What Your Loved One Won't Say At the Doctor's Office

I am the caregiver for my 101-year-old feisty, and alert great aunt. In the past 2-3 months I've had numerous calls from her telling me to take her to the hospital. I do my best to navigate and convince her she doesn't need to go. She gets frustrated and we start a sophisticated game of cat and mouse.

She'll have the receptionist at the retirement community call me, or the maintenance man. They only hear her saying "I need to go to the hospital" and then they tell me she needs to go. Her latest trick is having her friends who have cell phones call and say that she needs to go to the hospital.

After a particular challenging weekend, she called at 6 am saying she was in excruciating abdominal pain and needed to go to the ER. I took her in hopes of getting answers or assurance that nothing is wrong.

She confirmed to the triage nurse that she was having severe abdominal pain. In the ER room, she quickly told the ER nurse that she had terrible right foot pain. When the doctor came in she said she was having unbearable back pain. When I reminded her that we came because of excruciating abdominal pain, she told the clinicians that her pain moves.

The test results confirmed that everything was fine. It was an unnecessary trip to the ER.

She's from the old school where a trip to the ER often meant a 3-day stay to observe. For her that's a mini retreat. But that's not how it works today. She was out of the ER in less than 2 hours.

How do you stop these visits? It starts with an honest conversation with the family doctor. Her primary care doctor listened to me and worked with me to help educate, comfort and convince her that ER visits aren't necessary. With a preemptive call days BEFORE her scheduled family practice visit, we worked together to coordinate a plan to combat these unnecessary visits and address her concerns.

My great aunt knows the time she has before her is far less than what is behind her. She is ready to die. She often questions why she's still here. She's got a living will but she's in great health, especially for 101.

Dying is scary. As much as she thinks she's ready, when she gets an ache, a pain, indigestion or any other symptom, she wonders if this could be the moment. At 101, it's far more real than for those of us half her age.

Sometimes the best medicine is reassurance that aging is normal. Being scared is normal. Start the conversation with the family doctor and other healthcare providers. They can be extra support for the patient and caregiver. Often, that's the best medicine.