It can be difficult to accept, but the people who took care of you when you were young may need your help as they age — and it’s a good idea to plan ahead for this time.
“Finding the right moment might not be easy, but waiting too long or until something frightening happens puts your parent’s health at risk,” says Dr. Zachary Bittinger, a clinical assistant professor in the department of family and community medicine at the Ohio State University Wexner Medical Center in Columbus.
He adds, “If you’re thinking about getting more involved with your aging parent’s care, the best time to do so is yesterday.”
There’s a lot to consider as you become more involved with your older loved one’s health care and visits to the doctor. Here, we’ve broken down the process into four major components:
— Talking with your parent about getting more involved
— Preparing for a doctor’s appointment
— Supporting your parent during a doctor’s appointment
— Following up and helping your parent stick with their care plan
[Related:How to Advocate for an Older Loved One in the ER or Hospital]
Talking With Your Parent About Getting More Involved
Ask your parent’s preferences for your involvement and what they hope to see come of your assistance, recommends Dr. Victoria Leigh, an internal medicine specialist with Providence St. Joseph Hospital in Orange, California.
“The best way to frame the conversation is to center the goal around how valuable their time and energy is,” Leigh explains. “The purpose of delegating some chores like shopping, meal prep, scheduling doctors’ visits, helping arrange medications, etc., is so they can spend time and energy doing things they love.”
However, these conversations can be delicate, so be ready for some pushback.
“Your parents may be worried about losing independence, losing the ability to do things on their own terms, losing respect and all other sorts of personal fears,” adds Dr. Anna H. Chodos, a professor of medicine in the division of geriatrics at the University of California at San Francisco.
To address those fears, Chodos recommends:
— Naming the fears when you talk with your parent. For example, say, “I know you may be worried that I’m trying to take over, but I really just want to help and I’ve noticed…”
— Offering help. For example, say, “I’ve noticed you’ve had a harder time remembering your doctor appointments lately — is that something I can help with?”
You might need to have this conversation multiple times.
“Continue to be compassionate, reinforce your intention that you want them to be safe in their homes, healthy and supported to live as independently as they can for as long as possible,” Leigh advises.
If communication breaks down and you have concerns about your parent’s situation, Chodos recommends contacting social services for help. Your parent’s doctor may have a social worker in the practice who can help, or you can contact adult protective services in their community.
[READ: How to Manage Sibling Conflict Over Care of Elderly Parents]
Preparing for a Doctor’s Appointment
When it comes to supporting your parent during doctor appointments, there are some things you should do ahead of time.
Designate a health care liaison
If you have siblings, you should decide who will lead the charge on assisting your parent with their health needs.
If you’re taking on this role, you should have access to the electronic portal accounts of your parent, if available. Some portals offer special proxy or linked access to another’s account. If that’s not available, having your parent’s username and password may be the only option, says Dr. Robert Murry, chief medical officer at NextGen Healthcare and a practicing family medicine physician.
You should also be the named health care proxy in your parent’s written medical advance directive and should discuss your parent’s wishes and goals for their overall health and end-of-life care.
As a health care proxy or liaison, you are the point of contact for the care team, and part of your job is to share information with other family members who need it.
Seek appropriate legal rights
You may also need to get certain legal instruments in place to properly care for your parent. Durable power of attorney for health care and durable power of attorney for finances are important legal documents that allow you access to your parent’s health care, financial and legal records and act as their agent as needed.
Getting power of attorney doesn’t mean the person doesn’t decide for themselves.
“It means they have designated someone if they were to become unable to decide,” Chodos points out.
Seek power of attorney sooner than you think you’ll need it; getting these designations becomes much more difficult if your parent’s cognitive abilities have slipped or they have a dementia diagnosis.
Understand HIPAA
The Health Insurance Portability and Accountability Act, passed in 1996, ensures privacy of each individual’s health information. It provides a series of rules about what information health care providers can share and with whom. If you’re an adult child getting involved in your parent’s care, you may need your parent’s written authorization to gain access to their health records.
“Your parent must provide consent for their doctor to share medical information with you unless you have legal authority,” such as power of attorney, Murry says.
Make a plan for the appointment
Before the visit to the doctor, collect this information:
— All of your parent’s medications, dosages and how frequently they take each one
— Any supplements or vitamins they’re taking, how much and how frequently
— Any past surgeries or major health issues, along with dates of first diagnosis, treatments completed and the outcome or ongoing prognosis
— A rough list of what and how much they typically eat
— A general idea of physical activity levels and sleep patterns
Also work with your parent to write down questions for the provider. Consider asking:
— About your parent’s overall physical health
— About their mental health
— How you can support their physical and mental health
— Whether the doctor thinks your parent can live alone safely or if they’re OK to continue driving
— Whether the medications they’re taking are appropriate and being given at the right dose
— Whether those medications have any concerning side effects to keep an eye out for
Complete pre-appointment paperwork
Many health systems require patients to fill out questionnaires, provide insurance information or complete other paperwork before each visit. If your parent isn’t able to do this on their own, you’ll need to help. This is where having access to their online health care portal can be very helpful.
Establish trust
Be prepared for your parent to feel your involvement is an intrusion. At worst, they may suspect you want to take away their independence. It’s important to build trust so they can see that you’re concerned and trying to help them.
Murry recommends engaging in “frequent, open and honest conversations with your parent and demonstrating sincere curiosity.” This can help your parent recognize that “you see the big picture around their health and that it may be OK to give up a little control.”
In some cases, a parent may want to keep their medical issues private, perhaps out of embarrassment or because they don’t want to burden you, Murry adds. This can be a challenge, but you can offer to step out of the room any time your parent wants to discuss something in private, as a skilled provider can usually figure out a way to keep an adult child in the loop when necessary.
[Read: How to Talk to a Loved One About Senior Living]
Supporting Your Parent During a Doctor’s Appointment
The core of the interaction with your parent’s doctor will take place in the office, assuming your parent is OK with your accompanying them to the appointment.
Encourage your parent to advocate for themselves
Even if you’re getting involved because your parent needs more help, that doesn’t mean they’re incapable of speaking for themselves.
“One of the most important things to remember when communicating with a parent’s doctor is that you are an advocate, not a replacement, for your parent’s voice,” Murry says, adding, “Encourage them to voice their own concerns and preferences whenever possible to reinforce their independence and ensure their wishes are heard.”
Collaborate with the doctor
Caring for a parent becomes easier when you develop a rapport with the care team. You should also ask to collaborate with them on all aspects of your parent’s needs.
Keep in mind, however, that physicians have bad days sometimes.
“If you have a less-than-ideal interaction with one, I would encourage you to give them a second chance, or even see if a portal conversation can address your concerns about what might’ve been missed during a visit,” Bittinger suggests.
Pay attention
Taking notes can help you keep track of what’s being discussed and allow you to review key points after the appointment. Jot down any unfamiliar terms or complicated care plans that could be difficult to remember.
Speak up when necessary
If there’s something your parent is forgetting or seems to be glossing over — such as worrisome symptoms they’re downplaying or not sharing details of a recent fall — be sure to add those details to give the provider the full picture of what’s going on.
And if you don’t understand something, ask for clarification.
“Be upfront about what you don’t know,” Bittinger notes.
Most providers are happy to review or explain anything that’s unclear or confusing.
Following Up and Helping Your Parent Stick With Their Care Plan
Post-visit, you’ll want to take a few actions to make sure you’re staying on top of your parent’s health care needs.
Create a list of questions
After you’ve visited the doctor, take a moment to write down any additional questions that surface so you don’t lose track of them.
“They might not all get answered in a given visit, but rest assured that everyone involved has the same priority in mind: your parent’s ideal health,” Bittinger says.
Develop a task list
You may need to make additional appointments with specialists or schedule follow-ups. You may also need to contact your parent’s insurance company to get preapprovals for any additional treatments or jump through other bureaucratic hoops. Make a list of these items and develop a to-do list or timeline for when you’ll make each call.
When you make the calls, jot down the date, the name of the person you’ve spoken with and the details they’ve shared. This can be very helpful later if there’s a problem or confusion about a certain aspect of your parent’s care.
Do your homework
Consider doing some research to understand what each provider does.
“As we age, adults can accumulate quite a variety of specialists,” Bittinger explains. “You’re not wrong to start with their primary care doctor for any given question, but if it relates to a specialist’s domain, getting the question referred to the right spot could delay care. So knowing who to address a concern to is job number one.”
Check in with your parent regularly
Your parent’s health situation will continually evolve, and if you’re not living together, it can be difficult to notice subtle changes day to day. Be sure to check in with your parent regularly and encourage them to keep you informed of everything that’s happening with them. You may also want to check in with anyone your parent regularly interacts with to learn whether they’ve observed any changes.
Seek additional support
It can be challenging for you to understand the full extent of your parent’s suffering, disability or sense of loss, Murry notes. And naturally it can be difficult for the adult child of an ailing parent to remain objective as their parent’s condition and decisions frequently affect their life too.
“Consider finding a therapist or support group to help you navigate these dynamics and to ensure you have a safe place to process aloud,” Murry recommends.
You can also ask a sibling, partner or trusted friend to step in and give you breaks as needed. In addition, Murry recommends engaging in fun activities, such as going out to dinner or to the movies, with your parent so you have some interactions that are not about their health.
“Ultimately, helping your parent navigate their medical care can truly be rewarding and help bring you closer together,” Murry says. “The goal is to create a partnership between you, your parent and their physicians to ensure the best possible care.”
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