While I'm away, readers give the advice.
On helping a loved one whose health is at risk:
I often wish advice columnists would counsel those who are concerned about someone to send a letter to the person's doctor. It's usually easy enough to find out names of people's doctors: The doctor's name and phone number are on the prescription bottle. If not, "New neighbors just moved in down the street and asked about good doctors, but mine doesn't take their insurance. Your doc has always seemed great. What's her name again?" works too. Include the patient's full name, date of birth and/or address so that we can connect the letter to the patient's file, and then be specific about any observations and concerns. We can't respond to the letter because of HIPAA regulations, but a reputable doctor will take it under advisement. The letter writer can request anonymity. While I can't guarantee the patient won't put two-and-two together, it's usually not too hard for me to make up a pretext about why I need to see the patient, and with a few routine questions and physical exam maneuvers, I can usually come up with enough evidence to take good care of my patients without disclosing the letter.
This could be useful for concerns about driving safety, dementia, mental illness, elder abuse, domestic violence, sexual abuse, child abuse or substance abuse. These are all situations in which neighbors, friends and family are well positioned to provide collateral history that patients may hide, and thus doctors may miss unless prompted.
Of course, we can't "cure" any of these problems, but with this information in hand, we can offer the patient our professional assessment, support and the appropriate referrals.