With doctor visits getting shorter and shorter, what are the key questions seniors should ask their doctors?
By Deborah Jeanne Sergeant
With electronic medical records, tighter margins for medical practices and a shortage of providers, most doctors cannot offer their patients much time to talk during visits. To get the most out of your visit, plan ahead the questions you should ask. Local experts offered a few ideas.
• “It is very important to make decisions with your doctor. You will benefit most from a treatment if you are involved in making the decision. Ask about different treatment options. Are there any risks associated with the treatment? How soon should the treatment start? How long will it last? What should I do if I feel worse? How much does the treatment cost? Will it be covered by my insurance? Will this treatment be affected by or have an effect on medications I am already taking? What happens if I do nothing? Be an active participant in the final decision, after all: it is your health.”
Jodi Cacciotti, registered nurse and program coordinator at Lifespan, Rochester.
• “Ask about how to decide who’s going to help with their final wishes, a health care proxy.
• “Patients should ask their primary care doctor about future planning. ‘Do you think I should start looking at a nursing home now?’ ‘Help me prepare for the future I’ll have because of this disease.’
• “A lot of older adults take medication for pain. They’re not always open if they cannot afford their medication. Some [medications] they must have, some medication is nice to have and others they can skip if they cannot afford it. We need to know if they cannot afford it. It’s rare for them to say they cannot afford it.
• “Older adults are more stoic about their medical situations. We have to coax them to tell us this information. A part of it is how their parents handled chronic disease.
• “Asking about how their disease will progress in five years and 10 years will make a difference. If you don’t ask you won’t know.
• “I would like my patients to be more open about their incontinence. Older adults don’t bring it up. It is very hard to discuss a topic when the patient doesn’t want to talk about it. It causes major impact on quality of life. It’s very common. The patients — and particularly male patients — are not open about those types of problems. They’re happy to talk about bowels, breathing and chest pain. But incontinence they don’t want t talk about. They probably feel it’s part of getting old and there’s nothing that can be done. Downplaying the problem is a major issue.
• “They also may not want to talk about depression or isolation for the same reason. They’re not willing to seek treatment for it. When they start losing weight, someone else might say, ‘They’re not doing well; what can we do?’ but we can start treatment for depression so much sooner.
Physician Geria Furtuna, who works as geriatrician at University of Rochester Medical Center.
• “’Are there any medications that I am currently prescribed that I do not necessarily need?’ Geriatricians are always thinking about deprescribing and willing to discuss the benefits as well as risks of doing so with you.
• “’Are all of these labs, images, procedures vital to my health goals?’ While it is important to know the benefits of preventative health screening, it is equally important to discuss the necessity and even potential risks associated with screening and testing.
• “’What recommendations do you have to prevent dementia?’ This is a vital topic to geriatricians and something we help manage daily. Every day new research is published regarding both treatment and prevention of dementia. Your geriatrician can help you understand what is being written, said and published while integrating the information with your specific needs.’”
Physician Mary Bonnet, instructor of clinical medicine, URMC, division of geriatrics and aging.