To Change the Subject: Practical Matters

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, 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 more information and resources on these topics, see the section on additional resources included at the end of this booklet.

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 diffi cult. 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 diffi culties. 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 — 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 fi lling the prescription. Then 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.

Summary: Practical Matters

• 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 troubling 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.

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