Indirect Questions

• "Are you having any medical or health problems? What symptoms do you have? What do you think these mean? Have you felt this way before?"
• "Do you see a doctor or other health care provider regularly? When was the last time? Do you see more than one? Why? Have you switched doctors recently? Why?"
• "Have you experienced any negative or unwanted events that altered the way you lived (in the last 5 years)? Any since we last met? How much of an impact did the event have on the way you lived or felt? What feelings or beliefs did it cause or change? Do you believe that you are coping with the changes in a healthy fashion? How (specifically) do you manage (control) the circumstances (consequences) of the problem(s) or event(s)?"
• "What prescription drugs are you taking? Are you having any problems with them? May I see them?" (This question will need to be followed by an examination of the actual containers to ascertain the drug name, prescribed dose, expiration date, prescribing physician, and pharmacy that filled each prescription. Note whether there are any psychoactive medications. Ask the patient to bring the drugs in their original containers.)
• "Where do you get prescriptions filled? Do you go to more than one pharmacy? Do you receive and follow instructions from your doctor or pharmacist for taking the prescriptions? May I see them? Do you know whether any of these medicines can interact with alcohol or your other prescriptions to cause problems?"
• "Do you use any over-the-counter drugs (nonprescription medications) or herbal or vitamin supplements? If so, what, why, how much, how often, and how long have you been taking them?"

If the questioner suspects that prescription drug abuse may be occurring, a clinician should probably be notified to probe further if any of the following is true:

• The older adult is defensive about his or her use.
• The older adult is confused about various prescription drugs.
• The older adult is seeing more than one doctor or using more than one pharmacy.