What do healthcare providers, caregivers and their loved ones living with dementia have in common? Looming frustration at medical appointments!
Could the waiting room experience be improved? My dear client has moderate stage Alzheimer’s, arthritis, hearing loss in one ear, and a slow, unsteady gait even with a walker. Daily life for him is no walk in the park. Add a trip to the doctor? Expect confusion, a slow pace, a change in disposition and possibly an abrupt change of plan. No one wants to hear “we’ll have to reschedule!”
Let’s disrupt the traditional medical office visit and improve the experience for providers, caregivers and care recipients. Here’s a list of suggested ways to improve the medical waiting room and exam experience for people living with dementia and their caregivers.Medical professionals take note of the part you can play in this encounter.
- Caregivers: Plan ahead. Ask for an appointment time that fits well with the daily routine, e.g., mornings are challenging, afternoons are calmer, after lunch and not too close to dinnertime.
- Caregivers: Prepare well for the appointment with appropriate clothing, incontinence supplies, a snack, entertainment (IPad, puzzles, fidget blanket, photo album…), and a trip to the bathroom before you leave home (you and your care recipient).
- Caregivers: Bring a list of written questions and medications list.
- Caregivers: Notify the front desk staff (quietly, respectfully) that the patient has dementia. You can purchase or make your own cards (we have some for you, just ask) to hand to people that explain the person with you has dementia. Recommend that the most important tests are done first in case patience runs out and the visit unravels.
- Medical staff: Perhaps the doctor could see the patient first and then do tests? For vision testing, consider dilating eyes as soon as the patient arrives. Is it possible to re-evaluate the testing protocol for a patient that may become uncooperative and end the visit prematurely? Which tests are most crucial to inform a diagnosis?
- Medical staff: Listen and act on a caregiver’s suggestions to facilitate patient interaction, e.g., patient is hard of hearing, patient has balance problems, patient is incontinent, a long wait in a cold exam room will sink the ship, etc.
- Physician/Physician Assistant/Nurse Practitioner: Use a person-centered approach, please. Be inclusive of patient and caregiver when asking questions, making diagnoses, describing treatments. Speak clearly. Make eye contact. Smile (or at least try not to look scary).
- All participants (you too, doctors): bring along your sense of humor. Share a smile or a laugh. Music, natural lighting, or fun distractions may ease anxiety. Position the patient so that he can look out a window. One practice that I visit is known for its beautiful saltwater aquarium in the reception area. Flexibility and good humor will lead to a greater chance of a successful visit.
