Do you need a medical escort?

photo of a young woman and a senior woman smiling together

Need a colonoscopy? Cataract surgery? Extensive dental work? These minor procedures and others like them, which involve anesthesia or sedation, aren't trivial when you factor in one thing: all require a medical escort — someone who can usher you home safely afterward.

This seemingly small detail is becoming increasingly significant as more older adults lead solo lives. About 27% of the more than 54 million Americans who are 65 and older live alone — and most of them are women, according to the U.S. Administration for Community Living.

Outpatient surgery centers, doctors' offices, and clinics usually require you to submit the name and contact information of the person who'll take you home after a screening test or same-day surgery. Many of these facilities won't allow you to leave unescorted, for fear your safety might be compromised.

If you don't have an escort, the stakes quickly climb. "Many people will forgo the procedure because it's too complicated to get it done," says Dr. Suzanne Salamon, clinical chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center.

"I've seen people go without needed screening or treatment," agrees Katherine Lyman, a geriatric nurse practitioner at Beth Israel Deaconess Medical Center. "It's heartbreaking that we have these barriers."

Transportation pitfalls

Overcoming this hurdle is becoming an issue for many older adults as the population ages. If you're single, your grown kids or other family members don't live nearby, and friends can't fill in, you may find yourself in a predicament.

Calling a cab or taking the bus won't suffice, compounding the problem. The same is true for rideshare services such as Uber or Lyft. Why? The drivers, however friendly, don't have a stake in your safety and typically won't accompany customers into their home.

"Uber or taxi drivers are not going to walk you out of the car and help you get into bed," Dr. Salamon says. "It's not in their job description, and if the patient falls, that could be trouble."

The concern is indeed warranted, Harvard experts say. Anesthesia and sedatives tend to remain in your system for many hours after a procedure, even if you feel otherwise fine. You might go home and happily sink into the sofa, but you might also be nauseated, vomiting, in pain, or unable to make cogent decisions.

"The anesthesia may be brief, but it can still knock you out to the point where you're not able to get home on your own without support," Lyman says.

And "anything involving general anesthesia raises the risk of you falling or being confused afterward," Dr. Salamon says.

Try these workarounds

If you don't have a medical escort handy, Harvard experts encourage you to think out of the box. Try one of these strategies:

Ask your doctor for guidance. Some medical offices employ a social worker or resource specialist to help coordinate this type of service.

Rely on community. "If you're tapped into a church, temple, or another house of worship, very often they have a cadre of volunteers that do just this," Lyman says.

Contact local organizations. Your area's Office on Aging might point toward volunteer or paid medical escort services. "They're not only sympathetic, but have a wealth of resources they can hook you up with," Dr. Salamon says.

Check with home health aide agencies. While these organizations typically hire out professionals who spend a certain number of hours with clients every week, some also offer medical escort services.

Brainstorm alternatives. Sometimes clinicians can use local anesthesia in place of general anesthesia, so you can drive yourself home or take public transportation afterward. Alternatively, they may allow you to stay in the office for a few hours after your procedure before allowing you to drive home.

Why you might want to bring a plus-one to your next doctor's appointment

Going to a routine doctor's visit on your own seems pretty straightforward. But for some people, it's anything but. Nearly four in 10 adults have felt anxious before such appointments, while almost half have left a visit feeling confused, according to a nationally representative survey of more than 2,000 Americans, conducted in October 2022 by market research company OnePoll.

"It's a big problem," says Katherine Lyman, a geriatric nurse practitioner at Beth Israel Deaconess Medical Center. "They're worried about what the doctor will find and what they'll hear. Are they going to uncover a dreaded disease?"

One way to smooth your concerns is by bringing someone with you. Ideally, this person would be a family member or good friend who's aware of your home life, what medical issues you face, and your medication use. Alternatively, try looping in a family member over speakerphone during the appointment.

When should you ask for such assistance? Harvard experts point to these solid reasons:

You're upset. Your symptoms may be distressing, or you worry your clinician won't take them seriously. The person who goes with you can help you convey fraught or embarrassing information in a clear, organized way.

You're overwhelmed. If you expect a difficult diagnosis or exhaustive information about treatment options, your plus-one may be better equipped to focus on what your doctor says. She can also write down important details and help you follow through.

You're forgetting things. Your companion can remind you what you planned to discuss with the doctor and help you recall what she said. "Many times people with memory issues will report problems they've had for years or forget to tell me problems that are really concerning," says Dr. Suzanne Salamon, clinical chief of gerontology at Beth Israel Deaconess. "The visit can really be fruitless."

You've been falling. As hard as it is to admit, divulging this information to your doctor is crucial to prevent a future calamity. A family member or friend who knows what's happening can provide useful context.

You're considering a major medical procedure. Your loved one can ask pivotal questions you might overlook and take notes on what to expect during the procedure and your recovery.