 A friend recently sent me a great TED Talk titled: 4 Questions You Should Always Ask Your Doctor (by Dr. Christer Mjaset*). She knew I’d be interested because I speak to community groups about how to talk to your doctor. The 4 questions Dr. Mjaset recommends we ask our doctors are:
These questions work in all sorts of situations:
Your concerns may be medical/clinical (e.g., are there side effects?) or they may be financial (e.g., will my insurance cover it or will I have to pay out of pocket?). While you may not think you can question your doctor’s advice, trust me, you can! Examples:
*Christer Mjåset, M.D. is a neurosurgeon, author, columnist and lecturer who currently works as a Harkness fellow in Health Care Policy and Practice at Harvard T.H. Chan School of Public Health in Boston studying value-based health care models.  Choosing the right health insurance plan can be overwhelming. It may be tempting to just keep the plan you currently have rather than look at spreadsheets and dense, hard-to-decipher descriptions of coverage options. That’s a mistake. Whether you’re over 65 and inundated with advertising about Medicare open enrollment options, getting your insurance through the Marketplace, or working for a company whose annual open enrollment is taking place this fall, it’s imperative that we review our current plan and see what our options are for 2020.  Here are some things to keep in mind regardless of where you get your health insurance:
Medicare Medicare Open Enrollment started October 15 and you can’t watch TV these days without seeing commercial after commercial about different Medicare insurance options. During Medicare Open Enrollment you can:
A few tips:
Health Insurance Marketplace and Employer Health Plans
Bottom line: Be sure you understand your options, get your questions answered, and know your preferences (cost, access, convenience, willingness to accept risk, etc.) before you make a decision. Contact me if I can be of help.  “My doctor put me on XYZ medication? Do you think I should be taking it?” “My 3 year-old has a rash and is throwing up. My doctor said to bring him to the office. What do you think I should do? “My dad sometimes seems confused and sometimes doesn’t. Does he have Alzheimer’s disease?” The above are simplified versions of actual posts I have seen on community Facebook groups. Then 50-100 people respond with their opinion. While these groups are useful for many things, the people responding are not medical experts — and if they are health care professionals, they do not know all the specifics of your situation. If you want credible health information, you need to go to credible health sources to get it. So, what is a “credible health source?” Your doctor. You might not like what your doctor has to say, or you may not feel the information you get from your doctor is complete, easy to understand, or right for you, but your doctor/health care provider should be a credible source of health information. If you don’t feel that way, it may be time to try a new doctor. SOME sites on the Internet. Not all. How do you know the difference?
 This Chicago Tribune article perfectly captures the spirit of a program psychotherapist Allison List Hutner and I have been facilitating. Please contact me if you’d like to learn more about the program or have us facilitate a session for your organization, book club, family, or friends. You can also participate in this program at the Vernon Area Library on Wednesday, October 2 at 7:30pm (register here) or the North Suburban YMCA on Thursday, November 7th at 11:15am (register here).
Read the entire article here.  I recently came across two important articles for older adults and wanted to share them with you.
This article provides an excellent framework for having an honest, helpful discussion with your surgeon before deciding whether to have surgery. It provides questions that really address and explore a patient’s values about quality of life. I encourage you to take a few minutes to read it. Did you know that many regularly used medications can cause confusion in older adults? Be sure to read this article to learn more about anticholinergic drugs (eg, antihistamines) and how they can be harmful. Searching the Beers list for potentially inappropriate medications use in older adults is also a must; if you see medications on the list that you or a family member is taking, don’t hesitate to ask your doctor about it.
First, it can be confusing when people talk about Alzheimer’s and dementia. Are they the same disease? Dementia is an umbrella term that includes Alzheimer’s disease, vascular dementia, Lewy body dementia, mixed dementias, and frontotemporal degeneration. Alzheimer’s disease is the most common form of dementia. If you're concerned about yourself or a loved one, be sure to consult with a health care professional.
Wondering what signs and symptoms you should be concerned about versus what is considered “normal aging?” Here is a link to 10 early warning signs to watch out for, courtesy of the Alzheimer’s Association. Symptoms can range from frustrating, difficult to manage, or harmful for the person as well as for family members and friends. For example, hearing someone tell the same story over and over can be frustrating but it’s not harmful; however, wandering off in the middle of night can be extremely dangerous and needs to be addressed appropriately. This article has a lot of detail about symptoms, stages of the disease, and coping tips. Caregiving is tough as well as rewarding. An important message caregivers will hear, regardless of the illness, is that self-care is critical. A wise person once told me, during a health crisis, to remember what we hear every time we go on an airplane: you have to put your own oxygen mask on before helping someone else put their’s on. In other words, if you can’t breathe, you can’t help somebody else breathe. Look for local caregiver support groups, find someone to give you a break so you can run errands, exercise, have dinner with a friend, or do whatever reenergizes you. If you are caring for someone with Alzheimer’s or a related dementia, take time to learn tips and techniques for maximizing cognitive symptoms, engaging the person in meaningful activities, and having a person-centered care mindset. Techniques for caring for and helping someone maximize their cognitive function include:
There are options for getting help with caring with someone with Alzheimer’s or related dementias including in-home caregiving, adult day care, respite care, and memory care communities. Don’t feel like you have to do it alone. Search for options that work for you and your loved one. These can be expensive options but there may be programs in your area that provide free or reduced services depending on financial need, veteran status, or other factors. If you’re considering placing your loved one in a memory care community, here are some questions to ask when touring the communities. If you have long term care insurance, be sure to know what services and options are covered. Usually, someone with Alzheimer’s or related dementias will need to provide evidence that (1) they have severe cognitive impairment, and (2) they need substantial assistance with at least 2 activities of daily living (ADLs) such as bathing, eating, dressing, and transferring. Read your policy ahead of time and be sure to work with your physician to document these needs appropriately. If you’ve been reading my blog, you know I often talk about the need for advance care planning, making your end-of-life wishes known to family members. It is critical to have these conversations and have documents in place before a person’s Alzheimers or other dementia gets too advanced and they no longer have the capacity to make these decisions. You don’t want to find yourself in a situation where you are wondering what your loved one would have wanted you to do. Find resources here.
child is still on your health insurance plan. Please refer to this article with advice from a lawyer about what forms - and an explanation of each form - you should have your 18+ year-olds sign. You can complete these forms on your own or meet with an estate planning attorney. (Special thanks to Emily Rozwadowski of Spencer & Rozwadowski, LLP for reviewing this information.)
Briefly, the four important documents are:
Once you’ve filled out the forms, keep them in a secure place. Also, be sure to scan them so you can easily access them from your phone as well as from your child’s phone. So, while you’re checking towels, sheets, comforter, etc off of your college packing/to do list this summer, please add “fill out important forms!” Disclaimer: this blog does not constitute legal advice. If you have specific questions about what forms to use or how to fill them out, please contact an estate planning attorney.
I recently became intrigued with a program known as Death Over Dinner. No, it’s not a murder mystery party. And it’s not as depressing or morbid as the title may suggest. It’s also not just for older people.
Last week, I facilitated this program with an amazing group of women in their 40s and 50s. Many of them were hesitant and skeptical ahead of time. We discussed deep, important topics. “if you had an hour left, what would you feel was unresolved?” A discussion on what we would say if we had to give our own eulogy. And more. Some of the comments after the program included “that was so worthwhile” “can we do this again?” “this was hard, thought provoking and inspiring.” “I felt exhausted when I got here but energized when I left.” The long term goals of the program are multi-fold:
My colleague (and traveling Medicare-certified social worker), Allison List, LCSW, and I will be facilitating this program at the Vernon Area Library and the North Suburban YMCA this fall (click here for program dates), and are talking with several other organizations. If you’d like us to facilitate a program at your organization or for your family/friends, please contact me. Resources to help you start the conversation… and fill out your advance directives: The Conversation Project The Five Wishes State-specific Advance Planning Forms from the American Bar Association  I recently led an engaging and informative talk about “Talking With Your Doctor: Making the Most of Your 15 Minute Appointment.” I’ve always believed that most of the problems people experience with navigating the health care system are a result of poor communication and coordination. It can be difficult to question providers, know what to ask, and be able to process the information. It is especially challenging to do so when you are emotionally overwhelmed by the situation.
The most important advice is to Speak Up and Ask Questions! It’s your health, so take charge of it. If you don’t understand what the doctor is telling you, ask them to repeat it. Ask questions about medical tests, medications, your diagnosis, treatment options. Speak up about your symptoms, your needs, your values. Prepare for your appointment as if it’s a business meeting - have an agenda, put your priority items first in case you run out of time, and end the appointment with a clear understanding of what was accomplished and an action plan for next steps. This brochure about Talking With Your Doctor, from the National Institute on Aging is a great resource for people of all ages about how to prepare for and get the most out of appointments with your doctors. It’s filled with advice, tips, and worksheets. I strongly recommend taking time to look at it and using it to prepare for your next appointment. Ask me how I can help with your patient-doctor communication… or to schedule a presentation for your organization.  A couple of weeks ago, I was prescribed a new medication... that had a hefty price tag! My first question was “what’s the cash price?” When that wasn’t any cheaper, I checked with the pharmacy tech about the coupon from the drug manufacturer’s website (apologies to everyone behind me in line at my local pharmacy). I ended up leaving the prescription at the pharmacy and went home to look into more options. What can you do to lower your prescription costs if a medication you need isn’t covered by your health insurance?
So, what did I do about my medication? Well, in my case, the GoodRx price was only a few dollars less, there were no substantive coupons available for this particular medication, and the pharmaceutical assistance program was income-based. My doctor gave me free samples while we work together to request an exception from my health insurer. It’s a long shot but it’s worth a try because if you don’t ask, then the answer is definitely no. |
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