Based on content from the NIH/National Institute on Aging publication, “Talking With Your Doctor: A Guide For Older People.”
People benefit most from medical treatments when they know what is happening and they are involved in making decisions.
Here are some suggestions to make sure that you understand what your course of treatment involves and what it will or will not do.
Ask for It in Writing
Have the doctor give you directions in writing and feel free to ask questions. For example: “What are the pros and cons of having surgery at this stage?” or “Do I have any other choices?”
The doctor can work with you to develop a treatment plan that meets your needs. If your doctor suggests a treatment that makes you uncomfortable, ask if there are other treatments that might work. If cost is a concern, ask the doctor if less expensive choices are available.
Here are some things to remember when deciding on a treatment:
- Discuss choices. There are different ways to manage many health conditions, especially chronic conditions like high blood pressure and cholesterol. Ask what your options are.
- Discuss risks and benefits. Once you know your options, ask about the pros and cons of each one. Find out what side effects might occur, how long the treatment would continue, and how likely it is that the treatment will work for you.
- Consider your own values and circumstances. When thinking about the pros and cons of a treatment, don’t forget to consider its impact on your overall life.
For instance, will one of the side effects interfere with a regular activity that means a lot to you? Is one treatment choice expensive and not covered by your insurance? Doctors need to know about these practical matters and can work with you to develop a treatment plan that meets your needs.
Ask About Prevention
Doctors and other health professionals may suggest you change your diet, activity level or other aspects of your life to help you deal with medical conditions. Research has shown that these changes, particularly an increase in exercise, have positive effects on overall health.
Until recently, preventing disease in older people received little attention. But things are changing. We now know that it’s never too late to stop smoking, improve your diet or start exercising. Getting regular checkups and seeing other health professionals, like dentists and eye specialists, helps promote good health. Even people who have chronic diseases, like arthritis or diabetes, can prevent further disability and, in some cases, control the progress of the disease.
If a certain disease or health condition runs in your family, ask your doctor if there are steps you can take to help prevent it. If you have a chronic condition, ask how you can manage it and if there are things you can do to prevent it from getting worse. If you want to discuss health and disease prevention with your doctor, say so when you make your next appointment. This lets the doctor plan to spend more time with you.
It is just as important to talk with your doctor about lifestyle changes as it is to talk about treatment. For example: “I know that you’ve told me to eat more dairy products, but they really disagree with me. Is there something else I could eat instead?” or “Maybe an exercise class would help, but I have no way to get to the senior center. Is there something else you could suggest?”
Just as with treatments, consider all the alternatives, look at pros and cons, and remember to take into account your own point of view. Tell your doctor if you feel his or her suggestions won’t work for you and explain why. Keep talking with your doctor to come up with a plan that works.
Working With Specialists
Your doctor may send you to a specialist for further evaluation, or you may request to see a specialist yourself. It’s likely that your insurance plan will require you to have a referral from your primary doctor.
A visit to the specialist may be short. Often, the specialist already has seen your medical records or test results and is familiar with your case. If you are unclear about what the specialist tells you, ask questions.
For example, if the specialist says that you have a medical condition that you aren’t familiar with, you may want to say something like: “I don’t know very much about that condition. Could you explain what it is and how it might affect me?” or “I’ve heard that is a painful problem. What can be done to prevent or manage the pain?”
You also may ask for written materials to read, or you can call your primary doctor to clarify anything you haven’t understood.
Ask the specialist to send information about any further diagnosis or treatment to your primary doctor. This allows your primary doctor to keep track of your medical care. You also should let your primary doctor know at your next visit how well any treatments or medications the specialist recommended are working.
Questions to ask your specialist:
- What is your diagnosis?
- What treatment do you recommend? How soon do I need to begin the new treatment?
- Will you discuss my care with my primary doctor?
If You Need to Have Surgery
In some cases, surgery may be the best treatment for your condition. If so, your doctor will refer you to a surgeon. Knowing more about the operation will help you make an informed decision about how to proceed. It also will help you get ready for the surgery, which makes for a better recovery.
Ask the surgeon to explain what will be done during the operation and what reading material, videotapes or websites you can look at before the operation.
Find out if you will have to stay overnight in the hospital or if the surgery can be done on an outpatient basis. Will you need someone to drive you home? Minor surgeries that don’t require an overnight stay can sometimes be done at medical centers called ambulatory surgical centers.
Questions to ask your surgeon:
- What is the success rate of the operation? How many of these operations have you done successfully?
- What problems occur with this surgery? What kind of pain or discomfort can I expect?
- What kind of anesthesia will I have? Are there any risks associated with it for older people?
- Will I have to stay in the hospital overnight? How long is recovery expected to take? What does it involve? When can I get back to my normal routine?
If You Are Hospitalized
If you have to go to the hospital, some extra guidelines may help you. First, most hospitals have a daily schedule. Knowing the hospital routine can make your stay more comfortable. Find out how much choice you have about your daily routine and express any preferences you have about your schedule. Doctors generally visit patients during specific times each day. Find out when the doctor is likely to visit so you can have your questions ready.
In the hospital, your primary doctor and various medical specialists, as well as nurses and other health professionals, may examine you.
If you are in a teaching hospital, doctors-in-training known as medical students, interns, residents or fellows, also may examine you. Many of these doctors-in-training already have a lot of knowledge and experience. They may be able to take more time to talk with you than other staff. Nurses also can be an important source of information, especially since you will see them often.
Questions to ask medical staff in the hospital:
- How long can I expect to be in the hospital?
- When will I see my doctor? What doctors and health professionals will I see?
- What is the daily routine in this part of the hospital?
If You Go to the Emergency Room
A visit to the emergency room can be stressful. It may go more smoothly if you can take along the following items:
- Your health insurance card or policy number.
- A list of your medications.
- A list of your medical problems.
- The names and phone numbers of your doctor and one or two family members or close friends.
Some people find it helpful to keep this information on a card in their wallet or purse at all times.
Depending on the problem, you may have a long wait in the emergency room. Consider taking things to make the wait more comfortable, like something to read or a sweater in case the room is cold.
While in the emergency room, ask questions if you don’t understand tests or procedures that are being done. Before leaving, make sure you understand what the doctor told you or ask for written instructions. For example, if you have bandages that need changing, be sure you understand how and when it should be done. Tell your primary doctor as soon as possible about your visit to the emergency room.
Questions to ask medical staff in the emergency room:
- Will you talk to my primary doctor about my care?
- Do I need to arrange any further care?
- May I get instructions for further care in writing?
- Is there someone here who speaks my language and can explain the instructions?
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