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ElderCare Solutions of MI

Tag: Medical appointments


The older we get, the more doctor appointments we seem to need.  It is not uncommon for the average baby boomer or older adult to see a cardiologist, a neurologist, perhaps even a rheumatologist, pulmonologist or gynecologist!  But amidst these many appointments there is one that often gets forgotten…an annual physical with a primary care physician.

Why is it important to keep up with your primary care doctor if you’re seeing all these specialists?  That’s a frequently asked question among our clients.  And the answer is a timeless metaphor…to be sure the right hand knows what the left hand is doing, and vice versa! Most specialists will only diagnose, treat, and prescribe medications for illnesses that fall under their own area of specialization.  So problems that come up may not be addressed outside of a primary care physician’s office.  For example, you’ll routinely have your blood pressure checked as part of an office visit with a pulmonologist, rheumatologist, or gynecologist, but it will not likely be addressed or treated, even if it is elevated. That’s also true if your labs show elevated cholesterol levels.  Instead you’ll be referred to primary care.  Also, routine general preventive care and screening will not be done by specialists, who need to use the appointment time to focus in-depth on the condition they are treating.

So, as much as you would love to eliminate another appointment, call your primary care doc, and schedule your annual appointment.

Getting out my calendar,


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Doctors…the average older adult sees many different medical specialists.  So why is it often a good idea to switch from an internist or family practice doctor to a geriatrician?  And the answer, of course depends! 

A geriatrician is a physician who specializes in treating older adults. Many of us took our children to a pediatrician when they were young, because we recognized that the very young need specialized care.  Well, the same concept applies to older adults.  Our physiology changes as we age, including the way we metabolize medications.  In fact, many commonly used medications have a different set of side effects when taken by older adults.  Geriatricians are generally more aware of what medications to use (or not to use) when treating older adults.

Another difference you can expect to see is that geriatricians usually schedule fewer appointments each day, so they are able to spend more time with each patient.  They are also likely to screen for cognitive changes, depression and anxiety on a routine basis.  But perhaps the biggest difference is that geriatricians will often tackle difficult topics outside the scope of a traditional appointment including driving, moving to a more supportive environment, and bringing help into the home.

If an older adult and their family feel that all their needs are being met by their current physician, then there is no need to make a change.  But all too often I hear stories from clients who feel that their doctor is too busy to be able to spend as much time with them as they would like.

Passing this on to my in-laws,



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One of the challenges older adults and their families face regarding an older adult’s care is the need to coordinate schedules and share information.  Seniors often see many different physicians, may be in physical therapy, and also may be  working with a homecare company.  Juggling appointments and more importantly sharing information can become challenging. 

There also may be multiple family members helping to care for an older adult, taking them to medical appointments as well as making sure there are groceries in the house.  But often times what happens at a physician appointment doesn’t get shared with other family members, who then feel left out.  Or, if there’s a change in the caregiver’s availability, who needs that information?  Who will find a replacement?

One way around this dilemma is to choose a point person to funnel all information through that pertains to an older adult.  It’s one person to call or email with updates after a doctor’s visit, one person to contact to schedule appointments or to share concerns with.  That person can then share information with all family members so no one is out of the loop.

Ideally, if a family member lives locally, has the available time and is willing to take on that role, that would be a first choice.  However, if there is no local family able to take on this role, a Geriatric Care Manager can become the family point person.  For more information about Geriatric Care Management visit

 Coordinating schedules as we speak,


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Many of our clients tell me that they feel overwhelmed when they go to the doctor’s office.  They see their physician every 3-4 months, and so much happens during that time that they have a hard time remembering it all.  Most people tell their doctor what hurts, and whether or not they’re sleeping, but that’s about it.  There’s usually so much more going on, for example whether or not they’re eating as they used to, or if they’ve been having any cognitive difficulties.  That’s the information the doctor needs to hear during the appointment in order to make  meaningful changes like ordering a diagnostic test or changing a medication. 

It can be just as overwhelming to implement all the doctor’s recommendations at home after an appointment.  Medications can be changed, dosages adjusted, follow-up tests ordered, and new diagnoses given.  That can be a lot to process!

It’s really important that older adults have someone to accompany them to their medical appointments that they feel comfortable with, so they will let them go into the exam room with them, speak with the doctor and help them with their follow-up at home.  

If you’re able to take your parents yourself, that’s great.  But if not, a Geriatric Care Manager who has a relationship with your parents can be an invaluable resource.  They can be the line of continuity between the doctor’s office and your family, making sure that the doctor knows what’s going on at home between office visits, and insuring that what the doctor intends to have happen at home after the appointment is carried out.

Scheduling an appointment now,


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There are so many different types of legal documents we need at different times in our lives: wills, trusts, guardianship papers, different Powers of Attorney documents, etc.  It can be overwhelming.  Would you believe I need a signed HIPAA release for my son when he goes to college next year?  I know my parents didn’t need one when I was at school…we didn’t have HIPAA laws then! 

Attorneys are a great resource to draw up any documents you or your family might need as well as answer any questions you may have.  But there is one question I keep hearing over and over again.  “Is a Durable Medical Power of Attorney   the same as a Health Care Power of Attorney or Patient Advocate Designation?”

Yes.  A Health Care Power of Attorney, also known as a Durable Medical Power of Attorney or Patient Advocate Designation, is a vital document to have, because it is where you name a Patient Advocate, someone to speak for you if you are incapacitated.  The person you designate can be a family member, but does not have to be. 

Here are a few things to consider when naming a Patient Advocate:

  • Who do you trust?  Be sure you identify someone you trust deeply, because by naming them as Patient Advocate you are literally trusting them with your life.
  • Speak with your medical team so you can understand different situations you may face, and what types of interventions you may wish to consider or reject.
  • Have a lengthy conversation with your Patient Advocate, so they will understand your wishes and will speak for you, rather than make decisions for you.
  • Distribute copies of your documents to all your health care providers, and provide a copy to your Patient Advocate.
  • Review your Power of Attorney documents every year, because both your health and family relationships may change.
  • This document is fully revocable, which means it can be cancelled at any time.

Not putting this off,



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Many people dread going to the doctor, but for older adults, it can be an overwhelming experience.  This week was certainly a testament to that!  Our Care Managers had several requests to take clients to medical appointments over the last few days.

Typically an older adult sees their doctor every 3 months, and so many things happen during that time, that it becomes challenging to remember everything.  Our clients tell us that they find it very overwhelming.  They feel they accurately talk about their pain, and whether or not they’re sleeping.  But often times more subtle details, like changes in eating, changes in cognitive abilities or driving difficulties, escape them during the appointment.  But it’s these unmentioned details that the doctor needs to hear, in order to make a difference during that appointment.  When we’re with a client, we’re able to fill the doctor in on all that’s going on at home.

It can be just as confusing leaving the appointment! There’s almost always a change made when an older adult goes to the doctor.  A medication can be discontinued, a new medication can be added, a dosage may be changed, a test needs to be scheduled, a new diagnosis is made…you get the picture.  We’re able to let the family and caregivers know what the doctor has recommended in order to insure those recommendations are carried out at home.

If your parents are beginning to need a little help, consider going to their medical appointments with them.  It’s time well spent.   And if you can’t…we will.

That’s all for now,


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  • Does an older adult's family live out of town?
  • Are local family members overwhelmed and need help?
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  • Do family members have differences of opinion regarding a senior's care?
  • Is a senior living in an environment that needs aging-in-place modifications?

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ElderCare Solutions of Michigan is a division of Jewish Family Service of Metropolitan Detroit, a non-sectarian not-for-profit organization that has served the metro Detroit area for more than 80 years.