Cape Cod's Premier Senior Living Community
(HYANNIS) – Perhaps this is the reason they call doctor’s appointments “exams”: As a patient, to get the best results, you need to do your homework, especially as you age.
There is important information you can bring with you to make a visit to a medical provider more effective and more efficient, said Dr. Arash Tadbiri, MD, a Cape Cod Healthcare specialist in family medicine and geriatrics who practices in Bourne.
Here’s the homework he hopes patients bring with them to appointments:
1. A list of your medications, doses and directions, or better yet, the actual medications.
Older adults can be taking more than a dozen prescribed medications, Dr. Tadbiri said. “What I usually do, is ask them to bring the actual bottles,” he said. “And that’s the time that I really know what medication they are using and what medication they are missing. Sometimes, it’s in the chart from their cardiologist, but when they bring in the bottles, we know they aren’t taking it.”
2. A list of any over-the-counter medicines, supplements and vitamins.
These should be included on your medication list, he said, since they can interact with certain conditions or prescription medications.
3. A list of any medical diagnoses and specialists that you see.
This list should be “active” problems, Dr. Tadbiri said. There’s probably no reason to include the appendectomy you had when you were 16, but you should include the reason for treatment, any upcoming appointments and the doctor’s name, phone and fax number (medical offices communicate via fax). Don’t assume that your primary care physician will have immediate access to your medical records from a different facility or health-care system.
4. A log of anything you’re monitoring at home.
If you take your own blood pressure, or check blood sugar levels, make sure to bring your recent history with you to all appointments.
5. A list of questions.
Write down medical questions as you think of them – keep track in your phone or a small notebook or whatever works for you. Then, take that list with you to the doctor. Don’t rely on your memory, Dr. Tadbiri said. “Patients think about questions, but they don’t write them down and then they come to the office and they don’t know what questions they have.”
6. A second listener.
About a third of older adults take a family member or caretaker with them to doctor’s appointments, and those who took a “visit companion” were more likely to be satisfied with the visit, according to researchers at Johns Hopkins Bloomberg School of Public Health. Taking another active listener, or someone who can answer questions about your health, is important particularly if you have a serious medical condition or have difficulty listening or following instructions, Dr. Tadbiri said. “Somebody from the outside thinks more clearly, especially if it’s a loved one or a person who’s caring for the patient.”
7. Your health-care proxy.
Dr. Tadbiri asks all his patients to supply a health-care proxy, designating someone to make healthcare decisions if they are unable to make decisions for themselves. “Sometimes, people have their friends as their healthcare proxy. They need to document it because, automatically, if something happens, healthcare providers go to the family members.” Choosing the right healthcare proxy is important, he said. Your designated healthcare decision-maker should not only be someone you trust to follow your wishes but also someone who’s likely to be available in case of an emergency, he said. A healthcare proxy is easy to do in Massachusetts; it just requires two witnesses. Keep a copy with you if you have a serious medical condition.
8. A MOLST form or other advanced directive.
Your doctor and your loved ones need to know about your wishes for the end of life. Dr. Tadbiri suggests patients fill out a form called MOLST – Medical Orders for Life-Sustaining Treatment and keep it on file with their doctors and family. This is the paperwork to tell the doctor and your loved ones how you feel about life-sustaining treatments such as cardio-pulmonary resuscitation, intubation (a breathing tube) or feeding tubes. “Healthcare providers should know the patient’s wishes before they become unconscious,” he said.