Being prepared when accompanying your loved one for the first time to a Dr’s appointment is essential to a successful examination. This is especially true when symptoms of memory impairment are involved. Going unprepared will leave all parties with unanswered questions and will likely require an additional visit.
Everyone knows that doctors are very busy and once you’re in the examination room, things can go really quick if you are not prepared. Being prepared just makes sense if you want to take advantage of the time you have with the doctor and to help them make an accurate assessment.
Here are my top 6 ways you can prepare:
1. Ensure that you have access to your loved one’s medical records
A lot of people don’t understand the government’s rules regarding patient privacy (you can research HIPAA for more information). They assume they can’t see a loved one’s medical records, or even worse the doctor’s office is confused by the rules and won’t share with a caregiver. According to the U.S. Department of Health & Human Services website (link at bottom of page), “if you (the patient) don’t object, a health care provider or health plan may share relevant information with family members or friends involved in your health care or payment for your health care in certain circumstances”.
Go to the link provided at the bottom of the article and print the pdf. It couldn’t hurt to have this in your hands.
With this understanding, talk to your loved one and explain your intentions so that there is a mutual agreement. Then, contact the doctor’s office and tell them your intentions. Make sure that there is a clear understanding of each other’s expectations. Ask if they have a HIPAA waiver form. If so, get a copy and share with your loved one.
2. Create list of current medications
This is very important because a lot of drugs have side-effects that include memory impairment. We would all like to think that the doctor should already have this information but they can’t possibly know if we’ve been to another doctor or what over-the-counter medications we might be taking. With your loved one, review all medications including prescription, over-the-counter, herbal remedies, crèmes, and supplements. Properly dispose of any old prescriptions or expired medications. Doing this together will help you to understand what medications your loved one is taking. After all, from now on, it’s your responsibility.
To get started, you may want to read my article about medications: Medication Management: A Caregiver’s Responsibility.
You will then be prepare to use this form by the FDA to itemize your loved one’s medications:
My Medicine Record
3. Complete a Cognitive Questionnaire
There’s a reason you suspect that your loved one has something wrong so let’s get the details on paper. There are simple and brief questionnaires that will get you thinking about symptoms. This will help you accurately answer the doctor when asked about symptoms and their frequency.
I recommend using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) screening test. This test is available in both a short (16 questions) and a long (26 questions) format. To complete this test, you remember how your loved one was 10 years ago. You then compare that to how they are today. It’s a very straight forward test and you can find it here: IQCODE.
Remember: In-home testing is not a substitute for professional medical advice!
4. Family History
This is a good excuse to get your family involved, and believe me, if you don’t get them involved, you’ll likely hear about it later. Do your best to put together a family medical history. Over the years, this will benefit everyone in the family.
To help you think about ways to gather your family history, I recommend you read this article from the Centers for Disease Control and Prevention: Family Health History: The Basics.
You should then print this worksheet that I have created for you to input the information: Family Medical History.
If you are bold and want to try an automated system from the Surgeon General, then you should check this out: My Family Health Portrait.
I must caveat that I have not used this system.
5. Prepare a list of Questions for the Doctor
Your mind is racing and you probably think of questions all the time. So as questions come up, jot them down. Don’t fool yourself that you will remember. You are under a lot of stress so you need to take notes as you can. If you have time, try to get answers prior to the Doctors visit, so that you can get more from your conversation with the doctor.
6. Schedule an Appointment with the Primary Doctor
Seems obvious, huh? Well, it had to be said. You can’t assume that your loved one will schedule the appointment so don’t procrastinate any longer – go make an appointment right now! You can’t keep putting things off. Otherwise you are going to drive yourself crazy with worry.
Understand that the doctor is unlikely to make a complete diagnosis at this visit. If the doctor suspects dementia in any form including Alzheimer’s, your loved one will probably be referred to a specialist. This specialist will likely subject your loved one to more detailed questionnaires (tests) and possibly brain imaging.
And as suggested above, use this link to get more information about patient privacy: HIPAA – U.S. Department of Health & Human Services
Please check out my Talking with Your Doctor resource for additional information.
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So, what do you think about this list? Are there things you would include or exclude? In the comments below,I would love to hear any input or experiences that you may have.
I received this really great advice today from a caregiver who has been through this so I wanted to share: “One thing that I have done is to always take a single notebook to every medical appointment to log each visit chronologically for my husband. Most important to WRITE EVERYTHING DOWN.
In fact, I would suggest a little different approach based on my experience. Had I known how involved as far as the number of different medical people involved, this is what I would do. In a notebook — probably loose leaf — have a master page that logged each medical appointment by date and doctor. Then make a separate section in the notebook for each doctor or facility to log all the details of each visit or event. In addition, have a section that would record all meds and changes of strength and frequency of taking, etc. There would also be a section to include the paper work or copies of the 6 Steps.”