See the article as published in The City Review New Rochelle on Sept 11, 2020.
Too many Americans have experienced less than ideal healthcare in recent months as they work through an overwhelmed system. The elderly need to be especially vigilant and prepared as states reopen and seniors begin seeing their doctors again.
The system’s deficits have proven particularly dangerous for elderly persons of color. The COVID-19 pandemic has both magnified and amplified the impact of racial health disparities on its victims in the U.S. There is less access to quality healthcare in many predominantly Black communities—including, perhaps surprising to some, in more affluent districts. Compounding this, Black people are more likely to suffer from diabetes, hypertension and other underlying conditions that make COVID-19 particularly fatal.
The guidelines outlined here will apply to any senior, whether going to a supposedly ‘routine’ appointment with a doctor or nurse practitioner, or having a procedure done at a doctor’s office or a hospital. Seeking the help of a good care manager can support each of the guidelines below:
• Call a week ahead to find out about the office’s COVID-19 protection protocols.
Ask: Will your temperature be taken and how many people will be allowed in the waiting room? Can a family member, friend or aid accompany you when you see the doctor? Do they have hand sanitizer? Do they enable social distancing? If you are not comfortable with their protocols, can the appointment be converted to a telehealth visit?
• Be sure to wear a surgical mask and take hand sanitizer when you go.
Don’t go solo. If at all possible, have a family member, friend, aide or geriatric care manager accompany you. Inform them beforehand about the topics you want to cover with your doctor. Ask them to make sure your questions are answered.
• Take a ‘self inventory’ prior to your appointment.
Understand how are you feeling emotionally and physically—and don’t neglect emotionally. Recall if there have been changes to your appetite/eating, thirst, weight, sleep, memory/cognition?
• Prepare a checklist of items to discuss—then bring it with you and check off each item.
Keep a diary of all related medical tests, procedures or specialty visits since last appointment. Your main doctor should have the list, but it helps to have your own especially if you saw a doctor who is not in the same system. If you have been to an emergency room since your last visit and/or seen any specialists, make sure to discuss all. If you’ve had x-rays or other tests taken in the interim, make sure your doctor has the results.
• Be on time or early.
There will be forms to complete or vital signs to measure. Bring your insurance card, Medicare card and identification.
• Confirm your ride.
If you’re not driving yourself make sure you have reliable transportation, at least a week before your appointment. This way, if anything changes, you will have time to make alternate arrangements. If you are booking a community or locally provided transportation, follow their reservation rules. Ask about their COVID-19 safety measures.
• Bring a list of medications.
Review the list with your doctor and explain how you are responding to each. The dosage may need to be adjusted or a different medication may be in order. If the doctor recommends a new medication, ask about possible side effects and symptoms.
• Be specific and discuss options.
Ask if there are other courses of treatment. Depending on your condition, ask if changes to diet, additional exercise or holistic options will help.
• Ask about the next steps in treatment at the conclusion of the appointment.
Insist on a timeline, even if somewhat approximate. Schedule as many appointments as possible before leaving.
Always remember to: Be an Informed Patient
Research your health condition and find out about treatments that are considered best practices. If you cannot do this, ask someone to help you. Advocate for Yourself or Take an Advocate with You Do not be afraid to speak up, question and challenge. Share your research and ask you provider to respond. Take someone with you (or dial them in by phone) who can help you advocate for yourself. Speak freely. Don’t worry about taking too much time and don’t hesitate to broach any topics of concern.
Document the advice or direction that your physician gives you in case you want to seek a second opinion. This is also something that a family member, friend or care manager can do for you.
Seek a Second Opinion
If you are unsure about the medical advice you receive, seek a second opinion from another physician. Do not be afraid to seek out a physician with a higher level of cultural competency. Care managers can be especially helpful with this research. There are also community resources that can provide support.
For more information, these resources can help: The National Institutes of Health publishes a worksheet that can help organize conversations with your doctors: https://www.nia.nih.gov/health/discussing– your-concerns-doctorworksheet
Abbe Udochi is the founder and CEO of Concierge Healthcare Consulting, a New Rochelle-based geriatric care management practice.