Caregivers Primer

A Personal Medical History

Have you visited a new doctor lately, or took a trip to the ER? How long did it take to fill out those long patient history forms? Could you remember when you had your tonsils out? Or whether it was a relative on your mother's side that had diabetes or on your father's side?

Just think how much more difficult it is for an older adult to remember past surgeries and if they had measles, mumps, or both? If your parent has vision or hearing problems, so you really want to ask them questions in a quiet waiting room about personal problems, like their last menstrual cycle or a man's prostrate or ED problems?

The answer is to write a complete personal medical history, including current problems and medication, and have it available for each doctor's visit. Having all the information at your fingertips is especially important in an emergency situation or when your loved one is too ill or infirmed to answer questions.

About six years ago, I started gathering the information and writing medical histories fro each member of our family and for some of our older friends. As people grow older, they tend to need more medical care and visit more specialists. It's great to fill out only the name, address, insurance pages of the big stack of forms and write "See attached medical history" on all the others.

I have included instructions for writing a personal medical history. (Medical History Example in the sidebar) I've listed the primary topics you should include, like allergies, medications, and continuing medical conditions, with examples of the kinds of things you might put in each section.

Next to allergies, the medication section is the most important, and useful. For the emergency room or a new doctor, knowing what medicines a patient is taking will affect treatment. For example, if you have diabetes or a latex allergy, or if you are on a blood thinner, the doctor will know what you can or cannot have in the way of treatment for an injury or illness.

For regular appointments with your doctor, take your history with you. At home, mark any prescriptions you need to refill or need to ask about. Have it handy as you talk to the doctor, so he or she can easily see what you are taking, how much, and how often. Cross off any medicines that are discontinued, and write in any changes to the dosage. If the doctor adds anything new, write it down on your history as he says it, so you know you have the dose and frequency correct. This is also a good time to ask about any drug interactions or cautions, like taking the medicine with meals or do not take alcohol, cheese, or grapefruit while taking the medicine.

When you get home, update the file in your computer (using Save As with the current date as part of the title) and print a new copy for reference. (Be sure to keep the old versions of your history.  You never know when you might have to look up a date or a type of medication you took a year ago.) 

The history I wrote for my father was priceless to me as his Alzheimer's progressed. When my mother cut her leg badly and we had to call an ambulance, I got her settled with a large towel around the cut and hit the button on the computer to print copies of her history as I was talking to the 911 operator. I had one ready for the paramedics so I could concentrate on her and not on answering questions.

I gave another copy to the ER doctor. She was shocked at having everything she needed to know in one place, clearly organized. She said it saved her a lot of time in determining what medications to prescribe and what not to do. In mom's case, she doesn't take blood thinners, but she is allergic to penicillin and latex, all of which was important in her emergency care. The doctor came to find me later and thank me for having the information written up. She said so many patients come in with no idea what they are taking or the dose. Some can only vaguely remember that their doctor gave them a little white pill or a big yellow on, and they aren't sure what it was for. If someone is in great pain, or unconscious, a doctor needs to know if they have a history of seizures or a pacemaker. If you are caring for a family member, you need to know all you can about their medical conditions.

Think about preparing a medical history for yourself and your loved ones. I've actually had people pay me up to $50 to help them gather their information and get it organized. It's that important.

NOTE: This is also a good time to go through the medicine cabinet, clearing out old, outdated prescriptions, and determining what the person is actually taking, or what they should be taking but aren't. A friend had diuretics prescribed from three different doctors over a period of time, and had continued each one. By checking the prescriptions she was taking, we discovered the duplication and it answered a question about her health and weakness. Her doctor selected the right one and canceled the others.

To help someone put together their medical history information, go through the questions on the example, filling in everything they know easily. Then give them a list of things they need to look up, ask relatives, etc. After a day or two, go back and finish the history with the information they gathered. It may take a little time to set it up in the first place, but the results and security of having the right information on hand in an emergency is well worth it.

Click on Medical History Example in the side bar for more information.

Take care,

Kathy Frost

Before Your Parents Need Help

Welcome to my new blog.  I am currently the primary caregiver for my mother who is legally blind.  I also cared for my father, until his passing three years ago, both at home and in the nursing home as his Alzheimer's grew progressively worse.  I have experienced a number of situations regarding caring for aging parents and it took time to work out all the problems.  In this blog, I hope to pass along what I have learned, the experiences of others, and listen to my readers as they share their experiences or questions.  In this blog, I hope we can help each other.

Today's post concerns what you should do BEFORE your parents are in need of care.

When you were growing up, your parents were the caregivers, guiding you as you became an adult.  But in time, your parents may need you to act as their caregivers, aiding them in everything from legal and financial issues to home care if they become disabled or too frail to live alone.

Whether your parent or parents eventually develop physical problems or diseases that keep them homebound or debilitating mental health issues, such as Alzheimer's, you should do some of the preparations early, while they are still healthy with a sharp mind.

See side bar items for more details.

The Basic Three

1) A Medical Power of Attorney with a Directive to Physicians (also called a Living Will)

This document gives you the opportunity to say what measures, reasonable or extrodinary, that you wish to have taken if you are not conscious or unable to communicate your needs, and who can make decisions for you if you can't.  You can state whether you want to be resuscitated or be kept alive on a machine, or allowed to die in dignity.  You make the choices YOU want for your life and your future quality of life. 

2) Power of Attorney (POA)

Like a medical power of attorney, this document designates a representative to handle your affairs when you are unable to.  There are two types of POAs.  One is a limited POA where you specify exactly what a person can do in your name (like buy or sell a property in another state if you can't be there) and for what specific time period.  The second is a Durable POA and is in effect until your death or if you change it in the future.

3) A Will

Ideally, you should make out a will as soon as you are on your own and have any property or assets, just to be sure that in case an unexpected early death, your wishes will be known and carried out.  A will should be updated every few years, especially at major events in your life time, such as marriage, birth of a child, divorce, or death of a spouse. 

For our parents, we need to make sure that the will is current, that the person selected to be the executor is still available and able to do the job. 

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Each of these legal documents should be reviewed and updated at least every couple years.   Be sure to update the name and address of your representatives and beneficiaries when they move or when a woman marries.  I have a sheet with the current names and addresses paper clipped to each copy.  This is especially important in an emergency when a hospital needs to contact the primary representative or the alternate.

Obtaining POAs and Wills

A basic Living Will, in a very abbreviated form, can usually be obtained at your local hospital. 

For a more comprehensive Medical POA, Durable POA, and even wills, try the Internet.  The link below is a representative one and has estate planning documents that can help you do most of the work yourself and save you some money.  There are several of these sites and you may be able to find one specific for your state of residence.  http://www.expertlaw.com/library/estate_planning/medical_power_of_attorney.html  This site has one very valuable caution.  "This free legal form is provided for general informational purposes. Before you utilize any legal form you find on the Internet, you should have it reviewed by a lawyer in your jurisdiction to be sure that it meets your legal needs, and will be held valid by a court in the jurisdiction where you reside."

Be sure you keep extra copies of these documents available.  When your parent goes to a hospital, the registration office will probably ask for a copy.  You will need one to pick up medical records and x-rays.  Doctor's offices, labs, and other diagnostics centers may require one for you to access your parent's medical records or to be given medical information over the phone for the patient.  Be sure you contact each insurance company and pharmacy (local and mail-in) for their requirements.  You want your name on their account so they will have the legal authority to discuss patient records and accounts.  This includes homeowner's, life, and vehicle insurance as well as medical.  Some companies will require that the patient fill out and sign a form giving your name as an approved representative.  You must return the form with a copy of the medical POA, before they will discuss anything with you.  (Other companies may allow you to have the person speak to them on the phone, identifying themselves, and give verbal permission for you to conduct their business but this must be done each time you call and could cause a problem if you are away at work or they are at the hospital and you're at home.)  In our case, my mother is legally blind and losing her hearing.  She can't read the tiny account numbers on her insurance card or hear half the questions some customer service person asks on the phone, so we made sure my name was on each of her accounts so I could deal with any problems.

Again, these are all issues that you should work out with your parents long before the day you must take over caregiver duties on their behalf.  The documents can be put away for safekeeping until they are needed, as long as you have access to them in time of an emergency.  With luck, your parents will love a long healthy life, but if they eventually need your help, you'll be prepared.

In the next post.....

My next topic will be about writing a comprehensive medical history for each member of your family that you can print out each time you visit a new doctor, go to the hospital, or need an ambulance ride.  I'll explain why it is so important and what to include.

Until next time,

Hugs and best wishes,

Kathy Frost