We all tend to perceive our parents as young and strong and vibrant...until mom falls, dad has a heart attack or some similar occurrence shakes us from our complacency.
Then we begin to be concerned. Our very first thought is usually somewhat selfish: I don't want to lose my mom or dad.
The second is usually more about them: How can I make my parents healthier and happier so they'll be around for a long time?
Take the first step!
That's the point when most adult children begin researching how best to help their parents. The first step is asking them about a will and whether they have a durable power of attorney (POA) and a Health Care Power of Attorney.
- A durable power of attorney appoints an agent, usually an adult child, to do certain things even if the person is incapacitated. You may specify certain actions they may perform, such as selling your home or signing checks, or may make it broad enough so that the agent may act as if he were you in any matter. A durable power of attorney ends at the person's death.
- A Health Care Power of Attorney specifically deals with healthcare issues. It permits your agent to make health care decisions for you if you are incapacitated.
The American Bar Association suggests that Health Care POA agents be "someone you trust with your life," but shouldn't be anyone associated with your healthcare provider, a court-appointed guardian, or anyone who works for a government agency responsible for your care.
These actions will initiate conversations about how to best help your parents as they age and about end-of-life care. Somewhere along or after that process, it may be time to speak to your parents' doctor to make decisions about their care.
Here are suggestions on how to work with your parents' health care team:
- Go along with your parent to a doctor visit. Just sit and listen. The doctor isn't prepared for or scheduled to give you extra time to answer your questions at this point, but you'll get an idea of the state of your parent's health and demonstrate your willingness to work with the doctor.
- Contact the doctor's office for information. If you aren't the agent on either of your parents' POAs, the doctor legally can't give you any information because of the Health Insurance Portability and Accountability Act (HIPAA). However, you can ask the doctor to allot some time to answer your questions in front of your parent at the next appointment.
If you can possibly be named as an agent on the POA, do so. That way, your parents' physician can speak to you frankly and truthfully without your parents' presence to inhibit him.
Also, ask the doctor how she'd like to be contacted. You'll get a quicker response.
- Only select one person in the family to contact the doctor. Neither physicians, nurses nor other members of the health care team have the time or patience to be answering the same questions from multiple family members.
- Prepare a list of questions to ask, then send them over to the office in advance so the doctor will be prepared. He may prefer to send them back to you via fax or email to save time or because he doesn't believe he can respond frankly in front of your parents.
- Ask helpful questions.
- How is their physical health?
- How is their mental health?
- How can I help them improve their health?
- What can I do to keep them healthy and safe?
- Should my parents make any lifestyle changes? If so, what is your recommendation?
- Are they able to live alone?
- Are they safe to drive?
- What medications have you currently prescribed? What are the dosages? Are there any specific side effects you've noticed?
- Help the doctor help your parents.
Here are some necessities to bring to every doctor's appointment:
- A list of all medications and their dosages and frequency
- A list of all vitamins, their dosages and frequency
- Surgery history: What, when, and where
- Major health condition history: diagnosis, date of first diagnosis, current status
- A list of alternative therapies
- Current symptoms
- List of questions
- Notebook and pen to write down doctor's answers and suggestions
Pack them in a small tote so you can pick it up and take it with you each time.
- Don't assume your parents' doctors and specialists are sharing Information. They're not. This is especially important to your parents' health when two or more doctors are prescribing medication. Ensure each physician has the most up-to-date list of prescriptions each time your parents visit.
- Evaluate the health care team during each visit. Sometimes, physicians can no longer meet the needs of their patients. They may discontinue hospital affiliation at the closest hospital. The practice may decide to focus on younger patients. Your parents' doctor may retire. Your parents' doctor may become remote and perform his duties by rote and no longer actively engage with your parents. Your parents' doctor may become difficult to reach or slow to respond.
Your parents' health care team should also work with you. The expert opinion of a doctor can be a potent influence.
For example, if your parents are resistant to your questions about their health status or medications, send a note to the doctor before the appointment and ask him to ask your parents.
Similarly, if you're concerned your parents are not eating right, the doctor's questions may elicit responses you're unable to pry from your parents.
Your parents' doctor should be working for them even when they are actively resisting help. Sometimes, that means pointing out that they need more help than the caregiver can provide.
When it comes time for your parents to change their living arrangements, their doctor may not only make recommendations about which choices are available, but her professional expertise is also a powerful persuasive tool.
The evaluation by your parents' doctor is the determining factor in deciding whether your parents would do better in an Assisted Living community or in a skilled nursing facility.