“I’m overwhelmed as a caregiver—where do I start?”
It’s a question I frequently hear from adult children who are noticing age-related changes in their parents. So, if you’re worried about Mom or Dad’s health and safety, where should you start? My best suggestion for new caregivers is to urge their loved ones to make an appointment for a comprehensive health assessment.
Like many seniors, my own mother resisted this idea at first. However, I reminded her that I was recommending this step for a very good reason: to help keep her healthy and independent in her own home like she wanted. When it was presented to her that way, her hesitation faded and she expressed gratitude for my interest in her safety and wellbeing.
A health assessment may seem unnecessary (especially if a parent has recently experienced a medical setback or been hospitalized) but try to think of this evaluation as the foundation for all your other caregiving duties. You can’t jump in and offer solutions without a good look at the big picture first. The results of this medical appointment will give you a better understanding of your parent’s overall condition, highlight their needs and help you make care decisions moving forward. Of course, their health and needs will change over time, but gathering as much information as possible about their situation will help you find constructive ways to extend their independence, avoid crises and plan for the future. Best of all, this information and preparation will give you some peace of mind.
First Steps to Take as a New Caregiver
Step 1: Schedule an overall health assessment with your parent’s primary care physician (PCP). If they don’t currently have a PCP, ask family members, friends, or neighbors for recommendations.
Step 2: Before the appointment, sit down with your parent and create a comprehensive list of all the prescription and over-the-counter medications they take, along with dosing and prescribing information. Don’t forget to include dietary supplements, herbs and vitamins. Talk with your parent about their medication regimen and ask if they ever have difficulty filling prescriptions, remembering doses or keeping their pills in order. They might need assistance organizing and managing their medications. Solutions may be as simple as a labeled pill box or arranging to provide medication reminders personally or through a professional in-home care service.
Bring this list to the health assessment so that the doctor can review their medication regimen. This will help the doctor screen for potential medication interactions and give them the opportunity to suggest discontinuing any medications that are no longer necessary or changing medications to minimize adverse side effects.
Your loved one should keep a copy of their medication list in their wallet or purse in case of an emergency and post a copy in a prominent place in their home. As their primary caregiver, you should also have an updated list for your files.
Step 3: Accompany your loved one to the appointment and bring a notebook with you to take notes and keep their health information organized. The sooner you implement an organizational strategy, the easier it will be to help manage your parent’s health care and other affairs. Use this notebook to track all your loved one’s symptoms, any questions, the doctor’s answers and instructions, and follow-up appointments. Questions or concerns to address with the doctor during this appointment might include:
- What new diagnosis/prognosis should we be aware of? Does my parent need to see a specialist?
- What tests does my parent need currently? If so, when and where?
- What changes in their health should I keep an eye out for?
- When would you like to see my parent again?
- What blood work should be done today? (A complete blood count is very important to have as a baseline, especially for health markers like cholesterol, blood sugar, thyroid function, vitamin B-12 and iron.)
- If a new medication is prescribed, what are the possible side effects?
- What are the emergency and after-hours procedures for your practice?
Be sure to communicate with your parent about their expectations for your involvement in their care. This will help avoid embarrassment and discomfort during this initial appointment and on future doctor’s visits. If your parent is still capable of managing their own health care, let them handle the above questions to the best of their ability. You are there as an advocate to help ensure they get the best care possible, but try not to take over the appointment. If you have questions or concerns that were not addressed, you can run down your list with the doctor towards the end of the visit.
Step 4: Ensure that your loved one has signed a HIPAA (Health Insurance Portability and Accountability Act) release form. Using this document, your parent can grant you permission to receive their medical information either in person or by phone (this is very important if you are a long-distance caregiver and do not live nearby). While HIPAA authorization helps bring you into the loop regarding your loved one’s health care, it does not grant you the ability to make decisions on their behalf. For that, you would need to be designated medical power of attorney for your parent—one of several legal documents that caregivers must obtain to manage an aging loved one’s health care and finances.
Step 5: If you or your loved one have been routinely unhappy with interactions with the current doctor, it’s time to reevaluate the relationship. Finding a geriatrician (a doctor who specializes in age-related medical conditions and treating older adults) to serve as your parent’s primary care physician may be the best option.
Here are some signs that it’s time to reevaluate who is on your loved one’s care team:
- Your parent can’t get an appointment when they need to see the doctor
- Appointments with the doctor are rushed
- Your parent can’t trust or be honest with the doctor
- The doctor ignores questions or dismisses complaints
- The doctor fails to fully explain conditions, treatments or options for care
- The doctor is inexperienced with conditions related to aging
Once your loved one establishes with a new doctor, it’s important to make sure their personal medical records, including physician’s notes, test results and other relevant health information, are transferred to their file at the new office. Most doctors’ offices have a release form you can use to request patient records and have them transferred directly, usually for a fee.