Q: As my mother gets older, she's finding it more difficult to communicate with her doctor. I would love to accompany her to appointments, but I work a demanding job that makes it difficult. Are there any tips I can provide my mother with so that she can have more productive doctor's appointments?

A: Patient-doctor communication is one of the fundamentals of good health care. It used to be very common for the doctor to take the lead while the patient simply followed, but times have changed. Today, a good patient-doctor relationship is built on a partnership in which both the patient and doctor work together to address the patient's health needs. For the patient, this means asking questions if the doctor's explanations are unclear and pointing out problems or concerns even if the doctor doesn't ask.

Along these lines, the more active a role your mother takes in her health care, the more productive she and her doctor can be in finding the right treatment. Even if you are unable to make it to the actual appointment, you can do the following to help her prepare for a successful appointment.

Before the appointment:
Make a list of your mother's questions and concerns, starting with the most important ones.
Prepare a list of all her prescriptions, along with the dosages. This list should include prescription drugs, over-the-counter medications, vitamins, and herbal remedies.
Gather all of her medical records and documents, including her insurance card, as well as the names and phone numbers of other doctors who care for her.

On the day of the appointment:
Remind her to bring her eyeglasses or wear her hearing aid, if she uses them.
Coordinate with family members or friends who may be taking her to her appointment, and ask them to take notes for you.
Arrange for an interpreter if her primary language is not English.
Prepare a document for the doctor outlining your mother's symptoms, progress, daily habits, and so forth, as well as any concerns you may have about her condition or treatment regimen.

After the appointment, of course, you may learn that your mother's physician wants to conduct a medical test, has given her a diagnosis, or has prescribed a new medication. In those cases, be sure to follow up with the doctor by asking the following questions, either on the telephone or with your mother at the next appointment. Remember to take notes and repeat what the doctor says to make sure you understood his answers:

If the doctor wants to conduct a medical test:
Why do you want to conduct the test?
What does the test involve?
Are there any dangers or side effects?
When and how will we get the test results?
What will we know after the test?
Is this covered by my mother's insurance?

If the doctor provides a diagnosis:
What may have caused this condition?
Is the condition permanent?
How can the condition be treated or managed?
What are the long-term effects?
How can I learn more about this condition?

If the doctor prescribes a new medication:
What are the common side effects?
When will the medicine begin to work?
What should my mother do if she misses a dose?
Should she take the medicine at meals or between meals?
Should she drink a whole glass of water?
Should she avoid any foods, drugs, or activities while taking this medicine?
Will she need a refill?
Is this covered by my mother's insurance?

When the doctor writes a prescription, it is important to understand the directions for taking the medication. Sometimes doctors or pharmacists use abbreviations that you see on the prescription labels. The most common abbreviations are as follows:
p.r.n.: as needed
q.d.: every day
b.i.d.: twice a day
t.i.d.: three times a day
q.i.d.: four times a day
a.c.: before meals
p.c.: after meals
h.s.: at bedtime
p.o.: by mouth
ea.: each

Remember, your involvement, caring, and support will all be essential to helping your mother have more productive doctor's visits. By preparing her in advance and following up afterward, you'll be taking important steps toward enhancing your mother's health care and improving her quality of life.

Joanne Hill, M.S.W., is the author of Elder Organizer: A Journal of Information for Family Elders. This self-help book is a comprehensive guide, with educational articles and record keepers for important information, designed to help adults with retirement planning or with aging parents. For more information, visit www.lifeworkspublishing.com. Ms. Hill is a member of the American Society on Aging, the National Association of Baby Boomer Women, and the International Council for Active Aging.