Dear Laird: My dad is 85 and lives alone across town. Recently I’ve noticed he’s been misplacing items, appears to be confused during conversations and doesn’t want to bathe. I’m going with him to his next doctor’s appointment to discuss my concerns. However, I don’t know the doctor and I’m afraid my dad won’t like what I have to say. What should I do? 

It’s natural to worry about your parents as they age, particularly when changes in their behavior may signal more than just the usual effects of growing older. Ensuring your father receives the care he needs is your priority.

When a family member accompanies a loved one to a doctor’s visit for the first time, it can be uncomfortable for everyone involved. 

I call this relationship the “therapeutic triangle.” For it to work effectively, the doctor requires detailed information from you to make an accurate diagnosis. It’s also important that the doctor understands your capabilities and challenges as a caregiver, and that you grasp the future care demands that may lie ahead for your father.

Here are several strategies I’ve found helpful from the experiences of other caregivers:

• Write a note for the doctor: Before the appointment, write a note to the doctor introducing yourself as your dad’s primary caregiver. Share any observations and specific concerns you’ve noticed about his behavior or health. It’s also helpful to mention any caregiving limitations you may have, such as other caregiving responsibilities, work commitments or living far away.
• Prepare talking points: Jot down key points you wish to discuss. Practicing beforehand will also help calm your nerves.
• Talk to your dad before the appointment about his expectations for the visit.
• Engage with the nurse: Nurses play a vital role in communicating your concerns to the doctor. You might follow them out of the room to mention things your dad may be reluctant to discuss.
• Where to sit: If possible, sit close to but slightly behind your dad so you can signal agreement or disagreement with subtle nods or gestures.
• Introduce yourself to the doctor: When the doctor arrives, stand up, introduce yourself and maintain eye contact. This conveys your active involvement and willingness to work together.
• Listen and observe: Let your dad and the doctor lead the conversation as much as possible. Show support by nodding and ask clarifying questions, like “How does that work?” 
• Speak privately with the doctor: After the visit, call the scheduler to arrange a separate appointment with the doctor if you have more to discuss.
• Schedule a visit with your own doctor to discuss how caregiving may be impacting your health and explore any support or resources you may need.