Medical Needs

​Managing an Aging Loved One's Medical Needs

The following is a straightforward procedure for taking over the medical care of an aging parent or other loved one who can no longer make their own medical decisions.

Managing an Aging Loved One's Medical Needs
By Pierre Mouchette | Bits-n-Pieces

Do Preparation Work
One of the most important things to do is to make sure all your loved one's legal affairs are in order while still healthy and able to make sound decisions.  That includes having them create a Healthcare proxy (HCP) with the help of an attorney.  Once they have decided, have a lawyer help them create a legal document that allows the proxy to talk to their loved one's doctors, nurses, and other members of the care team and read medical records if the person can no longer make medical decisions for themselves.
Sometimes, your loved one will also want to create a living will, where they list out specific medical treatments they may or may not want (for example, a "do not resuscitate" order).  Some states have a standardized form for both, while others allow you to draft your own.  Whatever method you choose, it's always good to have all forms reviewed by an attorney before signing.
Once that is accomplished, make copies of the forms for your loved one's medical providers, so they have proof that they are authorized to speak to you.  When appointed as Healthcare Agent, your responsibilities begin right away once the patient can no longer communicate.
 
Accompany Your Loved One to Their Medical Appointments
If possible, you should plan to attend doctor appointments together.  It is a good idea for everyone, even those not incapacitated.  The worst possible case is that it is an extra set of eyes and ears to make sure you are not missing anything.
Use the following checklist for each appointment:

• Make sure that your loved one gets all their questions fully answered.
• Make sure you both understand any new diagnoses and any new medications or therapies prescribed at the appointment.
• Relay to the provider how any related medical conditions affect your loved one's quality of life.
• Suppose you are strapped for unavailable to accompany, or physically unable to be there.  In that case, you can also hire a caretaker to get your loved one ready for their appointment and accompany them there.

A doctor visit for an elderly parent, for example, can take up to five hours if you factor in helping them dress, transporting them there, sitting in a waiting room, and then taking them to the pharmacy afterward. 
 
Verify That All Information is Shared Among The Medical Providers
Even in the era of electronic health care records, you cannot assume that your loved one's medical team members are communicating with each other.  That is why you will need to keep track of tests, diagnoses and treatments yourself and then share the information with your loved one's health care providers. 
 
Keep Your Loved One Involved
To serve as your loved one's health care proxy, you need to understand their values and wishes in any situation to make the best decisions about their care, Dr. Ticoras says.  That may mean asking them to write down any questions they have before a medical visit to make sure health care providers address them.  It also means having honest conversations with them about their condition and how it affects their quality of life.
Some people choose to do everything possible to manage their disease to continue living an active life, and others are fine with a less-aggressive treatment as long as they can still spend time with family.  This is particularly important if you are talking about hospice or palliative care.  Some patients don't want to continue living if they have to live with a feeding tube, which is OK.  If you manage their health care, you must respect their wishes.
 
Switch Doctors if You Need To
Should your loved one's physicians not return calls, appears to be rushed and distracted during appointments, or dismiss the concerns of either you or your loved one, get a second opinion.  If you have difficulty talking to them now, it will worsen during an actual health crisis.  If you disagree with the medical provider about your loved one's treatment plan, make a separate meeting to discuss your concerns.  The best approach is to offer specifics about what you know about your loved one.  For example, they responded well to a particular medication in the past, or a similar situation came up once before with others.  Remember, doctors do not address emotional outbursts.  They want facts and information.
Bear in mind that most of the time, both you and the medical team have the same goal: to provide your loved one with the best possible care during the last few years, or even months or weeks, of their life.