Q. My sister and I are constantly taking my 86-year-old mother to the doctor for her real and/or imagined problems and the doctor will make suggestions or prescribe treatments. She either disagrees with what the doctor says and requests to see a different doctor, or decides that she doesn’t want to do the treatment or take the medicine. How do we get her to comply with what the doctors prescribe?
Debra B., New York
A: This sounds like a very frustrating situation for everyone concerned: you and your sister, your mother and her physician. In the meantime, her medical complaint — whether real or imagined — is not being properly addressed.
You didn’t indicate whether this is a relatively new behavior and whether it is confined to accepting advice from physicians. But, it is clearly exposing her to more serious health consequences and you are right to be concerned.
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For advice from an expert in these situations, I contacted Dr. David Bernstein, a geriatrician in Clearwater, who has spent more than three decades treating aging patients. He is the author of an excellent book on aging called I’ve Got Some Good News and Some Bad News: You’re Old.
Here’s his advice: “Going from one doctor to the next is a form of doctor shopping and the family should at least try to discourage this behavior. The patient/mother should commit to trusting one of her physicians. If she is not doctor shopping, the children could encourage her to see a geriatrician — if there is one locally — whom she will commit to trust. Alternatively, have her choose just one physician to act as quarterback of her healthcare, for the sake of continuity of care.”
Dr. Bernstein also stressed how important it is for family members to forge a strong alliance with the physician and his nursing staff.
“If she has a trusted physician, I recommend the children (within the confines of privacy guidelines) develop a rapport with the doctor, as well as with his/her nurse. Request to have a contact person at the office to share their concerns prior to the patient’s visit. The family might even be able to provide suggestions of possible solutions to the issue at hand. This could help prepare the physician to present his treatment options in a way that would be convincing enough to get the parent to comply.”
These steps might be just what’s needed to put enough pressure on your mother to comply with her doctor’s recommendations.
Recommended reading: For guidance on what seniors should expect from their physicians, Dr. Bernstein offers wise advice that’s succinctly compiled in a five letter acronym, Q.U.I.L.L. It’s his “special recipe” for caring for his aging patients. You can find this on his website, www.davidbernsteinmd.com.
Nancy Stein, Ph.D., is the founder of SeniorityMatters.com, a local caregiver advisory and referral service for South Florida seniors and their families. You can contact her at nancy@ senioritymatters.com.