Geriatricians, the patient, and the social network

Physicians are advised to not treat patients in isolation from their families and community. A wise doctor knows when and how to work with the beliefs and social support to provide the best medical care possible. Geriatricians and pediatricians alike, are careful to assess the support network of their patients as part of the activities of daily living (Wedding & Stuber, p.28). Often an older person's or adolescent's- parents , spouse, adult children, siblings, or even neighbors, and grandchildren might be helpful in providing pertinent information. Yet, the provider must be extremely discerning when making this decision, for on occasion it has turned out that the alternative source was out of touch, uninvolved or misinformed regarding the patients life, medications, and activities. The person who appears to be an alternative source of information my have only seen the person twice in three years or less than a decade, and live across the country. Ultimately it is the patients choice who they would like to have share information that the physician relays. If the patient is cognisant, an authorization to share medical information, then a power of attorney must be part of the patient chart.

Especially with older people a physician can talk with the social network member(s) and determine the best people to be with the patient and help them stay organized, to keep track of their questions, as well as to follow instructions for treatment. This method has been found to reduce the possibility that the patient will sabotage the treatment plan through disagreeing with the recommendations.

Some young people are more open when they do not have to ask specific questions when a parent is in the exam room. It is a good practice to have the parent leave the room briefly, to allow the adolescent to discuss private issues free of stress or embarrassment. This is a subject of contention among some parents, especially if the patient is 16, and in some states it is legal to receive medical treatment without a parents input, yet the child may be too inexperienced, emotionally distraught, or simply chronologically immature.

Some families may prefer that all medical information be conveyed to one specific person other than themselves. The seemingly organized patient may wish to have another person present to keep track of their own question, as well as the doctor's answers and instructions. A support person can help remember what was said and to further encourage compliance.
This all sounds so simple and straightforward,yet when it comes to siblings making decisions during periods that their parents are not capable, it can be a tine of much confusion, disorganization, and mistakes may inadvertently be made. My friend works as the director of residential living at a long term care facility and has told me about several of the "unusual circumstance" situations she has had to deal with from time to time. Many of which could have been prevented. She among anyone I know , could certainly give feedback about this sensitive issue.