Arlette Adams didn’t waste time when she felt that her family doctor wasn’t properly addressing the bouts of dizziness she was experiencing.
At a nutritionist’s appointment days later, the 82-year-old Torontonian was told the symptoms were likely caused by a lack of water intake. She immediately started drinking more water.
”Within three days, the feeling of dizziness was gone,” she recalls. “I thought: ‘A doctor couldn’t have told me that?’”
She has since switched to a new family doctor who has been more supportive and attentive.
”If you’re not happy – you just have to do that,” she says of the change.
Seniors like Ms. Adams are realizing the value of advocating for their health, instead of brushing off symptoms as standard with age. Too often, seniors don’t realize that because of vision, hearing or cognitive issues, they’re at the highest risk of adverse drug reactions, medication mix-ups and simply not having their health issues addressed.
Some find it difficult to articulate their health concerns to their family doctors or are afraid to question authority, says Paige Lennox, chief executive officer of Nelson, B.C.-based Canadian Health Advocates Inc. “This generation still puts physicians on a pedestal,” says Ms. Lennox, who started her medical concierge service in 2018 after working as a critical care nurse for 25 years.
She says some seniors also don’t know what medications they’re on or understand their side effects.
Some seniors also feel the time crunch of shorter medical appointments, says Samir Sinha, a geriatrician and director of Health Policy Research and co-chair of Toronto’s Ryerson University’s National Institute on Ageing. They may feel pressure to oversimplify their symptoms, which can result in leaving out important information.
”We’re used to going to a primary care provider who basically says: ‘One issue per visit.’ What do you bring up?” he says.
Hasty visits can also mean that older patients fail to disclose all of the drugs they’re taking.
It’s an issue, given that seniors are the heaviest users of prescription drugs. On average, two-thirds take five or more prescription drugs over a year and one-quarter take 10 or more, according to a 2017 study by the Institute for Research on Public Policy. This puts 1.1 million frail older adults at risk of adverse drug reactions, according to the Canadian Frailty Network.
Some seniors also have concurrent chronic health issues. Approximately 37 per cent of Canadian seniors’ report having at least two of the 10 common chronic diseases, according to “conservative” estimates from Ottawa’s 2017–2018 Canadian Community Health Survey.
“Older people have lots going on at the same time,” Dr. Sinha says.
He suggests retirees, with the support of family members or friends as needed, prepare for their doctor appointment well in advance to prevent potential health issues from being missed.
”Document all of the information you can – bring your medication list, past medical history, as well as symptoms,” Dr. Sinha says. “Write out questions and concerns – and identify what the priority is. It allows them to be heard and how each issue will be tackled.”
He also recommends printing out test results and other reports from medical labs, clinics and hospital websites as well as a list of prescriptions to give doctors the full picture of your health.
Some seniors may also wish to bring a family member or friend to the appointment, to avoid potential miscommunication, Ms. Lennox says. The third party can also ask more probing questions, write down the doctor’s guidance, and mention any missed points.
“When people are feeling unwell, they’re really vulnerable,” she says. “And you’re also not going to retain everything.”
Dr. Sinha says people receiving home care may want to bring that person to their appointment as well.
“That can prevent a lot of broken telephone,” he says, given that the caregiver is often most familiar with their patient’s symptoms and medications.
For people with cognitive impairments, he says it’s critical to have a trusted family member or patient advocate who can reliably fill the doctor in on what’s been going on.
To prevent white-coat syndrome, which occurs when your blood pressure rises due to anxiety in the presence of a doctor, Dr. Sinha suggests taking your blood pressure at home for a week or more ahead of a doctor’s appointment and writing it down to potentially provide to the physician.
“Often the patients are nervous or they’re worried about what’s going to happen, so their blood pressure is always high,” he says.
By providing the at-home reading, he says doctors can have a more accurate record of their patient’s blood pressure in a more-calming home environment. The past results will also help ensure the doctor prescribes the proper medication.
For people dealing with two or more chronic conditions, Ms. Lennox suggests booking two medical visits instead of one. It gives them time to discuss multiple issues without feeling the time pressure.
Ms. Lennox also suggests being persistent if your medical concerns haven’t been addressed or your doctor brushes off or fails to answer key questions.
“Don’t leave until they’re answered,” she says. “Say ‘I need a few more minutes of your time.’”
She adds that seniors sometimes need to be more assertive, without being aggressive.
Also, she urges them to remember to follow up on test results, requisitions or referrals that may get lost in transit.
It’s important to paint the clearest picture you can for your physician so that you can get the best possible medical outcome, Ms. Lennox says.
”Give your doctor the best chance of understanding what’s going on.”
Have a question about money or lifestyle topics for seniors, or want to suggest a story idea for the Sixty Five series? Please e-mail us at sixtyfive@globeandmail.com and we will find experts and answer your questions in future newsletters.