Communication

Questons to ask about the condition

• What do you know about this disease (or condition)?
• What did your doctor tell you? What do your family, friends or religious leaders tell you?
• How do you picture yourself in 10 years (1 month, 5 years)
• What are the long-term ramifications of this condition?
• How do your religious beliefs help you?
• What do you think?
• Do we ever know what is going to happen? What would you like, what do you NOT want, what do you hope for that you can control? (eight stations of life, be specific about your terms)
• for more ideas on questions to ask go to Listening questions

When talking to your doctor

Many people assume their doctor and family understand them. Here are two problems:

Family Caregiver Alliances study found 57% of caregivers want information about what to expect as a disease progresses, 38% said they received it, 83% of doctors said they gave it.

• YOU need to take responsibility for asking what you want to know
• Write your questions down ahead of time, even send them to the doctor before the visit
• Take along a pad of paper to write the answers
• Take along another person to help you get the questions asked and to help remember the answers.
• Be specific about your function and discomforts, your desires and your resources (time, money, energy, caregivers)

Check lists for talking with your doctor (PDF)
checklist for talking with your therapist (PDF)

Be specific about your terms

Its easy to define for your doctor what you DO want in the way of treatment. Its harder to define what you dont want. Help your doctor understand what you mean.

• No tubes does not define what the tubes are for or how long they might be used.
• No heroic treatment does not define what heroic means.
• No extraordinary measures can become outdated, what is extraordinary today may not be tomorrow.
• Not a vegetable is difficult to define, and needs clarification about the potential for coming out of it. Also, if one does come out, what degree of disability would you find find acceptable?
• And, very important, does the person you designate to make these decision agree with them?

THE EIGHT STATIONS OF LATE LIFE

This list can help you see the stages a person might go between, and therefore might help you define and discuss your observations with others. The book, My Mother, Your Mother, listed below, has many helpful suggestions for each stage.

Station 1: Stabilty
Everything is just fine, dear -Mom

Station 2: Compromise
Moms having a little problem -Dad

Station 3: Crisis
I cant believe shes in the hospital -Sister

Station 4: Recovery
Shell be with us for a while -Rehabilitation Nurse

Station 5: Decline
We cant expect much more -Visiting Nurse

Station 6: Prelude to Dying
I sense a change in her spirit -Nurse in Long-Term Care

Station 7: Death
Youd better come now -Hospice Nurse

Station 8: Grieving / Legacy
We did the right things -Brother

Dennis McCullough, M.D.
Community Geriatric Consultant
Associate Professor of Community and Family Medicine
Dartmouth Medical School HB7250
Hanover NH 03756
www.dennismccullough.com
www.mymotheryourmother.com