Heath and Aging

Talking With Your Doctor: A Guide for Older People

Changing the Subject: Practical Matters

Overview

  • Don’t hesitate to bring up concerns, even if they don’t seem directly related to a medical condition.
  • You and your doctor can make better decisions together if the doctor knows about your non-medical concerns.
  • If the doctor can’t help solve your non-medical problems, he or she may be able to refer you to other resources that can help.
Calculator, showing how the cost of medications and prescription drugs can add up

If your prescriptions are too expensive, ask your doctor if a generic brand would be more affordable.

It helps the doctor—and you—if he or she knows about the non-medical parts of your life. Where you live, how you get around, and what activities are important to you—these are all things that can make a difference in decisions about your health care. The following are some examples of practical matters you might want to discuss with your doctor. For additional information and resources on these topics, see the section called For More Information.

Planning for Care in the Event of a Serious Illness

You may have some concerns or wishes about your care if you become seriously ill. If you have questions about what choices you have, ask your doctor. You can specify your desires through documents called advance directives, such as a living will or healthcare proxy. One way to bring up the subject is to say: “I’m worried about what would happen in the hospital if I were very sick and not likely to get better. Can you tell me what generally happens in that case?”

In general, the best time to talk with your doctor about these issues is when you are still relatively healthy. If you are admitted to the hospital or a nursing home, a nurse or other staff member may ask if you have any advance directives.

Driving

Driving is an important part of everyday life for many people and making the decision to stop driving can be very difficult. Tell your doctor if you or people close to you are concerned about your driving and why. He or she can go over your medical conditions and medications to see if there are treatable problems that may be contributing to driving difficulties. Vision and memory tests are important. The doctor also may be able to suggest a driver’s education refresher class designed for older drivers.

Moving to Assisted Living

Another hard decision that many older people face is whether or not to move to a place where they can have more help—often an assisted living facility. If you are considering such a move, your doctor can help you weigh the pros and cons based on your health and other circumstances. He or she may be able to refer you to a social worker or a local agency that can help in finding an assisted living facility.

Paying for Medications

Medicare Prescription Drug Plans

Medicare prescription drug coverage is available to people with Medicare. For information, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare website.

Don’t hesitate to ask the doctor about the cost of your medications. If they are too expensive for you, the doctor may be able to suggest less expensive alternatives. If the doctor does not know the cost, ask the pharmacist before filling the prescription. You can call your doctor and ask if there is a generic or other less expensive choice. You could say, for instance: “It turns out that this medicine is too expensive for me. Is there another one or a generic drug that would cost less?” Your doctor may also be able to refer you to a medical assistance program that can help with drug costs.

Tips: Advance Directives

Advance directives are written instructions letting others know the type of care you want if you are seriously ill or dying. There are two main kinds:

  • Living wills—A living will records your end-of-life wishes for medical treatment in case you are no longer able to speak for yourself. Living wills typically refer only to life-prolonging treatment when you are close to death.
  • Healthcare proxies—A healthcare proxy is named through a “durable power of attorney for health care.” Sometimes this person may be referred to as a representative, surrogate, agent, or attorney-in-fact. A healthcare proxy is helpful if you do not want to be specific about your end-of-life treatment, and you would rather let the healthcare proxy evaluate each situation or treatment option independently. This type of advance directive is also important if you want your healthcare proxy to be someone who is not a legal member of your family.

Make sure your doctor and family understand your advance directives and your views about end-of-life care. That will help them make the decisions you would want. Sometimes people change their mind as they get older or after they become ill. Review the choices in your advance care directives from time to time and make changes as needed.

Advance care directives are legally valid everywhere in the United States, but laws concerning them vary from state to state. Forms approved for the state you live in are available from many different healthcare organizations and institutions. Make sure that the form you choose is legal in your home state and any other state that you may live in for part of the year.

The National Institute on Aging at NIH offers free resources with more information about advance directives and end-of-life considerations. Go to www.nia.nih.gov/health/publication/legal-financial-planning to see these resources, including Advance Care Planning: Tips from the National Institute on Aging and End of Life: Helping With Comfort and Care.

 

Publication Date: April 2010
Page Last Updated: August 21, 2014