Dealing with Eldercare : Managing Medical Situations

Probably one of the most distinct aspects of
eldercare is that you’ll have to handle an increasing number of
health-related situations. These events can be quite stressful, so
you’ll want to do everything you can to plan your schedule so that they
go as smoothly as possible.

To do list Introduce yourself to the staff at your elder’s doctors’ offices Purchase an accessory that makes it easier for your elder to get in and out of your vehicle, if your elder and you can benefit from such a device Make sure you understand your elder’s medications Create a chart of your elder’s medication schedule, if he’s taking multiple medications Set up a system to remind your elder to take and reorder her medications Write your own step-by-step instructions for filing your elder’s medical insurance claims Plan ahead for medical emergencies

Making Doctor Appointments

You can develop a real
ally by getting to know the people in your elder’s doctors’ offices who
handle the appointment scheduling. Help them to help you by

• Letting them know that you need to be included in any appointment changes because you’re the one who’ll be bringing your elder

• Explaining what days and times work with your schedule

• Giving them your phone numbers so they can reach you with a minimum of effort

• Telling them if a particular time of day is more difficult for your elder

MORE PRODUCTIVE DOCTOR VISITS Take as much relevant information as you can when you go to the doctor: Make a list of any problems or concerns your elder is having so that you don’t forget to mention them. Get a printout from your elder’s pharmacist of all of the medications that your elder is taking. You may need to have your elder sign a medical release form before the pharmacist will give you this information. If you can’t get your elder to sign the form, ask the pharmacist to fax the information directly to the doctor’s office. Get your elder’s medical records from other doctors whom she’s seeing. Again, you’ll probably need a signed medical release form, or you’ll need to have the information faxed directly to the doctor. Have your elder’s medical insurance information. Ask your elder if she has an insurance card. If she’s not able to supply you with current information, keep a watch on her mail for statements from the insurance company.

If your elder
has decreased mobility, transporting him to and from the doctor—and on
errands—can require added time, energy, and patience. You can purchase
an accessory to make getting into and out of the car easier for both of
you. The accessory can be as simple and inexpensive as a seat cushion
that swivels or as sophisticated as a factory-installed seat designed
for the mobility impaired. With the growing population of senior
citizens, new and more innovative products are becoming available all
the time.

Tracking Medications

The elder for whom
you’re the caregiver is likely taking multiple medications. The
instructions for taking them may be quite complicated. You’ll want to
know the answers to all of the following questions:

• How many of the pills should the patient take?

  note

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• How often should he take them?

• Must they be taken with food? If so, is the frequency such that your elder will be eating at the right time?

• Must the pills be taken with water, or is another liquid okay?

• What are the likely side effects? Which ones require you to notify the doctor?

• Will there be any adverse reactions with other medications the elder is taking?

• Can the elder drink alcohol while on this medication? (If no, let the doctor know if this restriction will cause a conflict.)

• Should the elder curtail any activities while on the medication, such as driving, being in the sun, or eating certain foods?

• What should the elder do if he misses a dose: skip it or double up?

• Is there an alternative way to take the medicine if the elder has trouble swallowing it?

  tip

  The www.epill.com
  website, which specializes in the sale of medication reminder devices,
  features a medication reminder product selector. You indicate whether
  your elder

  • Needs a reminder only or a reminder with a pill container

  • Will use the system at home or away from home

  • Has normal hearing or is hearing impaired

  • Takes medication once, a few, or many times a day

  Then the selector indicates which products will meet your elder’s needs.

  
  

• Is there anything else the doctor thinks you should know about the medication?

When you
understand the intricacies of the medication regimen, you may find it
helpful to create a visual schematic of it along the lines of the one
illustrated in Table 1.
For the medication plan in the illustration, we needed a chart two days
long to cover all of the combinations because Med C is taken only every
other day. Your chart may be even more complex if your elder is taking
any medications that alternate between a higher and lower dosage or that
cannot be taken in combination with others.

Table 1. Sample Medication Schedule

Medication	Med A	Med B	Med C	Med D	Med E
Instructions	With water only	With food	With liquid	2 hours after eating	Before bed
Dosage	Twice a day	Twice a day	Every other day	Once a day	Once a day
Day 1
Before breakfast			X
With breakfast		X
Mid-morning	X			X
Mid-evening with snack		X
Bedtime	X				X
Day 2
With breakfast		X
Mid-morning	X			X
Mid-evening with snack		X
Bedtime	X				X

Next, you’ll need to
ensure that your elder is taking the medications according to the
schedule. If your elder is still living by himself and handling his own
medications, you’ll want to be confident that he’s remembering to take
the medications at the right time—and that he’s not forgetting when he’s
already taken the medicine and double-dosing. You can purchase
medication reminders and timers for just about every situation from a
simple alarm that reminds the patient it’s time for medication to a
computerized dispenser that releases only the proper pills at the
prescribed times. You can even subscribe to services that will phone you
automatically if the elder doesn’t take the pills out of the dispenser.
Figures 1, 2, and 3 show a range of the timers that you can buy.

Figure 1. You can set this pill case (shown here from both the front and back) to ring or vibrate up to five times a day.

Figure 2. The alarm clock in the top of this bottle reminds the patient
when to take the medication; the voice recorder in the bottom can be
used for special instructions, such as “take with a full glass of
water.”

Figure 3. When it’s time to take medication, this device sounds an alarm
and rotates into position dispensing the appropriate pills only.

Another scheduling
aspect of a prescription medication regimen is making sure that the
patient always has a supply of the medications. You can keep track of
the refill schedule by making the following entries in your planner as
soon as you have the prescription filled for the first time:

• A reminder one
  week before the medication will run out to order a refill, together with
  another reminder the day before it will run out

• A
  reminder two weeks before the last prescribed refill will run out to
  contact the doctor for a new prescription—and to schedule an appointment
  if necessary—together with a backup reminder one week before the
  prescription will expire.

Submitting Insurance Claims

Filing health insurance
claims can eat up a lot of your precious time unless you invest the time
upfront to create a smooth-flowing tracking system. Your goal here
should be to decipher the system once and record step-by-step
instructions for yourself so that you won’t have to repeat your efforts
every time you’re faced with a new claim. One way to develop your
procedures is to track one claim from start to finish, writing lots of
notes to yourself as you go, as follows:

Preparing for Emergencies

When a person’s
health is in decline, emergency medical situations are inevitable.
Emergencies, by definition, require immediate attention and a departure
from whatever you had scheduled. You can minimize the disruption to your
schedule—and reduce your stress—by preparing as much as you can in
advance. You should

• Have emergency phone numbers—doctor, ambulance, hospital, family, neighbor—in your individual planner and with you at all times

• Make sure several people have access to your elder by giving house keys to trusted and caring neighbors

• Keep
  an up-to-date list of all of your elder’s medications with you and
  posted on your elder’s refrigerator so you can tell emergency personnel
  where to find it

• Have
  on file with your elder’s doctors and hospital whatever legal documents
  are appropriate to your situation—durable powers of attorney, living
  wills, and the like

• Know what your options are for home-care providers if they are needed

Take time now to schedule these preparations into your planner and actually make the preparations as soon as you can.