Thursday Troubleshooter: How to handle patients who pull the "age card" to refuse treatment

It's becoming more frequent – patients who refuse treatment due to their age. Is it a legitimate excuse? If not, how do you respond and encourage them to receive needed treatment? These two DDSs share their thoughts.

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QUESTION: How do you suggest I respond to my elderly patients who obviously require treatment, but have taken to giving me the "age card" as their excuse not to pursue needed treatment? It’s happening more often these days, and I’m actually at a loss regarding what to do.

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ANSWER FROM WAYNE E. KERR, DDS, MAGD,Wayne@KerrSpeak.com:
Even after providing restorative care for patients of all ages for 37 years, the refusal for treatment based upon age still drives me absolutely crazy! What is my general response? Do you plan to eat next week or the week after that? Clearly, teeth that are the sources of infection or pain must be treated or extracted, but others – with obvious (but asymptomatic) decay – are often ignored by some of our "senior" patients, even after they are advised of the need for definitive care.

Certainly I recognize that age does impact the decisions of some patients, but I also acknowledge that some simple restorative plans are rejected just because our patients don't expect to live long enough to benefit from the recommended procedures.

Providing needed restorative services to our geriatric patients can really be a challenge, and this obligates us to ensure that we are absolutely aware of their current medical status. No one wants to recommend an implant to a patient who has a life expectancy of six months, but no one wants to fail to offer the appropriate restorative services to any patients, regardless of their age.

ANSWER FROM ROY SHELBURNE, Owner, The Appalachian Dental Group:
I would respond like this: “You know, I understand your concerns. None of us are guaranteed another second, me included, but I know that I want to enjoy every second I have to its fullest, however long that might be. You know I care about you and want you to have the highest quality of life for as long as you have, however long that may be. I’m betting you do too.” (Their obvious response is, “Of course!”)

Your response should be: "Taking care of your overall health, and especially your teeth, will help ensure your continued health, not to mention you’ll be able to eat anything your heart desires. I don't know about you, but eating is one of my greatest joys.” (Wait for their response; you know what it will be.) “So let's go ahead and schedule your treatment appointment and take care of [name the problem you're fixing]. You’ll be glad you did!”

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Send your questions for the experts to answer. Responses will come from various consultants associated with Speaking Consulting Network, Academy of Dental Management Consultants, or Dental Consultant Connection. Their members will take turns fielding your questions on DentistryIQ, because they are very familiar with addressing the tough issues. Hey, it's their job.

Send your questions to megk@pennwell.com. All inquiries will be answered anonymously every Thursday here on DIQ.

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