"I'm overwhelmed as a caregiver -- where do I start?"
It's a question I frequently hear from adult children who are noticing changes in their elder parent. So, where do you start? Get yourself involved -- starting with a Health Assessment. Even though they may initially resist thinking they don't need the help, take my word, they will eventually be grateful for your interest in their health, safety and independence.
How did I convince my mother to let me get involved? Like many, she resisted at first but was thankful after being reminded that I was doing this for a very good reason -- to keep her healthy and independent in her own home like she wanted.
And most of all, this will give you peace of mind knowing that you are well informed on your loved one's overall health, allowing you to make educated decisions going forward and hopefully, avoid a crisis.
Step 1 - Start with scheduling an overall health assessment with their primary care physician so you know what you are dealing with. If they don't currently have one, get a referral from a family member, friend, neighbor or the Council on Aging.
Step 2 - Assist your loved one to the appointment. Keep a notebook to track all your questions, observations and follow up from appointments. Questions or concerns to address with the doctor would include:
- What new diagnosis/prognosis should I be aware of? Do they need to see a specialist?
- What tests do they need at this time? If so, when and where?
- What changes should I be reporting? When would you like to see them again?
- What blood work should be done today? A CBC (complete blood count) is very important to have as a baseline, especially for cholesterol, blood sugar, thyroid, B-12 (could impact memory) and iron.
- If a new medication is prescribed, what are the possible side effects? Have the doctor review the medications your loved one is currently taking and explain the reason. Be proactive in removing meds that are not providing real benefits and may be contributing to a cognitive decline or inability to function.
- What are the emergency/after hours procedures for this doctor in case of concerns or questions after you leave.
Step 3 - Get clear on the medications they are currently taking. If needed, provide supervision by you or someone else (family member, neighbor or aide) to be sure they are taking them with the correct frequency and dosage. A list of their medications should be placed in their wallet in case of an emergency and posted in a prominent place in their home. As the primary caregiver, you should also have an updated list.
Step 4 - Be sure that your loved one has signed a HIPAA form (Health Insurance Portability and Accountability Act), allowing you to receive medical information on their behalf either in person or by phone (very important if you live at a distance) and placed in their medical file at the doctor's office.
Step 5 - If your loved one or you have been routinely unhappy with interactions with the doctor, it's time to re-evaluate the relationship. It may be time to seek out the services of a geriatrician. Here are some signs that you may need to move on:
- You can't get an appointment when you need to see the doctor
- You can't trust or be honest with the doctor
- The doctor ignores your questions or dismisses your complaints
- The doctor fails to fully explain the condition, treatment or options for care
- The doctor is inexperienced with conditions related to aging
If you decide to leave your loved one's current doctor, it's important to make sure their personal medical records, including physician's notes, test results and other relevant medical information are transferred to their new doctor. Most doctors' offices have a release form you can use to request your loved one's records. Once you fill out all the proper paperwork, you can usually have the records sent directly to their new doctor, but there may be a fee involved.