How to Talk with Your Doctor About Sensitive Issues
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Much of the communication between doctor and patient is personal. To have a good partnership with your doctor, it is important to talk about sensitive subjects, like sex or memory problems, even if you are embarrassed or uncomfortable. Most doctors are used to talking about personal matters and will try to ease your discomfort. Keep in mind that these topics concern many older people. You can use booklets and other materials from NIA or the organizations listed at the end of the article to help you bring up sensitive subjects when talking with your doctor.
It is important to understand that problems with memory, depression, sexual function, and incontinence are not necessarily normal parts of aging. A good doctor will take your concerns about these topics seriously and not brush them off. If you think your doctor isn’t taking your concerns seriously, talk to him or her about your feelings or consider looking for a new doctor. Read on for examples of ways to bring up these subjects during your appointment.
Anyone at any age can have a drinking problem. Alcohol can have a greater effect as a person grows older because the aging process affects how the body handles alcohol. People can also develop a drinking problem later in life due to major life changes like the death of loved ones. Talk with your doctor if you think you may be developing a drinking problem. You could say: “Lately, I’ve been wanting to have a drink earlier and earlier in the afternoon, and I find it’s getting harder to stop after just one or two. What kind of treatments could help with this?”
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.
Falling and fear of falling
A fall can be a serious event, often leading to injury and loss of independence, at least for a while. For this reason, many older people develop a fear of falling. Studies show that fear of falling can keep people from going about their normal activities and, as a result, they may become frailer, which actually increases their risk of falling again. If fear of falling is affecting your day-to-day life, let your doctor know. He or she may be able to recommend some things to do to reduce your chances of falling. Exercises can help you improve your balance and strengthen your muscles, at any age.
Regular exercise makes you stronger and can help you prevent falls. NIA has articles and free videos designed for older adults that can help you fit exercise and physical activity into your daily life.
Feeling unhappy with your doctor
Misunderstandings can come up in any relationship, including between a patient and doctor or the doctor’s staff. If you feel uncomfortable with something your doctor or his or her staff has said or done, be direct. For example, if the doctor does not return your telephone calls, you may want to say something like this: “I realize that you care for a lot of patients and are very busy, but I feel frustrated when I have to wait for days for you to return my call. Is there a way we can work together to improve this?”
Being honest is much better for your health than avoiding the doctor. If you have a long-standing relationship with your doctor, working out the problem may be more useful than looking for a new doctor.
Grief, mourning, and depression
As people grow older, they may lose significant people in their lives, including spouses and cherished friends. Or, they may have to move away from home or give up favorite activities. A doctor who knows about your losses is better able to understand how you are feeling. He or she can make suggestions that may be helpful to you.
Although it is normal to mourn when you have a loss, later life does not have to be a time of ongoing sadness. If you feel sad all the time or for more than a few weeks, let your doctor know. Also, tell your doctor about symptoms such as lack of energy, poor appetite, trouble sleeping, or little interest in life. These could be signs of depression, which is a medical condition.
Depression is a common problem among older adults, but it is NOT a normal part of aging. Depression may be common, especially when people experience losses, but it is also treatable. It should not be considered normal at any age. Let your doctor know about your feelings and ask about treatment.
Learn more about how to stay connected if you are experiencing loneliness and social isolation.
After divorce, separation, or the death of a spouse, some older people may find themselves dating again, and possibly having sex with a new partner. It’s a good idea to talk with your doctor about how safe sex can reduce your risk of sexually transmitted diseases such as HIV/AIDS. It’s important to practice safe sex, no matter what your age.
Older people sometimes have problems controlling their bladder. This is called urinary incontinence and it can often be treated. If you have trouble controlling your bladder or bowels, it is important to let the doctor know. To bring up the topic, you could say something like: “Since my last visit, there have been several times when I couldn’t control my bladder.”
Many older people worry about their ability to think and remember. For most older adults, thinking and memory remain relatively intact in later years. However, if you or your family notice that you are having problems remembering recent events or thinking clearly, let your doctor know. Be specific about the changes you’ve noticed. For example, you could say: “I’ve always been able to balance my checkbook without any problems, but lately I’m very confused.” Your doctor will probably want you to have a thorough check-up to see what might be causing your symptoms.
Problems with family
Even strong and loving families can have problems, especially under the stress of illness. Although family problems can be painful to discuss, talking about them can help your doctor help you.
If you feel that a family member or caregiver is taking advantage of you or mistreating you, let your doctor know. Some older people are abused by family members or others. Abuse can be physical, verbal, emotional, or even financial in nature. Your doctor may be able to provide resources or referrals to other services that can help if you are being mistreated.
Most health professionals now understand that sexuality remains important in later life. If you are not satisfied with your sex life, don’t just assume it’s due to your age. In addition to talking about age-related changes, you can ask your doctor about the effects of an illness or a disability on sexual function. Also, ask your doctor about the influence medications or surgery may have on your sex life.
If you aren’t sure how to bring the topic up, try saying: “I have a personal question I would like to ask you...” or “I understand that this condition or medication can affect my body in many ways. Will it affect my sex life at all?”
Learn more about how growing older might affect your sex life.
For more information on discussing sensitive subjects
NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
The NIA ADEAR Center offers information and free print publications about Alzheimer’s and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.
National Library of Medicine
This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.
February 03, 2020