Talking With Your Doctor: A Guide for Older People

Giving and getting information are two important steps in talking with your doctor. The third big step is making decisions about your care.

Ask about different treatments

You will benefit most from a treatment when you know what is happening and are involved in making decisions. Make sure you understand what your treatment involves and what it will or will not do. Have the doctor give you directions in writing and feel free to ask questions. For example: "What are the pros and cons of having surgery at this stage?" or "Do I have any other choices?"

If your doctor suggests a treatment that makes you uncomfortable, ask if there are other treatments that might work. If cost is a concern, ask the doctor if less expensive choices are available. The doctor can work with you to develop a treatment plan that meets your needs.

Here are some things to remember when deciding on a treatment:

• Discuss choices. There are different ways to manage many health conditions, especially chronic conditions like high blood pressure and cholesterol. Ask what your options are.
• Discuss risks and benefits. Once you know your options, ask about the pros and cons of each one. Find out what side effects might occur, how long the treatment would continue, and how likely it is that the treatment will work for you.
• Consider your own values and circumstances. When thinking about the pros and cons of a treatment, don't forget to consider its impact on your overall life. For instance, will one of the side effects interfere with a regular activity that means a lot to you? Is one treatment choice expensive and not covered by your insurance? Doctors need to know about these practical matters and can work with you to develop a treatment plan that meets your needs.

Ask about prevention

Doctors and other health professionals may suggest you change your diet, activity level, or other aspects of your life to help you deal with medical conditions. Research has shown that these changes, particularly an increase in exercise, have positive effects on overall health.

Until recently, preventing disease in older people received little attention. But things are changing. We now know that it's never too late to stop smoking, improve your diet, or start exercising. Getting regular checkups and seeing other health professionals such as dentists and eye specialists helps promote good health. Even people who have chronic diseases, like arthritis or diabetes, can prevent further disability and, in some cases, control the progress of the disease.

Talking About Exercise Exercise is often "just what the doctor ordered!" Exercise can: Help you have more energy to do the things you want to do. Help maintain and improve your physical strength and fitness. Help improve mood and relieve depression. Help manage and prevent diseases like heart disease, diabetes, some types of cancer, osteoporosis, and disabilities as people grow older. Help improve your balance. Many doctors now recommend that older people try to make physical activity a part of everyday life. When you are making your list of things to talk about with your doctor, add exercise. Ask how exercise would benefit you, if there are any activities you should avoid, and whether your doctor can recommend any specific kinds of exercise Start exercising with NIA's exercise and physical activity guide, developed specifically for older people. See how to stick with a safe, effective program of endurance,stretching, balance, and strength-training exercises. Call1-800-222-2225 (toll-free) or visit www.nia.nih.gov/Go4Life to order your free copy.

If a certain disease or health condition runs in your family, ask your doctor if there are steps you can take to help prevent it. If you have a chronic condition, ask how you can manage it and if there are things you can do to prevent it from getting worse. If you want to discuss health and disease prevention with your doctor, say so when you make your next appointment. This lets the doctor plan to spend more time with you.

It is just as important to talk with your doctor about lifestyle changes as it is to talk about treatment. For example: "I know that you've told me to eat more dairy products, but they really disagree with me. Is there something else I could eat instead?" or "Maybe an exercise class would help, but I have no way to get to the senior center. Is there something else you could suggest?"

Just as with treatments, consider all the alternatives, look at pros and cons, and remember to take into account your own point of view. Tell your doctor if you feel his or her suggestions won't work for you and explain why. Keep talking with your doctor to come up with a plan that works.

Summary: Making Decisions With Your Doctor

Ask about different treatments:

• Are there any risks associated with the treatment?
• How soon should treatment start? How long will it last?
• Are there other treatments available?
• How much will the treatment cost? Will my insurance cover it?

Ask about prevention:

• Is there any way to prevent a condition that runs in my family—before it affects me?
• Are there ways to keep my condition from getting worse?
• How will making a change in my habits help me?
• Are there any risks in making this change?
• Are there support groups or community services that might help me?