How many Dr.'s are enough Dr.'s?

I signed mom up for the AL doc exclusively and nixed the rest. Once AD has been diagnosed, it's comfort care from there on out imo anyway. Mom was in Memory Care Assisted Living for nearly 3 years with the same PCP who'd order traveling radiologists and bloodwork tech's as needed to go visit HER. I also hired a travel dentist to pull a tooth once.

Good luck to you.

Interesting, usually the facility (if he is in one) handles these appointments, from making them to transportation to them.

Use the PCP at the facility . I assume a podiatrist comes to the facility to cut toe nails. Perhaps a dentist and audiologist and optometrist comes to the facility as well.

The PCP can oversee a lot of these other things and can write renewals for medications. Let the PCP decide when Dad needs to go back to see a specialist , if at all .

My FIL with dementia gets seen every 2 weeks by his PCP in AL because he has fantastic insurance . He doesn’t need to be seen that often, but he likes the attention . We’ve cut specialists unless he needs to go . He did go to the hematologist this year for severe anemia.

When my mother had dementia she decided she only wanted to see the PCP in her facility and the podiatrist. She was tired of doctors.

February question. I hope the OP has cut down on some of those doctors.

You may just need more beautiful dogs, not doctors to solve your problem!

My FIL, as he was actively dying from CLL (a type of leukemia) still insisted on seeing the dermatologist and the dentist for new dentures (which were delivered after he died!) his oncologist, his PCP, a podiatrist, and who KNOWs what else!

A month before he died he insisted on having a mohs procedure for a cancerous mole. He wasn't near healed when he died and I had schlepped him to and from the derm dr about 6 times.

I give him credit for his will to live--but seeing a dr or two every single week just got to be ridiculous. He needed only his oncologist the last year of his life.

1 imo

Maybe a dentist and optometrist as well

Your husband and i think alike.
i would have him palliative care.

Mother is 98, slight dementia, 2 doctors GP & Heart Specialist. Eye exams yearly.
Step Mother is 85, Front Temporal, 1 doctor GP. Eye exams yearly.

They will just keep adding more if you let them. Makes a lot of bills for Medicare, we taxpayers.

We have begun trying to wean nearly 90 year old FIL off of his plethora of doctors over the last few years -or at the very least whittle down the number of in person appointments he has to attend. First, because he considers doctor´s appointments the equivalent of social engagements and will therefore invent new and exciting reasons for them. And second, because we have noticed that some of his doctors tend to require appointments that just are no longer necessary.

He has two primary doctors - and while we think that is ridiculous - we haven´t figured out a way around that - between the VA and Medicare. His private practice primary and his VA primary. Unfortunately they don´t do the best job of working together. A great example of this is his diabetes management. They cannot seem to agree on a good blood sugar number, the right insulin dosage and a good A1C. One prescribes the insulin, one prescribes the CGM and testing supplies. It is a constant struggle. They share medication management depending on whether Medicare or the VA will cover which medication. It´s a whole mess.

He wants to see a dentist - but that is one we have had to remove from the rotation. At his weight and near complete immobility - unless we can find one who can literally make house calls and just come do something in his bed or do something in his scooter that is not a deep clean - he just can´t do the dentist now. He can´t manage the dental chair (as in he will rip it completely out of the floor) and he can´t hold the position in his own scooter for them to clean his teeth. So outside of them brushing is teeth, there is nothing much they can do, and they said it wasn´t worth it for them to even try at this point.

The others, podiatrist, cardiologist, urologist, sleep specialist, internal medicine, wound specialist, currently physical therapist, occupational therapist, neurologist, and multiple surgeons.

We have managed to shave off everyone to date but the podiatrist, cardiologist (but we may be there now with this latest ER visit because what he was being seen for has 100% resolved itself and they advised he has the heart of a young person and a great EF), urologist, and sleep specialist. Plus the two primary doctors. Even still, before this latest merry go round in and out of the hospital and rehab, he managed to have a doctor´s appointment at least once every other week. in 2022 he had no fewer than 26 doctor´s appointments. We did manage to get two of those virtual.

The urologist is about to stop we think because the procedure they require him to do each year - they can´t do on him in their office anymore without the help of three of their staff members coming in to assist. So they will either need to send him to the hospital to do the test or just stop doing it.

But at this point, it may be moot. Because we are on the precipice of a skilled nursing facility decision. And if that happens - ALL of his medical needs will be transferred to the facility doctor.

My mom saw her primary doctor, her neurologist for Parkinson’s disease, eye doctor and dentist.

Just do the basics. Don’t kill yourself with all of the specialist.

Wishing you all the best.

My dad is much older (101) and has few heath problems but when he has been the the hospital he gets referred to all sorts of specialists. I ignore those referrals and just let the physician at the assisted living know that unless she thinks it's necessary I'm not going to make the appointments. So far she's saved both time and money. The dermatology referral would have created multiple trips and mohs surgery for a skin cancer that will never grow enough to kill him; the nephrologist referral would have resulted in many, many visits for his failing kidneys (which are going to fail anyway and we'd never put him through dialysis), and one of the specialist prescribed medications would have cost thousands a month and the AL physician substituted a generic which required more monitoring but that could be done by the AL nursing staff. At a certain point you should stop trying to CURE anything. You should also ask yourself if the treatment is really necessary. Many tests and treatments are prescribed not because they are really necessary but because it is available and standard of care for a much younger person. I always check and defer to the AL physician because she and I have the same understanding.

SusanHeart, yep, that list sounds about right. Plus my Mom knew the name of the receptionist and all the nurses in each practice. Oh, add in GYN for my Mom's list.

Any time I made an appointment for Mom, I also made an appointment for Dad, so it would be back to back. Thus, one trip.

My parents were in their 90's. I believe Mom had all these specialist because she liked hearing nothing was seriously wrong plus hearing "see you next year". Many of the specialist use to say she didn't need to see them any more, yet Mom would insist on making another appointment.... [sigh]. Dad like going just out of boredom.

At a certain age, going to a doctor unless you have a special need, special physical ailment requiring a specialist, should not be done. I am 80. I have one general practitioner. I am on Kaiser. If I have a special problem with eyes, heart and etc (am in chronic atrial fib) I see a specialist. I had breast cancer three plus decades ago; I no longer do mammograms and etc by my own choice.
You may wish to discuss palliative care with doctors now if you are medical POA. At some point keeping someone alive, and seeing conflicting docs for different things can almost be harmful. You should see your elder's ONE general practitioner now, tell him or her that all medical followup will be through that doctor unless a specialist is required for an illness.
Wishing you luck. Clearly your elder is being used as some sort of cash vending machine, or is very very ill indeed.

Simply use the doctor affiliated with dad's AL/MC and that shaves 20 doctors off the list right there. I refused to schlep my mother w dementia to any docs and we used the in house PCP in her AL/MC and things went perfectly. With dementia at play, most of us are not trying to take life extending medical care ANYWAY. So what's the point of running yourself ragged? The AL normally has a traveling dentist who can work on his teeth, if need be, from the comfort of his easy chair in his room. It's super expensive but worth it imo.

Good luck to you

I also lucked into an excellent situation using the medical staff associated with my LO’S residence.

They never hesitated to let us know if a specialist was needed, and most of the care LO needed was addressed on site.

Answer to 1 question might take care of 99% of the list.
What treatment would you take if he is diagnosed with -----------?
If you would not follow up with a treatment then there really is no need for the diagnosis.
and...
Is he taking medication from each of the doctors listed?
Would stopping any of the medication result in cutting his life short or causing undue pain? (Keep in mind with the diagnosis of Alzheimer's his life is cut short and he is not living a "quality" life at this point.)
Is he compliant with each doctor? with each test done? and any follow up? If not discontinue that doctor.

When my mom moved into Independent Living, we used the in-house geriatrics doc and in-house geriatric psychiatrist. Mom went to the dentist on the facility bus. I took her to eye doctor and dermatologist.

I would talk to your dad's primary (I hope s/he's a geriatrics doc) about why/if all those other's are necessary.