How to Advocate for an Aging Parent or Loved One at the Doctor

When an aging parent or loved one starts skipping meals, forgetting things, or going to the hospital more than they used to, it's worth getting a doctor to look at what's happening. As people get older, they get sicker quicker, and families often think those hospital trips are normal with aging, when they are not. In my experience, good medical care from a geriatric provider, a doctor or nurse practitioner with extra training in caring for older adults, can often head off problems before they become serious. Getting that care can take someone close to them speaking up. This guide is about how to be an advocate when you notice early warning signs that their health may be declining. Our guide on how to know when a loved one needs help at home goes through the signs to watch for.

How to tell whether a skipped meal is a choice

Families sometimes call me to ask whether something they're starting to notice is normal or worth worrying about. Skipped meals are a good example, because there's a simple way to tell. When older adults choose to skip a meal, there's a reason behind it. Often it's a plan they're following, a meal that doesn't sit right, or advice from someone. When I want to know whether it's a choice, I ask why. Usually, someone who has chosen to skip a meal can tell me. If they pause, search for an answer or need prompting, it makes me think it isn't a choice.

On your next visit, if your loved one has skipped a meal, you can calmly ask them why and notice how they answer. If it doesn't sound like a choice, make a note of it, so you and your loved one can bring it up together at their next appointment.

How to prepare to advocate for your loved one at the appointment

Advocating doesn't always mean going with them. Some people would rather see their doctor on their own, and helping them get ready is advocating too. If they'd like you there, they can tell the doctor it's fine to talk in front of you, and as long as they don't object, the doctor can talk with you about their care. If they'd like you to be able to call the office for them, they can put your name on the office's release form, sometimes called a HIPAA release.

A doctor sees your loved one for a short visit, and you both know what happens at home. Help them write down what you've each noticed, with examples and when each change started, so it gets said in the room. Put together a list of every medicine they take and the dose, including vitamins, supplements and anything over the counter, or put the bottles in a bag to bring. Their insurance cards and the names of their other doctors should go too.

When you or your loved one call the office, ask for an appointment about these changes, separate from a yearly check-up. Medicare's yearly wellness visit includes a check of memory and thinking, but Medicare suggests a separate appointment for specific concerns. If the doctor thinks there may be a problem with memory or thinking, Medicare Part B also covers a fuller cognitive assessment as its own visit. With Original Medicare, your loved one pays 20% of the Medicare-approved amount for that visit after the Part B deductible.

Being an advocate doesn't mean speaking for them. At the appointment, let your loved one answer questions unless you're asked, and include them when you talk. If something on your list doesn't come up, raise it before you leave. If they want time alone with the doctor, step out.

If your loved one doesn’t want to go

It's their choice, and you can't force them to go. Advocating here means helping them see why it's worth going, in a way that respects that the decision is theirs. Our guide on what to do when your parent says no to help at home covers how to raise it with curiosity, and when a provider they trust may be heard where family isn't.

How to find a good geriatric provider

A geriatric provider is a geriatrician or a geriatric nurse practitioner. Geriatricians are medical doctors trained in internal or family medicine who have extra training in caring for older adults. Geriatric nurse practitioners are advanced practice nurses with special training in caring for older adults, and they can examine patients, diagnose and treat illnesses, and prescribe medications. Both look at the whole person, including memory and mood, how safely someone moves, their medications, and what matters most to them. What sets a good one apart, in my experience, is that they're proactive. They make sure your loved one isn't taking medications they don't need, assess what they can still do safely, and help them get the equipment and therapy they need, like a walker, a roll-in shower, or physical or occupational therapy.

You can help your loved one find one. Ask their primary care provider, friends, relatives and other health professionals for names. The American Geriatrics Society has a directory of geriatric providers you can search by state, and Medicare's Care Compare lets you find and compare providers near you.

Before they choose, you or they can call the office and ask whether the provider is taking new patients and accepts your loved one's insurance and Medicare, whether they see many older patients, and how they feel about involving family in care decisions. After the first visit, ask yourselves whether the provider listened, and whether you both understood what was said.

How to keep advocating if you still have concerns

For many families, noticing these changes in someone they love brings some surprise and fear about what might happen and how to help. A short visit may not show the doctor what you see at home, or they may not be the right kind of provider for what's going on.

If you and your loved one don't get what you need the first time you talk with a doctor, don't stop there. Ask questions, and don't be afraid to challenge what you're told. Schedule a follow-up. And if you feel you aren't being heard, get a second opinion, from a different doctor or from a geriatric provider if they don't have one. In today's health care world, you really need to be an advocate, whether for yourself or for someone you love. You know your loved one and their situation best.

Don't stop advocating for your loved one, and don't wait to ask for help while it's still early.

And if anything changes suddenly, don't wait for an appointment. If you'd like to talk through what you're seeing, you're welcome to get in touch.