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The most important questions are often the ones you didn't know to ask. Even the best doctors in the world can't give you the right answers unless you ask them the right questions first.
But how do you know what the right questions are? "Ask your doctor." You've heard it a million times, but do you really know what to ask? What if you don't know very much about Alzheimer's disease yet, feel intimidated by your doctor's expertise, or just feel simply overwhelmed by this diagnosis?
More than ten years ago, when my mother suffered a major heart attack, I felt overwhelmed. As I nervously watched her vital sign monitors bounce around, it occurred to me that I didn't know what to ask the doctors about her condition. In that moment of total helplessness, the only thing I could control was my questions. But I just didn't know what to ask.
I vowed to learn how to ask better questions. When I started taking my mom to her follow-up doctor appointments, I spent time researching her medical options and planning questions for her doctor. I wanted to be a well-informed consumer for her sake so that I could make sure she was getting the very best care possible.
This experience sparked my interest in questioning skills. As I read about questions, I was surprised to learn how little attention most people pay to them. It seems that our society is so focused on solutions and answers that we rarely ever stop to first consider the quality of our questions.
I started teaching questioning skills as part of my graduate-level business classes in Washington, D.C., and Perth, Australia. My students liked it so much that I developed the concept of"The 10 Best Questions" as a way for them to learn questioning skills, team dynamics, and research skills all at once. Since 2003, I've taught hundreds of students who have interviewed thousands of experts. For example, my students have researched what to ask when you buy a house, get engaged, adopt a dog, hire a financial planner, invest in stocks, retire, plan a wedding, start a diet, and have great sex.
To learn more about questions, I conducted a series of interviews with top question askers to understand their secrets. Helen Thomas, the legendary White House reporter, is famous for her press conference questions to every president since John F. Kennedy. She told me, "Before a news conference I would think, What's the best question to ask? I have the courage of ignorance in my questions. I always get nervous, figuring out what to ask a president. But I believe you have to be curious and keep asking why."
Peter Block, an international management consultan and the author of the book The Answer to How Is Yes, said, " There's a deeper meaning to asking questions. It's a stance you take in the world, a desire to make contact and get connected."
I talked with many professional interviewers like Susan Sikora, a TV talk show host in San Francisco; New York radio host Debbie Nigro; and Richard Koonce, a journalist and consultant in Brookline, Massachusetts. Each responded with a version of "You are only as good as the questions you ask." For information specific to this book, I also interviewed experts in Alzheimer's, relationships, long-term care, stress, communication skills, financial planning, and caregivers, as well as two former U.S. surgeon generals.
So, who are the best question askers? They are smart, curious, and fearless, yet humble enough to learn from someone else. They value listening and inquiry. Great question askers see every person they meet as a walking encyclopedia of valuable information just waiting to be unlocked by the right questions. And finally, as Albert Einstein once said, "The difference between me and everyone else is my ability to ask the right questions."
The 10 Best Questions in this book won't make you an instant Einstein. And as the Question Doctor, I certainly don't claim any Einstein-like brilliance. I simply believe that a good mind knows the right answers, but a great mind knows the right questions. Now that great mind is yours. This book is "for smarties," not dummies.
Each chapter is a list of the 10 Best Questions derived from as many as 840 questions for that topic and from dozens of books, journals, and Web sites. Each Best Question really had to earn the right to be best by being cited many times. After each question, I've included the "best answers" my experts provided and from my own research so you'll know when you are hearing the full story. The information in this book should not replace medical guidance or professional counseling services.
There is one more question per chapter that I call "The Magic Question." A Magic Question is the one that even smart people rarely think to ask because it's a gut-level question without an obvious answer. Oftentimes, Magic Questions are the ones you think about later and wish you had asked.
In writing this book, I've taken a practical and holistic approach to researching the Best Questions to make you a best-informed patient or caregiver. My focus is to help your key decisions, choices, and relationships by suggesting what you can ask your doctors, medical experts, partner, family, friends, and ultimately yourself after a diagnosis of Alzheimer's disease.
Your lifetime prescription for good health is to stay informed. Former Surgeon General Dr. C. Everett Koop told me in an interview, "There's nothing that will lead to better medical care than a knowledgeable patient." Skip around and read the chapters most relevant to your needs at each stage of the disease.
The 10 Best Questions in this book give you the actual script and best answers in hand for each major conversation and decision you will soon be facing. At the same time, be sure to ask plenty of your own questions, too. As question guru Helen Thomas concludes, "There's no such thing as a bad question, only a lot of bad answers."
The Question Doctor sincerely hopes the Best Questions and answers in this book will give you personal strength and empower you and your loved ones with the knowledge to live as well as possible with Alzheimer's disease.
Copyright © 2008 by 10 Best Questions LLC
The two most common concerns expressed by newly diagnosed Alzheimer's patients and their families are the fear of the unknown and a fear of not communicating well with their doctors. Your medical team can help you make decisions, but you have to ask the right questions first.
Many people are intimidated by their doctors' knowledge and are reluctant to ask them questions, especially with a diagnosis like Alzheimer's. Use this book to help you. This is no time to be shy, to worry about hurting the doctor's feelings, or to be secretly afraid that he may not "like you" if you ask questions. There's no reason to be aggressive in asking your questions, but be firm in telling your doctor that you expect answers.
To be heard, you may need to repeat your questions or concerns. According to a 1999 study published in JAMA, The Journal of the American Medical Association, when patients are trying to talk, doctors typically interrupt after just twenty-three seconds. Persist through interruptions. If your doctor interrupts you before you make your point, try saying "I'd like to finish" or "Can we come back to my concerns later?"
The Best Questions in the first chapter suggest what to ask your doctor when you are first hearing the words "Alzheimer's disease." It assumes that you are talking with your family doctor and are probably too overwhelmed to ask a lot of detailed questions. Chapters 2 and 3 will help you find a top Alzheimer's specialist, while chapter 4 gives you the Best Questions to ask when you're discussing the details of the tests with your new specialist (or family doctor). The last chapter in this section arms you with the Best Questions for getting a second opinion on this diagnosis.
The Question Doctor says, Keep asking questions, both your own and from the following chapters. Even the best doctors can't give you the right answers if you don't ask them the right questions first.
Copyright © 2008 by 10 Best Questions LLC
Foreword Dr. Roger A. Brumback xiii
Part I Talking with Your Medical Team 5
The 10 Best Questions
1 About a Diagnosis of Alzheimer's Disease 7
2 To Get a Reliable Referral for a Top Alzheimer's Specialist 20
3 To Find a Top Alzheimer's Specialist 29
4 About the Test Results for Alzheimer's Disease 38
5 To Ask When Getting Second Opinion 48
Part II Choosing Treatments 57
The 10 Best Questions
6 To Ask About Alzheimer's Drugs 59
7 For Brain Fitness 68
8 To Avoid Alternative Treatment Scams 77
9 Before Participating in a Clinical Trial 83
Part III Caring for the Person with Alzheimer's Disease 97
The 10 Best Questions
10 To Decide if Your Loved One Can Remain at Home 99
11 To Assess Home Safety for a Loved One with Alzheimer's Disease 112
12 To Decide, Should Mom Move In with Me? 123
13 To Find Quality Adult Day Care for Alzheimer's Patients 131
14 To Hire a Top Home Health Care Agency 142
15 To Choose a Long-Term Care Facility for an Alzheimer's Resident 152
16 To Recognize Elder Abuse 168
Part IV Caring for the Caregiver 177
The 10 Best Questions
17 For a Caregiver's Emotional Health 179
18 When One Spouse Has Alzheimer's Disease 189
19 For Long-Distance Caregivers-Does Dad Need Help? 198
20 Before Joining an Alzheimer's Support Group 208
21 The 10 Worst Questions to Ask People with Alzheimer's Disease 218
Part V Planning for the Future 225
The 10 Best Questions
22 For Deciding When to Retire from Driving 227
23 For a Caregiver's Financial Health 239
24 To Settle Legal Issues at the End of Life 250
25 For Choosing Quality Hospice Care 261
Conclusion: Living Well withAlzheimer's Disease 271
Meet the Experts 301
Posted May 24, 2009
When I was told that my mother has multiple dementia, I had no idea what that meant other than not being able to remember things. I did the usual Google explorations trying to find some way of knowing the implications and what I could/should do. But there is so much information out there and no way to organize it so that I could use it--until I came across Dr. Bonner's book.
The book is organized in sequential sections according to what one experiences in the onset and progress of Alzheimer's Disease (AD): from the diagnostics, the treatments, the care giving, the care giver to managing the planning for AD's inevitable conclusion, including legal issues. Dr. Bonner's approach is to provide, for each important topic, the ten best (essential) questions that enable getting a sense of order (if not control) by which to take on this debilitating, incurable mental illness. I found that the initial explanation of AD and the implications and impact of AD, followed by each section of posed questions focused me on my role. In fact, I immediately typed up the first set of questions and rewrote them, personalizing them according my observations of my mother, and gave them to my father and the doctor. The result was that my father and the doctor used the questions to plan the next steps, giving me a clear and direct response of what to expect for confirming the diagnosis through deciding on treatments and accepted the necessity of assisted care.
Subsequently, I found that I kept turning to the book, rereading and reflecting because I not only found the answers to the questions that directly related to my mother, I found that the process of using the questions and seeking answers gave me a form of solace. At the end of each section is a list of ten best resources that have enabled me to know where to go next according my mother's needs and my own needs.
Dr. Bonner also provides specific examples of the best answers to those questions that have non-family specific answers. I had heard people talk to AD patients as though they were children (rather than people who no longer could use their short-term memory. I knew how to talk with my mother once I understood what it feels like for her when there is no reliable short term memory anymore. The "Question Doctor" tips taught me what to ask instead of, for example, "What did you do today?"
I find that more and more of my friends and acquaintances seem to be experiencing Alzheimer's in their families, too. Typically, I'll loan my books to people. But, because I find myself going back to Dr. Bonner's book to refresh my understanding and to guide my support of my mother (and just to feel better about what I can and cannot do), I will not loan this book to anyone. But I will recommend it!
I write this recommendation because I hope that it saves others from some of the fear and frustration that come when one is told that a loved one (or one's self) has AD. Although AD cannot be cured, there are definitely better ways to face it and manage the response to it. Those ways are clearly, thoughtfully, and expertly provided in Dr. Bonner's book. I am grateful that I have had it to read and refer to during this difficult time.