You said what I was avoiding saying, that the ds is asking to be relieved of this duty. 
1 Like
Adding a gerontologist sounds like a good idea. There are differences among them. Sone do make house calls, so ask around. The primary care doc may have suggestions.
1 Like
Doctor kids do get curbsided way too often. I recall hanging out with my kiddo one night many years ago and she heard from a HS friend in the ED with a toddler, a HS friend considering surgical options, and a third one I don’t recall.
It’s a lot, each person had a good reason and she was a good person to bounce ideas off, but it’s a lot. That said DD-MD was immense help when Grandma broke her hip and we needed help having her not discharged too soon for their life setup.
I would not use my MD kiddo if I can help it (note: in our family, her rule is, if you bother her and ask her, then you have to do what she recommends 
)
6 Likes
Depending on the situation, perhaps palliative care services are available? I got that started for my father last year (when he was 98). The physician, who also handles the hospice side of the organization, does house calls every few months. Costs are covered by medicare, but palliative care offers more limited free services than with hospice.
4 Likes
Do you have any ‘urgent care’ places? We have hospital owned ones that are open 7 days a week, typically long hours on M - F and lesser hours on weekends. We see a NP (who is essentially overseen by one MD for all the NPs/sites) - they do a pretty good exam and patient history, order the tests and do interventions like a PCP would do. Shared test results with our PCP/specialists.
We don’t use our PCP’s NP - we do the NP stuff through urgent care. We can set up a time from home - and sometimes they are busy/backed up, but never a very long wait. The longest wait was 1 1/2 hours, but that was with a full waiting room. Shortest wait has been maybe 15 minutes after arrival.
1 Like
Although it sounds horrible to take a 95 year old to urgent care for every complaint, maybe it would make her think twice about all these maladies!
Personally and this is only my opinion, these sound like complaints to get you to pay attention to her. Or a mental health issue or maybe cognitive impairment.
6 Likes
Mom’s current PCP, while not a gerontologist, is who many suggest for the elderly. That said, her PA or NP usually see the sick visits. There is not a great gerontologist in her area. This all said, I am please with her cardiologist, nephrologist (who I also see,) pulmonologist and her PCP practice.
I think my son was cranky when I spoke to him about mom; he is usually open to providing information. As I had a few health issues myself this summer, I think he was just tired of questions. I apologized for bothering him, and explained that not having a husband to run things by, was hard. He understood, but still thought maybe concierge was worth looking into. He is more than happy to review my scans and doctors suggestions; I think he is worried about his grandmother and didn’t want to be the decision maker, which I wasn’t asking for. I was just checking if I had missed something, after all, I did not go to med school, nor do I play a doctor on tv!
Unfortunately mom is not on anti-anxiety medication; tried to get her to do so over a year ago, and filled the Rx, but she refused to take it. I discussed it with her again earlier this week, and she said absolutely not.
She has been a complainer forever, but since I deal with her day to day, I get to hear it the most, as does her sister. Like the boy who cried wolf, it is hard to know it the health complaints are real, or as bad as she makes them sound. She tells me one thing, then 10 minutes later tells her sister a different version. I do think some of this is for attention, but when she calls with this voice that sounds like she is dying, it is hard not to react.
We have done UC a couple of time, and both times got sent to the ER. They don’t love seeing an elderly person with heart or breathing problem. So both times, while I made an appointment with UC and got seen right away, after checking her out, we still got sent to the ER. Then I hear how the UC provider didn’t know what they were doing. There have only been a few doctors she would do whatever they said; they have retired years ago and no one else can hold a candle to any of them according to her.
I hadn’t thought about palliative care; I will have to take a look and see if that would be a good fit for her.
I feel terrible as I sit in her appointments with her, rolling my eyes as she tells the provider something they don’t need to know about, or is untrue. Again, while some of this has gotten worst as she has aged, this has been her MO for as long as I can remember. I knew my dad was a saint to have dealt with her for 70 years, I didn’t realize how much he endured.
4 Likes
General comment for everyone, if it applies …
You can email the doctor’s office with any concerns you don’t want to bring up in front of your loved ones. My sister didn’t want to talk about our mom’s dementia in front of her so I would craft an email the nurse would give to the doctor before the appt so he knew what was really going on. Not everyone has a medical POA or is on a HIPAA form, so this is one way to convey info without putting the doctor in the position of violating patient privacy.
2 Likes
It is helpful to have someone to “run things by,” and not having your H is very tough. I’m so sorry! Sounds like your mom is a complainer and a storyteller and inaccurate historian. This is a tough combo.
Maybe palliative care would be helpful for her. I have no personal experience but they may give her more attention, if that’s something she’s craving.
3 Likes
@snowball I am so sorry. This sounds so difficult.
I really felt that I was being too harsh and I apologize for that. I’m sure you are correct in that your son was having a tough day, we all have those and I’m sure he wants to be helpful. I’m sure that like you, he’s frustrated and feels for you dealing with his grandmother.
I’m sorry she won’t take anti anxiety medication. It seems like it couldn’t hurt.
My mom definitely struggled with anxiety that she didn’t want to admit, it only got worse as she got older.
1 Like
Yes, it seems that whatever people are their age just accentuates it as age reduces whatever filters they had. I’m sorry for those who are struggling to get the support they need.
Not all concierge docs are equal, and one would have to interview to be sure that they get what they expect when they pay for a concierge doc. I know several people who have opted for concierge docs and so far are satisfied enough to stick with them and have paid for several years.
3 Likes
@deb922 You were not harsh at all; I was just explaining myself better, I hope.
My daughter wanted to know if I could switch one of her current pills with the Prozac that was prescribed. As mom only takes a few medications, and needs them all, that wouldn’t work. Now if only there was a way to sneak it in her tea each morning!
2 Likes
What you are doing is really really hard, so please don’t beat yourself up trying to find a way to make it easier when “easy” probably doesn’t exist. I think you are 100% correct that your Mom is going to behave this way because it is her habit. Mine is not a complainer as much as a worrier, and those are hard to mitigate. Urgent Care where we are does what you have described – off to the ER — and the ER is lackadasical at best. I think the truth for most 90+ people in the US is that doctors just aren’t interested. (Gerentologists, a rare find, excepted)
You might trying getting a notebook for one or both of you (and her sister maybe) and tell her you are going to write down the complaints for the next doctor visit. We have had limited success w mine saying “you have an appointment in a few weeks, that’s a good thing to tell the doctor”. Of course, my mom has no sense of time, ymmv.
You are a good daughter and a good mom who has been through a lot. VIrtual hugs, and try to breathe.
7 Likes
I’m not sure what you hope to gain by hiring a concierge doctor.
2 Likes
@thumper1 Again, my understanding of many concierge physicians is to have 24 hour phone access, as well as same day appointments. So lets say mom is worried about her low O2 reading over a couple of hours, shortness of breath, weakness, or increase swelling in her ankles-instead of sending a portal message or phone call to one of her specialists or PCP, to wait hours or longer to get a reply, the concierge theoretically is to answer immediately. They would be the one to tell us whether she can wait to be seen that day or next in the office, or need to head to the ER. I guess you are cutting out the office staff, and getting directly to the physician.
My son’s thought was this would alleviate me second guessing what needs to be done; leaving the decision to a professional.
@greenbutton I notate ever complaint and symptom mom has in my notes app; the list gets longer and longer and is divided by her different specialist, although there is overlap. When I started taking her to visits, it helped to have her insurance info, medication and medical history at my fingertip. Mom is horrible about writing things down, including her grocery list. I recently gave her a small spiral notebook, as the notepads we had in each room wasn’t working. I told her the spiral was for me, but she was to only write in the spiral. This includes groceries, blood pressure readings, things she wants to tell the doctors, etc.. I told her she was no longer to write on anything else; we will see how this goes!
I do feel badly when I treat mom like a child as she is still with it. Of course she forgets things at time, she is 95, but there is no dementia that I am aware of.
3 Likes
Are you thinking your mom would make these calls…or would you still be involved in that part of the decision making. I ask, because it does no good to have this access unless the patient chooses to use it.
1 Like
@thumper1 I hadn’t really thought about who would make the call. I do make all her appointments and take her, but she is capable of making calls herself; any scheduling would need to be done by me so my calendar can be checked. My guess is, I would make the call and give them the short version, then they would have to call her if more information is needed.
Something to think about. Not sure this is something I would invest in, which is why I wanted to see if others had gone this route for themselves or parents. My MIL tried it for a year, but didn’t renew, although I don’t remember the reason.
We had a great geriatrician for mom & dad. She’d do telehealth calls and allow us to conference in extra siblings. She helped coordinate mom’s care. I really liked her. Unfortunately, she’s in a different med center than our internists so for H, we have a different (but highly recommended) geriatrician, who is same med center as our internists.
In the telehealth calls, I could move the tablet around to show mom’s feet and legs and we didn’t have to transport mom anywhere. We didn’t feel a need for any higher about of contact as the geriatrician was good about responding to calls and text messages if we had issues.
So far we’ve been satisfied with our providers and not tempted to go concierge.
1 Like
Remember that she is getting the treatment she is asking for by her actions.
I remember my mom’s last months. My niece called my D, said grandma was acting like a terrorist. I took umbrage with that description because mom was dealing with a lot. Part of me now understands that my mom was acting in a way that was keeping all of us on edge and making all of us doubt what we were doing or saying. Or how we were responding to her. It was a rough time, for her and for us her family.
4 Likes
Some medical insurance plans include access to a 24x7 phone line to talk with nurses etc. Not sure if that is true for medicare programs, but I sometimes recei postcards for the help phone number for my plan.
1 Like