Taking mom to the doctor is a true ordeal; any suggestions?

I have the opposite problem. My moms doctors speak directly to me and that agitates her. My mom will actually get angry with me. Do you have medical POA? If so they can communicate directly with you and with you alone!

kitty: So sorry. My mother was okay with one answer. I understand that not everyone is.

Update: spoke with her regular doc, and as usual he was very helpful. (As with all good things, this too shall pass: he's moving on to a different job.) He recommended we take a wait and see with the bump on her face, and he'll either get one of the nurses there to examine her ears if they can, or he will next week.

So, everything is getting sorted out.

I'm so grateful to everyone who responded with such good suggestions and their own stories. Thank you!

Touch (holding hands, a hand on the shoulder, etc.), eye contact, and short declarative sentences.

Where are we going/what are we doing? Hold her hand, look into her eyes, and say simply "We're going to take care of you." The emotion from the touch and eye contact will normally be enough, even if your mom doesn't understand or hear the words.

As far as the healthcare provider... I found it best with my mom to just have them talk to me and I would "translate" for my mom using the above techniques.

Grandmom (passed at 97) was pretty much deaf in both ears... hearing aids were slightly useful (on a good day). She did see an ear doc regularly for wax removal but the wax didn’t fix the genetic deafness. She did have some dementia but it wasn’t too bad ~ usually at doctor visits the doc would talk to her/get an answer then look at my facial expression to see if what Gran was saying was correct. Towards the finals months of her life, Gran deflected everything to me... “Talk to my granddaughter cause I don’t know....” or my personal favorite “Midnight78, when the time comes, I know that you’ll make the right decisions concerning my care.” Yea, no pressure Gran * face palm *.

Anyways, one of many times she was hospitalized thru the years (hospital as well as rehab) - I would bring the hearing aids home with me. Those things were mighty expensive to replace. I had made several hand written signs ~ “Gran is hard of hearing...but her eye sight is perfect ~ write down what you want to say to her and let her verbally respond to what you tell her. If there’s any concerns that she can’t answer... call my cell phone.” I’ve lost count of how many times I’d visit her, to see notes from the doctors/other staff left for me... “Thank you for your input ~ your problem solving skills are top notch... it’s very easy to communicate via writing to your grandmom, she’s a pleasure to visit.”

I know writing everything out does take time... but maybe it could be of some help. Also, if your mom wears hearing aids...check them for wax buildup regularly. Gran had hearing aids that went inside of the ear ~ had to clean the wax off of them weekly.

When my mother in law was bed bound at home, we had a physician making house calls. Maybe you could check with her insurance as well as the area agency on Aging to see if they can provide you with any information. Home care agencies might also know of someone.

Is she able to see to read and comprehend what she reads? Perhaps if the Dr could write the questions he needs to ask. If you know what her symptoms are those could be written in advance as well so the Dr will not have to ask those questions again at the visit. You can also write on index cards things like “We are going to the Dr” or “The Dr need to examine you now.” This will only work if she can still read and comprehend what she has read. On the way to the Dr, let her hold the index card that tells her where she is going? If she is not able to read, you will have to just repeat what the Dr says, but be sure that she is looking you right in the eye. My Mom is 90 and can’t hear either, but her mind is still good and she can see to read. I pray that she stays this way, but can see her declining slowly. My prayers are with you and all of the rest of us dealing with things that our parents are going through. We hurt for them, but also for ourselves.

I would say it one time - mom, you are going to the doctor's and I am driving you. After that resume silence since she's going to repeat, repeat, repeat. At my mother's doctor, I always went in to see the doctor with her because my mother was a sugar coater and would say "nothing is wrong." Yeah, right - that's why we came to the doctor's for nothing.

Oh sister, do I sympathize! I just went through getting my 93 year old mother through having a squamous cell cancer removed from her nose. It took 2 dr appointments to get it diagnosed, visit to the surgeon, then there will be 3 follow up visits. That's 6 visits. Now we are coping with her not remembering the care instructions. I wrote it all down but since she can’t wear her glasses she can’t read it!

I was figuring up all the medical visits I have to take her to in a year:
Annual physical
Lab for tests
Cardiologist
Dentist X2
Optometrist
Audiologist
Dermatologist
Allergist
Podiatrist X4

That's 12 times I have to get her out to the car, load up the walker, drive to the office, unload Mom and walker, navigate to the office, wait, into the exam room (always the room farthest from the door) wait again for dr, then repeat the trip back to the AL. Average trip is 2 hours by which time we are both exhausted.

her AL does have medical personnel who visit but not all of them take her insurance. Plus, I want to be there when she is examined and they don’t always have set schedules. And she is familiar with her regular practitioners and will Listen to their advice.

you have to wonder when it’s time to just stop the nonsense and leave them in peace.

As to how I deal with it, vodka.

Change of venue and surroundings, even a visit to a doctor away from home, is really, really distressing to a dementia/Alzheimer's patient. They're disoriented and confused, and it's often terrifying.

Consider asking her PCP if she can be put on hospice care. That way the doctor/nurse comes to her at home, and she isn't subjected to the endless distress of being put in the car, taken out, and hollered at.

You aren't required to die within a certain period of time with hospice, so ask about it. It might actually be the solution to your problems.

Obvious question as well, but -- does she have hearing aids? Has she been checked for wax in her ears, too? My mother is pretty deaf, but boy, her ears get all sorts of stuff in them, and when the doctor cleans them out, she can hear 100 times better with her hearing aids.

My 94 year mother has dementia along with hearing loss which seems to have gotten a lot worse lately. It does complicate things when there is a comprehension problem too. I was feeling frustrated having to shout to communicate when a friend who taught deaf and hard of hearing students recommended I try talking through a paper towel roll. Wow what a help! We could actually communicate a lot better. Hope this helps 😊

If she is residing in an assisted living facility, have you considered using the physician on staff for her primary care? In terms of the dentist, have you asked the DON about dental care on site? The communication issues are another matter. In terms of her repetition, I would explain/ reorient her to the situation and then try to redirect the conversation if possible. Sometimes older adults with hearing issues respond better to a lower tone of voice. Have her ears been checked for wax build up? Prior to the physician visit, I would suggest having a conversation with someone on staff who can document on her chart as well as relay to the physician her difficulties in communication due to hearing loss and cognitive issues(dementia). A geriatric physician would definitely be beneficial for her and you as well.

You are here interpreter. So in the case of ordinary doctor's appointments and dental appointments, I was always with mom in the room mostly as an observer/remember. When necessary, I would assist in conveying the question. My mom knew that she had memory deficit, so she would request a printed summary of the visit as a reminder, which was a good idea. In terms of hearing, wax can be an issue. My dad was discharged from rehab unable to hear at all which seriously interfered with his care. Due to eustachian tubes that were exceptionally narrow, using Debrox drops made his condition worse. We finally were able to get him to an ENT doc who used water (jetted) to remove the trapped wax. It took 10 containers of water before the wax gave and came out. Dad cried tears of relief when he could hear again. So, please have your mom checked by an ENT. The nurses and doctor at the rehab didn't recognize this issue; they would put the Debrox in and neglected to notice that his condition didn't improve.

On the hearing - my mom and most older folks develop lots of ear wax which affects their hearing. If you can get her to an ent, they do a great job cleaning it out. I can't, so I just ordered an otoscope from amazon that I hook up to my phone so I can clean her ears myself. I'm going slow because she doesn't trust me! But, I know I can make a difference so I keep working on it. If it's true deafness, try to get a good hearing aid. My mother will tell you that when you can't hear it makes everything worse. And, they tend to fall into themselves more in my experience.

My mother has a doctor that comes to her at her ALF so you may see if you can find one. He's terrible which even she acknowledges (she was an RN) but I cannot get her out at all except as needed to the ER as she is bedridden. Sometimes I have to get the facility's nurse to talk to him to get him to do the right thing, but we work with what we have. It at least eliminates the drama of transport and waiting.

When mom is in the hospital, I do have medical power of attorney but don't really have to use it but if you have it you could start out with - I have medical poa please speak with me. I let them talk to mom which takes some patience because she will sometimes not tell them something important or just want to chat, but then I talk to them. Most providers are thrilled to just talk to me. I'm no nonsense and to the point. Raised by a nurse and being a mom and a caregiver, I'm pretty savvy medically and I have my questions and suggestions ready and don't waste time - most docs love that. My mom is cognitively fine but she prefers to just delegate to me. She's pretty well trained/consistent in it - if a doctor comes when I'm not there she will point to my phone number on the whiteboard and say "call her she handles everything for me". Which is oh so true! In addition to the ear cleaning, I've learned to cut her hair, give her pedicures, and much much more...

Get a neuropsycholigists note saying that the DRs need to address you with her visits and not her.

Kittybee, just saw your comment regarding the basal cell biopsy and upcoming MOHS. My Mom went through a similar facial biopsy. I probably would have done nothing except she kept picking at a little mole, so it never looked “healed” Luckily we know the dermatologist well and I was able to take a picture of the sore on her face and email it to the doctor, who diagnosed it as basal right from the picture. I took her in the transport van for the biopsy (all the same nonstop questions as your mom) and asked them to take as big a biopsy as they could, with the hopes of them getting it all in one swipe. They took a huge sample, but unfortunately didn’t get it all, so I got the same lecture as you...”it’s slow growing but could kill her etc etc”. So I struggled with whether to put her (me) through the ordeal. I spoke to her NP at the NH, who looked at me like I was crazy. “Jean, She’s 93. She is NOT going to die of basal cell! I’m surprised you even did the biopsy!” Sooo, I opted out. No further consult...I just called them and said no. The biopsy incision healed, and that was the end of it. And she didn’t die of basal cell. Please think about if it’s worth putting her through it.

Doctors practice medicine for their own benefit and, in the event of a lawsuit, they can point to the battery of tests they did. You must remember that the more tests they do the greater the likelihood that they will find something. And then the cycle starts all over again.

Most doctors are never, ever going to tell you to bring your mother into the office less frequently. There is no financial incentive for them to do that when Medicare always pays.

See if your mom might qualify for hospice. Then you can skip the doctor visits. A nurse will come once or twice e a week and get directions from the hospice doctor. If your mom gets sick, no ER visit...hospice comes.
My mom has severe aortic stenosis so she qualified and it has really made life so much easier for her and for me.

Kitty,

I swear I was losing my mind dealing with my mom not wearing her hearing aid. One ear could not be helped by a hearing aid.

I had to yell and as you say, speak very slowly too. Do you know why? I detected that she was reading my lips. If I turned my head she would ask me to face her.

Another issue, wax buildup! My mom has a wad of wax removed in her audiologists office almost the circumference of a dime. I swear! I was shocked how much wax was removed. Hearing aids must be cleaned often for wax removal, at least once a week.

I almost bought a cordless microphone so I wouldn’t have to scream. It takes so much energy to yell like that. It wore me out.

Use CM flash cards with mom but also have some notes for the doctor.
Write out what you want the doctor to know in some detail. They generally ask pretty much the same questions. Why are you here? How long have you had the problem? How does the problem affect you? What have you tried so far? How did that work?
Even though he can ask you all those questions out loud you can speed things up by having that already written and thought out. Plus you can write this out without mom interrupting you asking what and where and why.
Make at least two copies. Give mom one to read as well as the doctor.
Also try giving your mom half an anxiety tablet on dr days so she can be a bit calmer for the trip. Start with a half and see if it helps. Worth a try.

Kitty, your mother is 92, yes, she will die of something. Why not skin cancer? If it is slow growing, how long does the doctor expect it to be before spreading? What would the doctor do since he has not yet removed it?

I am not trying to be facetious, my step dad died of Metastasized cancer a year ago. He was in the beginning stages of dementia. He had a peaceful death.

My Dad is almost 91. He has had many skin cancers removed over the years, various types. More recently he has used a Chemotherapy drug in a cream that he applies to the places he can reach. It has been used successfully on his nose, the back of his hands and his arms. He has the ones he cannot reach either frozen or surgically removed. Dad does not have dementia.

my MIL is 89 and hard of hearing and legally blind as she has been all her life. her vision is like looking thru a thin sheet of visquine plastic. she gets around fine. with her walker in house but needs her glasses to read anything, and does not know how to use cell phone or regular phone anymore for that matter. no one calls heer on the phone.. We live with her and manage the phone calls that do come which are usually scam callers 99% of time.
WE  my husband and I  have to repeat ourselves over and over again because she forgets within 3 minutes or less what we just told her. yes, short simple answers best. She refuses to go to the dr, and needs to get her wellness checkup so her son whos my jhusband will have to put her stern demanding hat on and make her understand. she wont listen to me. She says she doesn't like the dr, well so sad too bad, our previous dr. moved to Pennsylvania to take care of er mother, so she does not like change and this dr does not pamper her and
dote on her.. and the fact that dr agrees with what I say and MIL does not like that, so its a constant battle. before she goes I am going to make sure to tell dr not to say her name just go in and treat her..if MIL cant remember name she wont even know its the same dr that she doesn't like... I don't and wont go thru the process of finding new dr for her, and so she is just going to have to deal with it..never thought I would ever be in this  position as a DIL, but I am. I just deal with it one day at a time..the best I can with a good dose of prayer and support from my husband. I wish we did not live with her but it is what it is..

We were told the area of brain associated with hearing (and vision) will deteriorate and die.
1. encourage use of hearing aids for that reason. After a seminar on topic she went directly to her room and put hearing aids in. By the next day - the knowledge learned or the fear of never hearing was gone.
2. applies to walking. Advised to use walker now otherwise the brain will
forget how to use walker. They will be confined to bed/wheelchair.
3. some assisted living facilities have physicians and dental and foot doctors on site.
4. all these “help” for a short while. Today is In house physician appointment. I need my car, they have me locked in. When is my appointment? I need the address. How will I find it? I need a shower. I don’t have keys, so after a face to face reminder I will be accompanying you to doctor. A note with instructions and map of the third floor doctor office. And no less than 10 phone panic phone calls.
I now take what I learn here. I say I’m grateful because it helps for awhile. I then Surrender! 😊
It’s always Two steps forward....

I’m so irritated for you just imagining these trips.

My dad has some comprehension problems and my mother is one of those types that REFUSE to wear the $4,000 hearing aids we got her (at her request!) so that we end up having to holler to be heard. It drives me nuts. Between the two of them, it’s enough to make me want to scream sometimes. It’s nowhere near the severity of what you’re describing, so I can imagine I’d be a pissed off, aggravated monster in your case!

I found that I was ALWAYS getting annoyed and irritable, even when they didn’t do anything that deserved my general grumpiness. They didn’t deserve that treatment but more importantly, I could not exist in that state. It’s unsustainable.

After much thought, this has been my solution; I remind myself (like, 20 times per hour when I’m with them) that I asked, “But why?? WHY? And why?” and must have asked dumb questions 200 times per day when I was three-years-old, too. Admittedly, children are a tad cuter than our elderly parents, but this is payback. At home, I’ll answer as much as I can. But out of the house, especially when in the waiting room, I write things on my phone and show her. She can type her question to me or will say it out loud, and then I type back my answers, explaining I can’t shout here. That is, assuming your mom can still read and comprehend what she reads?

I still get annoyed that my mother can’t be troubled to be ”uncomfortable” with her hearing aid so as to make the rest of us comfortable and not having to scream. But it is what it is.

Hang in there. I wish I could help you!

When I took Mom to the neurologist, I took notes with me about things I had seen in the previous months. He referred to those notes in the questions he asked. I would sit in the corner and he would look at me for a response. All her other doctors would ask me what was going on. Actually had her hearing Dr. tell me trying to fit her with new hearing aides was a lost cause because she didn't understand the questions.

I did not tell Mom we were going to the doctor till we got there.

I dealt with the doctors. They would ask her questions but in the end, I dealt with them. They were all aware of Moms Dementia because they saw it.

Repeated questions, you try to redirect.

I cut back on Moms dr visits, once the labs were good.

I feel your pain. I too often wonder what the point of bringing mom to see doctors. We really only do it to keep her prescriptions going. Doctors legally need to see a patient to keep writing prescriptions. But whenever we go to see doctors, mom just sits there and the doctor only interacts with me.

As for having to repeat yourself over and over again. I'm the kind of person that if you tell me something once, that's enough. Thus I hate repeating myself. I've had to get used to repeating the same things over and over and over again every single day. Like kids, my elderly love to ask why? Then I have to explain it to them. Not just once, but 10 times in a row. Then I have to do it all again the next time. Multiple times a day. Every day. For years. So far. If I think of it, it drives me insane. So I don't think of it. I kind of do it on autopilot now. You get used to it.

I have found myself having a perfect conversation with my 97 yo aunt on the phone. No problems. Then, a certain word. She says "What?" like she didn't hear it. I say it louder. No response. Mind you we were just having a perfect conversation just before. Then I resort to spelling it. Then she gets it. It may be that some of your mom's issues is more than just bad hearing. I don't have a solution for you, but if she is continuously asking the same question, write the answer on a small white board or paper and if she keeps asking, just keep pointing to the paper. And if you're driving this works well, too. You can even write it in advance if you are pretty sure of what she'll be asking. Also use the white board to communicate to her, if she can still read. And I say *if* because last time we visited my MIL she had forgotten how to write. She could still read, just couldn't even sign her own name. Dementia makes everything a moving target, and on-the-fly problem-solving is the modus operandi. That's the beauty of this forum...lots of problem solvers ready and waiting. Blessings!

A cochlear implant has helped my step father who is basically deaf.

I was gonna say the same thing as Cwillie. Maybe it’s time for a palliative approach & cut back on non-essential appointments. And try to have as much done at home—doctors, nurses, even dentists will come out to the house.

I use the care team of doctors, PAs and nurses that come into my mother's ALF a couple of times a week. And the traveling lab people (for urine tests, blood tests, etc), the traveling dentist, the traveling x-ray team, etc etc. If they don't come into the ALF, mother doesn't use them. If she goes to the hospital, I will send an ambulance. If she needs to go to rehab, the non-emergent ambulance takes her there and then I hire a wheelchair van service to transport her back to Memory Care ALF where she lives. It's just impossible to do things any other way, so see what all you can sign her up for........that's part of the beauty of having her in an ALF!! The traveling medical team that comes by to visit.......it's honestly a LIFE SAVER!!! My mother is 75% deaf also and I have to yell at her for her to hear me. Then she asks why I'm HOLLERING at her. Then she forgets what she says mid-sentence, or what was said to her 2 minutes ago, or what the doctor told her, etc. etc. Yes, it's truly a nightmare and I would never take her out to the doctors anymore if I can possibly avoid it.

Last year, before she became wheelchair bound, she was having chronic vertigo. And I mean CHRONIC. It was horrendous, and the PT at the ALF was unable to help her using the Epley maneuver. So I had to take her to the ENT doctor who'd perform the maneuver. My husband would have to take time off from work, we'd have to load her into the wheelchair (she wasn't able to walk during a vertigo episode), drive her to the ENTs office, load her back into the wheelchair, get her into the office to be interviewed (which was a nightmare), and then ONTO the exam table, which was practically impossible. She has no core strength and could not sit up on the table. The doctor was almost unable to work on her, it was that bad. We had to take her there around 6x in a 6 month period. Once she became wheelchair bound, the vertigo stopped (thank GOD) so at least we have the ENT behind us, for the moment anyway.

Call the ED at the ALF and see what services you can sign mother up for. Like now. The mobile dentist, by the way, I only call when she needs a tooth pulled; I don't use them for cleanings or check ups or things like that. Because the only thing worse than getting her to the ENT is trying to get her to the dentist, which we've had to do about 10x since she's moved here in 2011. The mobile dentist is no more expensive than the regular dentist, but there IS a trip charge added on. Who cares, right? :)

The repeated questions: You just have to keep answering the questions, or try to DIVERT her by changing the topic. Turn the music up if you have access to music, and hope she starts listening to IT instead of trying to make small talk.

The healthcare provider doesn't have to communicate with our mothers; WE are there to do it FOR them. With dementia, there really is no other way.

How to deal with deafness/lack of comprehension: with continued prayers for patience. Sigh. I often lose my voice from having to 'holler' but she's not deaf! Only the OTHER residents in her Memory Care ALF are deaf! No use in suggesting a hearing aid; she either doesn't 'need one' or will lose it.

Good luck!!