Be prepared when communicating with your parents’ doctors

There are few familial mine elds trickier than discussing an aging parent’s medical care. And this is one topic that’s dif cult, not only from an emotional standpoint but from a legal one as well. Regardless, most will at some point face a situation in which we need to know our parents’ medical histories and current conditions.

Two local physicians, Dr. Jonathan Davis, an interventional cardiologist at CHRISTUS Highland Medical Center and a medical director for a local hospice organization, and Dr. Susan Kemp, an internal medicine, wound care and Hyperbaric Center physician at CHRISTUS Schumpert, weighed in on the best ways for adult children to be prepared when these sensitive issues arise.

“We are living longer over all these days, so more and more, adult children will nd themselves in a caregiver role for their parents,” Kemp said. At the very least, she said, adult children should have lists (preferably typed) of their parents’ medications, allergies, current medical conditions, past surgeries and physicians involved in their care along with phone numbers. “If the patient has a declared a do not resuscitate directive, this should be included as well,” Davis said.

While there are a number of legal instruments, such as a power of attorney, that can make handling a parent’s affairs much easier, one of the most important things an adult child can do is establish an open line of communication, both with his or her parents and the parents’ physicians, regarding medical diagnoses and prognosis, Davis said.

“I think it’s important that children attend their elderly parents’ doctor visits,” he said. “Frequently, it is dif cult for patients to articulate to their children the treatment plan that was made during of ce visits. On occasion, I have called an out-of-state family member and had them listen over a cell phone to our conversation. I also frequently ask permission to speak with their children after the of ce visit. Many parents want to minimize the perceived inconvenience to their children, thus isolating them from participating in their care. By asking permission to involve their family, this allows appropriate preparation when there is a sudden change in previously stable patient’s medical status. It is important for the children to have a trusting relationship with their parents’ physician. In situations where the patient is unable to participate in decision-making, this relationship is invaluable.”

Being present at a parent’s doctor visit is also important because of the privacy laws known as HIPPA. “Legally, all patients are protected by HIPPA,” Kemp said. “This prevents your doctor from releasing information about your health without your knowledge. There are some exceptions that are allowed, such as when it is urgently in the best interest of the patient’s health. However, this is a gray zone that is loosely left up to interpretation. The best way to be a part of your parent’s medical care is to be present at the appointments with them to ask questions directly. If that is not possible, then the adult children that the patient designates to receive information need to be listed on the patient’s privacy form. It is a good idea to provide a means of identi cation to the physician’s of ce so that a phone caller can be recognized, such as a driver’s license number or code word.”

Of course, it is always prudent to formalize a parent’s wishes through legal documents such as a power of attorney or a living will. Many times, these require consultation with an attorney, but the peace of mind they can provide is well worth the time and cost. “A well-prepared family should have on hand a living will,” Kemp said. “This is a statement that declares what the patient’s wishes are should they not be able to speak for themselves. Some speci c details can include whether or not they would want to have lifesaving measures taken should their medical condition be considered terminal. Also, this paper can request or refuse treatments such as antibiotics, ventilator use and feeding tube use. It is a good idea for everyone to have a Living Will, but especially as you age. “ Though these subjects may be unpleasant to contemplate, they nevertheless become increasingly crucial as parents age and face more frequent and often more serious health issues. “In the heat of the moment, it is very hard to put your own feelings aside and honor your parents’ wishes,” Kemp said. “If these things are decided in advance, the burden of making the decision does not fall to the adult children. Also, all the children need to be involved in the discussion and on the same page as much as possible. Remember, it is about what the patient wants, and quality of life should guide every decision.”

– Kelly Powell

HEALTH TIP:

Be present at doctor’s appointments. It’s important for you to have a relationship with your parents’ doctors.