We have been covering some essential advice for families who provide eldercare help to their aging parents or other loved ones, particularly focused on the complexities of managing medical care.  Becoming a loved one’s advocate takes a lot of preparation and a steep learning curve.  You have to be a skilled communicator, negotiator, relationship builder and a smart researcher.  You may feel like you have to learn a whole “new language”–terms like HIPPA, explanation of benefits, observation status, skilled nursing care and of course, the actual medical terminology for diseases, treatment, medications.

Our most recent blog posts have offered advice on preparing to handle a loved one’s medical decisions should they become incapacitated (and even how to assist if temporary or working in conjunction) as well as the importance of reviewing and updating legal documents for advance care planning.  Today’s post will delve further in to preparing to help with managing medical care and providing other eldercare help.

We are preparing to conduct a training session at the Professional Patient Advocacy Conference (in Orlando December 7, 2012) entitled, “The Successful Physician Visit: Best Practices for Advoactes”.  This is an essential topic for advocates assisting with managing medical care.  Patients with chronic conditions spend a lot of time at doctor’s appointments and often see multiple practitioners.  Older adults with multiple chronic health conditions have an average of 37 doctor visits, 14 different doctors and 50 separate prescriptions each year.  And, the more chronic conditions you have, the less likely you are to be satisfied with your doctor’s visit.  Most adult primary care patients have at least two chronic conditions, and these numbers are likely to be much higher for the elder who is being assisted by a family caregiver.

We will be sharing some of the special ways professional advocates can help elders and family members in making a doctor’s visit (and medical care overall) more successful.  We will also be continuing our series here on tips for you as the family caregiver and sharing when and how a professional patient advocate might help you.  Input your email address to get our updates!

Our tip today involves preparing a “health file” or “health record” for the patient (something valuable for you to do now proactively for yourself if possible, or something you can assist your elder relatives to do in order to be able to assist more effectively).  What does a health file need to include?

• Healthy history: diagnoses, surgeries, contact information for medical providers (for possibly obtaining records)
• Basic family medical history: immediate family history of major illnesses such as cancers, heart disease, Alzheimer’s, etc.
• List of medications: prescription, over-the-counter and herbal/vitamins with dosage and instructions (ideally, also have a list of past medications that have not worked effectively or produced side effects)
• Allergies (medications, food, etc.)
• List of current diagnoses and treatment (course of treatment, follow-up in progress or when needed, contact information for who is treating or treated the condition)
• Surgery history
• Activities of daily living/current status: an assessment of the patient’s daily living skills will help you communicate better information to the doctor.  For example, if a patient has trouble cooking meals or shopping, poor nutrition might impact health.  If the patient is falling or unable to manage hygiene tasks, this is vital for the doctor to know for determining a realistic plan of care.  Such information can be important even for very independent patients.  For example, is a spouse or support system available to help after a surgery or during treatment (cook meals, transportation, etc.)?
• Current symptoms or concerns (something to prepare prior to each appointment–wise to keep notes also and will help you be more accurate in describing the symptoms: when they occur, what precipitates them, etc.)
• List of appointments and follow up (calendar/reminder system)

Gathering and organizing this information is vital to being able to communicate with your medical providers.  Your doctors can only provide a plan of care based on the information they have, which too often is not completely accurate.  As a patient or family member assisting, this will help you tremendously.  It can save you time at each appointment, keep you from having to try to remember these details over and over again, and improve coordination.

You may want to consider using an electronic system for your health file.  This is what we do and recommend at Aging Wisely.  An electronic system can help with access, sharing (i.e. between various family caregivers) and make updating easier.  We have a detailed post on personal health records (PHRs) also known as electronic medical records (EMRs): the benefits and how to evaluate systems.

For many elders and family caregivers, this information is disjointed and will need to do some research to gather accurate and updated information.  Consider hiring professional geriatric care manager to put together your health file by researching and gathering all of your information, as well as assessing the current status and gaps.  The care management assessment will indicate issues/concerns such as how the patient is managing activities of daily living, medications and follow up, as well as areas that perhaps have either not been addressed or where a treatment plan isn’t being followed.

A geriatric assessment is an excellent way for you to prepare to provide eldercare help, as it gives you a valuable baseline about your loved one.  A care manager often uncovers concerns or small issues that can be proactively addressed to keep bigger issues at bay.  The care manager will also make specific recommendations, which serve as a sort of prioritized preparation checklist for you as a caregiver.

Considering hiring a geriatric care manager and want to learn more?  Wondering if a geriatric care assessment would help or how worthwhile it would be to have someone assist in organizing the health file?  Grab our checklist for Hiring a Geriatric Care Manager and contact us today for more information and answers to all your questions.

Our Senior Care Consultant, Sue Talbott, can be reached at 727-447-5845 or toll free at 727-447-5845 for a free phone consultation about your elder care needs, medical concerns or senior care help today.