Join the debate. Vote Now on the Dear Abby Poll of the week.

by Abigail Van Buren

DEAR ABBY: I work in a doctor's office where some of our elderly patients are dropped off by a transportation company. These patients often have no one with them or meeting them in the office.

If the person is coherent, it's not a problem. But when the patient isn't, then he or she is unable to fill out the forms or give us insurance information. Sometimes the people may not even know why they are in our office. Of course, this means they are unable to discuss their problem with the doctor. We assist these patients as much as we can, helping them fill out the forms, etc., but this is a busy office, and it causes other patients to be delayed as well as the doctor.

We don't blame the transportation services, but we are asking that someone accompany the patient and be prepared to fill out our forms even if the patient has been there before because the information must be updated every year.

If the patient has a designated power of attorney, then that's who should accompany the patient and be sure to bring the power of attorney papers along.

It's heartbreaking to see this scenario. We can't provide proper care if the patient can't communicate the problem to us and the doctor. I hope nursing homes and loved ones will read this and do what's best for the patient. -- AN OFFICE THAT CARES IN PENNSYLVANIA

DEAR OFFICE THAT CARES: You have raised an important issue, and thank you for pointing it out. It would be a good idea for doctors to require that patients who are unable to speak for themselves have an escort.

Ideally, the patient's family should see that their family member has someone in attendance. Some assisted-living facilities do send an escort or an aide. However, if that is not possible, then a case management program should be set up by a social worker, either through the nursing home or the hospital.

DEAR ABBY: I'm struggling with a question of family loyalty. I grew up in a broken home with no father and was subjected to various kinds of abuse. I'm now 21 and have had a serious boyfriend, "Will," for several years. Will's family has always welcomed me with open arms, and I enjoy being with them. They are easy to love, unlike my own family.

Of course I love my mom and sibling. We have been through a lot together. The problem is, I prefer spending holidays and trips home with Will's family rather than my own. His family get-togethers are filled with laughter, games and stimulating conversation. When my family gets together, there is nothing but negative talk about people, jobs, the future –- basically everything. There are often screaming matches and swearing, with me listening with tears in my eyes.

I endured the environment during my entire childhood, and I don't want to go back to it. Am I being disloyal in choosing my boyfriend's family over my own the majority of the time? –- DIVIDED IN MILWAUKEE

DEAR DIVIDED: Considering the circumstances, I don't think you are being disloyal. However, rather that writing your family off entirely, allot a certain amount of time to see them. When the negativity starts, explain that it makes you very uncomfortable when they act that way, and that you're going to Will's house. It will send a pointed message that may be overdue.

To receive a collection of Abby's most memorable -- and most frequently requested -- poems and essays, send a business-sized, self-addressed envelope, plus check or money order for $6 (U.S. funds) to: Dear Abby -- Keepers Booklet, P.O. Box 447, Mount Morris, IL 61054-0447. (Postage is included in the price.)

4520 Main St., Kansas City, Mo. 64111; (816) 932-6600