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Posted: June 30, 2004

Professional Caregiving

What?s Up, Doc? Ask, and the World is Yours

How many of us have gone to the doctor, and come out again, forgetting a few questions, leaving without a clear understanding or worrying about something not addressed in the office which has added additional stress to you?

Each of us has probably felt this way at one time or another. Whether we are professional healthcare providers, or family caregivers, learning skills to improve communication with our healthcare professionals can only benefit the patient, the caregiver and the healthcare professional or doctor.

Good communication between caregivers and their physician or healthcare provider will enhance a family member?s care, and for the professional healthcare provider, will make visits from them more efficient and thorough. Both patient and healthcare provider can benefit from improved skills in communication regarding medical conditions, concerns and questions during an office visit.

Our parents might have had a harder time asking their doctor for a few more minutes of explanation, or what the side effects of a medication are, but we have learned over time that firstly, we have the right -- no, obligation -- to get answers from the doctor during a visit. And the better prepared we are before we go into the doctor?s office, the less stress to ?think on their feet? the patient and/or their family caregiver will experience.

The National Family Caregiver?s Association (NFCA) has launched a nationwide educational program targeting caregivers and the issue of improved communication with healthcare providers. Based on their studies, better communication with the healthcare professional serves the patient, caregiver and doctor.

There are a number of pointers caregivers can learn for themselves as well as the person they are caring for. Learning to focus, stay calm and clear when visiting the doctor, knowing the most relevant questions and how to ask them and knowing not to leave until questions are satisfied, within reason, are some of the core items addressed in the two-day training conducted by NFCA for professionals. The training I was able to attend recently was designed to train local healthcare workers with practical experience so they could bring the information back to their communities in the form of workshops for caregivers.

The main topics addressed caregivers? need to understand the healthcare delivery system, learn effective communication techniques, understand how to work successfully with the caregiving team and how to use skills needed in varying situations doctor?s office, emergency room, and how to develop an action plan prior to an office or medical visit.

All of this may sound either obvious or like more work than caregivers can find the time for. But surprisingly, the content of ?Caregiver Training on Communicating Effectively with the Healthcare Professional? can be delivered in as little as a three-hour session. Once these skills are learned, the caregiver will realize the benefit for their own well-being as well as that of the person they care for. Trainers were encouraged to plan the workshop in conjunction with offering respite during the training, so the caregiver could participate, resting assured their loved one is attended to if they cannot be left at home alone.

Some of the most important points addressed issues from the patient/caregiver perspective and also from the healthcare professional?s perspective. Each gave tips on what would be most beneficial for them from the other?s perspective before, during and after an office visit. While this was focused primarily on helping caregivers learn these skills, even healthcare providers in their own lives have a lot to gain from this knowledge. Any of us may be or become a caregiver or receiver, and these communication skills will improve the patient/doctor experience regardless of who is wearing the white coat.

If you were to ask a caregiver what were the most important components of a meeting with the doctor, they would likely say they wanted a clearer explanation of the condition, medications and recommended treatment plans. They want unrushed time with the doctor. They also want the doctor to be sensitive to the impact of their family member?s illness on them, the caregiver, and the practicality of follow-through with care regimens.

A few moments of face-to-face, in seated conversation, would give the caregiver a sense that they had connected with the healthcare professional and he or she hopefully addressed their feelings, worries and concerns. This is much harder to bring up when the doctor is standing at the door, reading the chart or not making eye contact.

Family caregivers need to trust that the doctor is being forthright, honest and direct with questions posed to them by the patient or the caregiver.

Finally, but certainly not less important, is the need caregivers have for the healthcare professional to simply ask them how they, the caregiver, are doing. This is not intended to open up the caregiver?s whole life story, rather ensuring the healthcare professional sees the family unit in context, making sure caregivers feel heard.

Too often the caregiver feels ignored or even that their role is minimized or taken for granted by the physician. When caregivers know the physician recognizes the many responsibilities that are carried out by the family, caregivers feel acknowledged and this makes for a healthier, more satisfied customer. Satisfied customers, whether patients or patient advocates, are what doctors want to have, as they are more cooperative and compliant with care regimens.

It is also important to show the physician that you expect basic information and questions answered. IF you find yourself in a situation where the healthcare professional does not address you or your questions, you might do best by addressing it head on. If, after that, they do not demonstrate an interest in satisfying your questions, you might do better shopping for another doctor.

Likewise, if you ask physicians what would make the office visit run more smoothly and efficiently from their perspective, they will have additional recommendations that all of us should heed, taking into consideration the tight scheduling concerns that limit face-to-face time. Firstly, they also appreciate the time taken beforehand to prepare a list of questions and concerns, so you get the information you need at the time. This minimizes the need to call back to get them answered or let them go unanswered at all. Thinking about the questions and keeping a list with you (you never know when you will think of something you need explanation for!) will suffice.

Also, trying to keep social conversation to a minimum, and sticking to the point, will give more time for quality input from the healthcare professional. Sometimes, the hardest questions, usually those starting with ?Why did . . . ? or ?When will . . .? are not easily answered if answerable at all.

Give the physician room to say ?I just don?t know.? There is no crystal ball.

Coming to the office visit having done some basic ?research? (i.e., Googling for information, hearing experts, others who have gone through similar situations and reading prepares you with the basics of the conditions you are facing with your loved one. The healthcare professional will not have to take valuable office time to give you the entire overview of all the causes, prognoses and treatments for the condition a caregiver and patient are facing. Keep your questions specific to your loved one?s situation.

While these are only guidelines, they are not intended to indicate that the physician is not interested in giving you all the information you seek. The pressure on physicians to see many patients each day has limited the time they can spend with each. Use your time well, and the physician will appreciate it.

Don?t forget, the care team is comprised of the healthcare professional, family and patient and understanding each other?s world a bit better will lead better outcomes for all.


Sylvia Nissenboim is a licensed clinical social worker and who has been working in the field of adult day services in the St. Louis area. She is the director of four adult care and enrichment centers for the American Red Cross and also operates a personal and professional coaching firm, LifeWork Transitions, specializing in caregiving concerns, adult day care management and other aging services, such as virtual coaching and family care giving support groups. She co-authored The Positive Interactions Program, is a national speaker, and has served as president of the Missouri Adult Day Care Association and as a member of the Missouri Governor's Advisory Council on Aging..

© 2004 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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