A frequent problem expressed among family caregivers is that their aging loved ones aren’t honest with their doctors. At home, they may gripe about intense pain, struggle to complete activities of daily living independently, or exhibit memory problems that lead to unfair accusations, but the moment they sit down in a doctor’s office, a change occurs. Like an actor on stage, the patient becomes animated and charming and has no complaints to report to their physician. What gives?
Why Do Seniors Mislead Their Physicians?
While the reasons for a senior not being honest with their doctor are often multifaceted and difficult to pinpoint, fear, denial and a phenomenon called “showtiming” are usually to blame.
One reason our elders put on such a show for medical professionals is because they are afraid. They don’t want to face the reality of a bad check-up or a new diagnosis for many reasons. Hearing that one has heart disease, cancer, Parkinson’s disease or some form of dementia is devastating enough. But one of the most frightening consequences of such a diagnosis is a looming loss of independence. So, they put on their company manners, fail to mention or downplay their symptoms, and tell the doctor whatever sounds best in order to get out of there with the cleanest bill of health possible.
Fear of embarrassment is also a powerful motivator. Research has shown that people of all ages hesitate to share complete details relevant to their health with their physicians out of fear of judgment and/or embarrassment. Seniors avoid divulging information that makes it seem as if they are physically frail or exercising poor judgement.
Denial is a natural and powerful tool for humans. It often helps us get through difficult situations until we can emotionally wrap our heads around an issue and tackle it. In the case of our aging loved ones, when they come home from a doctor’s visit without any major developments, they’ve dodged a bullet. Whether or not it is a conscious attempt, many seniors gather and direct all their effort into that one appointment, and it’s often enough to convince a doctor or other professional who isn’t privy to their daily behaviors and routines that all is well. It also doesn’t help that healthcare providers are pressed for time and cut appointments increasingly short these days.
- Dementia and Showtiming
Piggybacking off fear and denial, dementia can seriously complicate doctor’s appointments, leaving family caregivers utterly flummoxed and frustrated. Seniors in the early and middle stages of dementia sometimes use all their energy and what remains of their faculties to put on a rather convincing performance that they are fully alert and lucid. This phenomenon is commonly referred to as “showtiming.”
Tips for Talking to Your Parent’s Doctor
Fortunately, there are some tips and tricks that family caregivers can use to ensure doctors are well-informed while their loved ones’ dignity remains intact. Start with the following strategies, but keep in mind that effective tactics will vary depending on a senior’s personality and medical concerns.
- Get Proper Authorizations
Keep in mind that you’ll need the proper HIPAA authorization and a valid medical power of attorney (POA) document to have a comprehensive discussion about a loved one’s condition and medical care.
- Talk With Your Loved One Ahead of Time
Encourage them to be honest and forthcoming.
- Identify Your Role as an Advocate
Remind your loved one that you are on their side and that their safety and health are your number one priority.
- Send Documentation
Another option for communicating with the doctor is to write and send them a letter or email ahead of the appointment noting your concerns. This way, the doctor is prepared with the facts when you see them.
- Keep a Diary of Observations
Consider attaching the notes that you’ve kept over a week or two to your letter that indicates the dates and times of new or worsening behaviors or health issues that concern you. Again, this will enable you to share detailed information with the doctor without blatantly contradicting or embarrassing your loved one during the appointment.
- Bring a Medication List
Make a complete list of every prescription, over-the-counter medication, herbal supplement and vitamin your loved one takes, including dosages.
- Keep Your Parent Involved
Medical professionals are notoriously busy, but during the visit, make sure the doctor interacts with your loved one. Some physicians will look over their notes and then speak directly to the family caregivers, since it’s faster and easier to get straight answers to questions. However, you are there to support your loved one, take notes and contribute to the improvement of their care plan. Taking over the appointment will only build resentment and cause your loved one to shut down further. Yes, in some cases where an elder is no longer capable of communicating with the physician, their caregiver must take a more active role in appointments. Nevertheless, a senior still deserves the dignity of being treated as an adult patient and participating in their own care as much as possible, no matter how confusing or childish their behavior may sometimes be.