It's getting to be an increasing problem to the point mom's doctor just doesn't want to deal with me. It's almost like I feel he is trying to make me go his way or it's no way as I still need his approval for any renewal of meds, etc. It's far too late in the game to change doctors, so I have to make this work. I plan on getting an appt. with the doctor just to have a heart to heart talk. Lately, I call him just for a diagnosis of what is going on with mom and what to do (mom is bedbound since falling and there are new things to deal with) and instead of giving me some direction, just bluntly tells me "well, you know she's going to die"........ I'm sorry, but I feel this is inappropriate and insensitive.....to say the least. He keeps wanting me to just go with hospice and while that may be appropriate in some situations, it is NOT for mom at this time for various reasons. (FYI---mom just fell out of bed and recovering....is happy to be alive at this time, NOT wanting to die. She does NOT have a terminal illness.) Any feedback on how you all have dealt with this would be appreciated. cadams
cadams
www.agingcare.com/articles/palliative-care-how-it-can-help-your-aging-parent-achieve-quality-of-life-136281.htm
www.agingcare.com/articles/palliative-care-what-is-it-and-how-is-it-different-from-hospice-197744.htm
And if hospice does not offer anything you need or any financial/coverage advantages for you or mom at this time, there is no reason they have to be involved. If you do find a good reason to start that though make sure their philosophy is compatible with what you and mom want too, in terms of medication use, etc., and not just a cookie cutter approach like everyone gets morphine and Ativan around the clock, and stop all the other meds that may help them function or feel better. Had to fight tht a little for my mom... difficult memories there!
As for changing docs. That is t going to happen. There are near no physicians accepting new Medicare patients. With the reimbursement cut and cut again...docs don't want more of this patient/payer. My Mom tried to fire this doc years ago...and found she couldn't get a new one.
I became eligible for Medicare...but..I do not have a primary. Because I cannot find one accepting new Medicare patients. So..I just stick with the urgent care "doc-n-a-box" services. Just make sure it is not Emergency care... Medicare won't pay for that.
A geriatrician who shares or at least fully appreciates your perspective on mom's life could be a better pick if your heart-to-heart talk does not work out. I would also have loved to have had more time to make memories with both my parents (especially with their grandkids) despite the onset of dementia and needs for care; we still respected their advance directives and all but didn't want to hasten death even with benign neglect, which is sometimes not so benign. I felt I had to tell my dad's doc that his quality of life was not so bad, and he did listen to me, but we did limit hospital stays for both my parents at the end when the status of major life-threatening impairments was non-reversible.
As to hospice, it sounds as though it might be a good idea, even though she is not actively dying. If the doctor will recommend it, it gets you a new set of medical professionals who will evaluate and support you in your keeping mom at home, and keeping her comfortable.
Many patients "graduate" from hospice because they do well.
It sounds as though there is not really a definitive dx for your mom at this point and what she needs is comfort care. That is really the definition of hospice.
Good of you to advocate for your mom. GardenArtist is right, its never too late to find another doctor. Or report this doctor the Medical Association if necessary. I know its hard to find a good doctor but its worth it. Take the time to call around and see if you can get a second and third opinion.
I wouldn't tolerate his attitude toward giving up. I assume he's not a geriatric doctor?
We had two PCPs who were lousy; only a few visits and they were history. There were also 2 internists who were more thorough but clearly didn't know how to deal with older folk and they're history now too. I've got recommendations for a geriatric doctor, so that'll be the next one, and hopefully he'll work out.
I tried to work with the doctors who are now history, but some of them weren't worth the effort. One of them insisted that my father should be taking Fosamax, and insisted that he "has to take something!" Never once did he raise the issue that walking is the best exercise for osteoporosis. Nor was he concerned about the side effects of dangerous drugs like Fosmax. After a few discussions and he just couldn't grasp the fact that we don't see medicine as the solution for everything, and after his office failed to cooperate in getting home care, we moved on.
You can try one last time but if the doctor doesn't change his attitude, I'd find another one. It isn't worth the agony of trying to make some of the old style doctors get on board. Some of the younger doctors are so much more progressive. I love to work with them.