to restrictions the doctor gives way better than limits or reminders we give her. It’s also reassuring when the doctor confirms our concerns are valid. I agree with giving the doctor a note in advance of the appointment. Some things if brought up at the appointment would just cause our loved one to be upset. I know the last thing I need is more tension between me and my mom.

Upcoming Geriatrician Appt; questions to ask?

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