Older People: Talking to Doctors : Sensitive Subjects

by National Institute on Aging

(Page 9 of 9)

Feeling unhappy with your doctor - Misunderstandings can come up in any relationship, including between a patient and doctor or the doctor's staff. If you feel uncomfortable with something your doctor or his or her staff has said or done, be direct. For example, if the doctor does not return your telephone calls, you may want to say something like this: "I realize that you care for a lot of patients and are very busy, but I feel frustrated when I have to wait for days for you to return my call. Is there a way we can work together to improve this?"

Being honest is much better for your health than avoiding the doctor. If you have a long-standing relationship with your doctor, working out the problem may be more useful than looking for a new doctor.

Grief, mourning, and depression - As people grow older, they may lose signifi cant people in their lives, including spouses and cherished friends. Or they may have to move away from home or give up favorite activities. A doctor who knows about your losses is better able to understand how you are feeling. He or she can make suggestions that may be helpful to you.

Although it is normal to mourn when you have a loss, later life does not have to be a time of ongoing sadness. If you feel sad all the time or for more than a few weeks, let your doctor know. Also tell your doctor about symptoms such as lack of energy, poor appetite, trouble sleeping, or little interest in life. These could be signs of depression, which is a medical condition.

Depression may be common, especially when people experience losses, but it is also treatable. It should not be considered "normal" at any age. Let your doctor know about your feelings and ask about treatment.

HIV/AIDS - The death of a spouse, divorce, or separation can lead some older people to find themselves dating again and possibly having sex with a new partner. It's a good idea to talk to your doctor about how safe sex can reduce your risk of sexually transmitted diseases such as HIV/AIDS. It's important to practice safe sex, no matter what your age.

Incontinence - Older people sometimes have problems controlling their bladder. This is called urinary incontinence and it can often be treated. Depending on the type of incontinence you have, the doctor may recommend exercises, suggest helpful ways to change your habits, prescribe useful medications, or advise surgery. If you have trouble controlling your bladder or bowels, it is important to let the doctor know. To bring up the topic, you could say something like: "Since my last visit there have been several times that I couldn't control my bladder."

Memory problems - Many older people worry about their ability to think and remember. For most older adults, thinking and memory remain relatively intact in later years. However, if you or your family notice that you are having problems remembering recent events or thinking clearly, let your doctor know. Be specific about the changes you've noticed; for example, you could say: "I've always been able to balance my checkbook without any problems, but lately I'm very confused." Your doctor will probably want you to have a thorough checkup to see what might be causing your symptoms. In many cases, memory problems are caused by conditions such as depression or infection, or they may be a side effect of medication. Sometimes, the problem is Alzheimer's disease (AD). With a careful history, physical exam, medical tests, and tests of memory and problem solving, specialists can diagnose AD with a high degree of accuracy. Determining the cause of memory problems is important to help the doctor, patient, and family choose the best plan of care. Although there is no cure for AD, medicines can help for a while, especially in the early stages of the disease. Medications also can ease serious behavioral symptoms such as agitation, anxiety, and depression. Support groups and education are important and can help patients and caregivers.

Problems with family - Even strong and loving families can have problems, especially under the stress of illness. Although family problems can be painful to discuss, talking about them can help your doctor help you. Your doctor may be able to suggest steps to improve the situation for you and other family members.

If you feel that a family member or caregiver is taking advantage of you or mistreating you, let your doctor know. Some older people are subjected to abuse by family members or others. Abuse can be physical, verbal, psychological, or even financial in nature. Your doctor may be able to provide resources or referrals to other services that can help if you are being mistreated.

Sexuality - Most health professionals now understand that sexuality remains important in later life. If you are not satisfied with your sex life, don't just assume it's due to your age. In addition to talking about age-related changes, you can ask your doctor about the effects of an illness or a disability on sexual function. Also, ask your doctor about the influence medications or surgery may have on your sex life. If you aren't sure how to bring the topic up, try saying: "I have a personal question I would like to ask you..." or "I understand that this condition or medication can affect my body in many ways. Will it affect my sex life at all?"

Who Else Will Help? Involving Your Family and Friends

It can be helpful to take a family member or friend with you when you go to the doctor's office. You may feel more confident if someone else is with you. Also, a relative or friend can help remind you about things you planned to tell or ask the doctor. He or she also can help you remember what the doctor says.

Don't let your companion take too strong a role. The visit is between you and the doctor. You may want some time alone with the doctor to discuss personal matters. If you are alone with the doctor during or right after the physical exam, this might be a good time to raise private concerns. Or, you could ask your family member or friend to stay in the waiting room for part of the appointment. For best results, let your companion know in advance how he or she can be most helpful.

If a relative or friend helps with your care at home, bringing that person along when you visit the doctor may be useful. In addition to the questions you have, your caregiver may have concerns he or she wants to discuss with the doctor. Some things caregivers may find especially helpful to discuss are: what to expect in the future, sources of information and support, community services, and ways they can maintain their own well-being.

Even if a family member or friend can't go with you to your appointment, he or she can still help. For example, the person can serve as your sounding board, helping you practice what you want to say to the doctor before the visit. And after the visit, talking about what the doctor said can remind you of the important points and help you come up with questions to ask next time.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.