Paul Wallis has been a practising optometrist for over thirty-five years and a large percentage of people he sees are over 83. Here he tells us how best to tackle taking Mum for an eye test, or indeed any other medical appointments with professionals.
Getting an appointment with a professional is a juggling act; when is Mum’s hair appointment? Will she have had her afternoon nap? Do the kids need a taxi run? Can I fit it in after that meeting on Friday? Having leapt those hurdles, on the day you’ve dropped her off, parked the car and rushed back to the opticians/dentist/GP. The waiting room is empty. Ten minutes later she totters out, smiles at you and off you go back home.
‘So Mum, what did she say about the fact your eyes that are always wet with tears?’
‘Oh, I forgot that’.
‘Did you mention you can’t see the TV? ‘
‘No I didn’t like to bother her.’
Did you say your vision went all funny last week in your left eye?’
‘Yes’
Well?
‘I can’t remember what she said but she was very nice, her name was Sharon.’
AAARGGH…
When I qualified in the late 1970’s often a patient would turn up with a ‘carer’ in tow. The tactic then was to detach the hanger-on, the patient professional relationship being the overriding factor. The carer was there to make sure the patient turned up and was removed promptly. My views have changed since; now the ‘Carer’ is the most important person in the room. But there are rules of engagement.
Appointments with professionals
1 Discuss being in the consultation before you leave home. You don’t want a row in reception about ‘you’ trying to barge into ‘my consultation’. Otherwise there are embarrassed faces all round.
2 If you have to drop them off before parking, pop in, and mention you want to be in the consultation to the receptionist. Then if they have already gone in you can join them later without causing a riot.
3 Identify yourself, all you need to say is ‘Molly is my mother’ I would then know you are a direct blood relative, or a quick explanation of any other relationship. I have to confess I have had in depth discussions with carers only to discover they only turned up this morning to provide transport and had never met the person before.
4 Being at the consultation in person means I know you have the permission of the patient to share information. Patient confidentiality is a minefield, it drives me insane at times, some practitioners can be difficult about it, tread carefully until you know they are happy to talk to you. If they have any experience and common sense they will chat to you.
5 Don’t try to be helpful at the outset, ‘ Mum is deaf, blind, demented I am here to help’. Sorry about this, they may be deaf, blind and demented at home but in front of a professional they will be firing on all cylinders. Keep your head down until after the initial signs and symptoms questions. I want to assess the patient, do tests etc and see how they respond and react. All professionals are used to the reactions of people in a consulting room and are making assessments as they go.
6 Your time is at the end of the consultation. That is when I need you and the real business happens. I know half the information I give is going to go over the head of the patient, it won’t be acted on or even remembered. I will talk as if I am addressing the patient. I am not, you are my audience. I will ask questions. At this point if you helpfully ask questions to clarify points that Mum has failed to raise, we can discuss actions to be taken and how to implement them.
I will always make it a three-way conversation even if only two thirds of us are participating. If I want something done it is via you that it will happen.
I will explain how the condition is affecting their vision and what effect it will have on them generally, not for their benefit, they know what the effects are, but you may not be aware of side effects caused by problems with vision. I am trying to educate you, so you can help better.
7 Sometimes but certainly not always I may take the carer to one side as the patient leaves. This would be to explain about problems that I don’t think is appropriate to tell the patient, if I consider that it would cause unnecessary distress to the patient. Ethically dubious but humane.
If you make yourself known to the professional you can build trust for the longer term which is ultimately useful for all three parties. If you feel no empathy or don’t get feedback switch practitioners.
Finally you are there to fight your parents corner and sometimes it may be a fight but only take up the cudgels when you are certain of your facts, don’t go in all guns blazing unless you are well armed, I’ll just put up the barriers.
Best of luck.
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