My Parents Got Old! Now What Do I Do?

In preparation for this huge chapter and since I used to be a teacher, I am giving you a pop quiz. You have 10 minutes. Put “Don’t know” as an answer when appropriate.

Pop Quiz:

1. What’s the name of your parents’ doctor(s)?

2. What type of doctors are they?

3. Do your parents have supplementary health insurance? What does it cost/month? Or do they have a Medicare Advantage Plan?

4. What do they pay monthly for drugs? Include Part D and co-pays.

5. What drugs are they on? And why are they on them?

6. What hospital do they go to?

7. Do they have a health care power of attorney? Where is it kept? Have you read it? Who is the health care agent (if answer to #7 is yes)?

8. Have you met your parents’ doctors? What is the address? How long does it take to get to the office?

9. Do you have the HIPAA form signed?

Chapter Two: Health

So how did you do on the quiz? Don’t worry, I won’t collect the quiz. This quiz starts you knowing about your parents’ health care situation. It may painfully show you how little you know. But it’s a beginning. You need to know the answers to those questions. You do not have to get all the answers at the same time.

I once gave this quiz in a class I taught on caregiving. I was amazed how little these very caring and thoughtful people knew about their parents. Then I thought of myself before caregiving started – I was the same. I didn’t know a thing. I didn’t know the name of my parents’ doctors or what drugs they took. Initially, my parents did not have Health Care Powers of Attorneys, but we fixed that.

This is a huge issue. There are many aspects of the health care surrounding your parents. You must understand the state of your parents’ health. You must know what conditions, diseases, and drugs they have. How can you help support them without knowing that information? How can you help them and help you and your family make the best decisions you can unless you have the facts?

Advice: Attend meetings with doctors, nurses, therapists or whatever other medical professional your folks go to. Take notes during the meetings. This is critical. Your attendance shows to the medical support team that you are engaged. It helps them put a face to the support your parents need. And it gives you an opportunity to know the level of care that your parents are getting.

Getting to know your parents’ medical support team is critical as the needs increase and when there is a medical crisis. Take the day off of work sometime and drive your folks to the appointments. Experience what they experience, the time it takes to get to the clinic, how they are treated, what the doctor/nurses look like and how easy is it for your folks to get around. Find out what route they take to the doctors and how long it takes them. Have them drive (if you are willing to have them drive). Find out what pharmacy they go to, is it close?

The Basics

You don’t have to be a medical professional to help your folks out medically. You do have to know their medical support team and know what their situation is. Knowing your parents’ situation means knowing what conditions/diseases they have, what drugs they take, what health needs they have (inhaler, cane, pacemakers, etc.), and what their medical schedule is. By medical schedule I mean what are their appointment times, do they have scheduled visits, what are their medication requirements (time of day, quantity), in-home visits, treatments times and durations.

Create a document with the name(s) of the doctors and their phone numbers. Your parent may have more than one doctor, the regular physician, and there may be specialists depending upon their medical situation. Next to the name of the doctors write down what the name of the clinic is and its address/phone number. As an example, my father-in-law had 4 doctors. We got to know those doctors well as we moved through my father-in-law’s medical situation. Share this with all concerned and maybe post it on the refrigerator. Create a calendar with medical appointments and schedules.

What kind of doctor is their regular doctor? Internist, family doctor or a gerontologist? If at all possible, switch the main doctor to a gerontologist. They aren’t everywhere. If you can’t find one labeled such there may be a doctor who is specializing with elder care. A gerontologist only works with people who are 75 years or older. The needs are different at that age. The gerontologist and the staff know older people. Just like a pediatrician who specializes in the care of children, this is the equivalent for older people. Gerontologists understand old age. They know the research and they know how drugs affect older adults. And most importantly they understand and know Medicare (medical insurance for over 65 crowd). They understand how to talk to the Medicare folks and they know how to write prescriptions so that Medicare approves the payments. They know what they can and cannot do to maximize Medicare. Medicare has many rules. If you don’t work in the field every day, you don’t learn these rules. Gerontologists and their staff work with Medicare every day. They know how to follow the rules established by Medicare.

They know what a supplemental health care plan is or a Medicare Advantage Plan and know what those restrictions are. They get old age.

Definition:

Medicare: Federal Government subsidized medical insurance for United States citizens 65 and older. Medicare is funded by contributions from both workers and through monthly premiums from the over-65 crowd. Medicare is health insurance. It is not dental insurance, vision insurance or long-term care insurance. It doesn’t cover everything, just like most health insurance plans. It does NOT pay for nursing home costs. Medicare has deductibles, co-pays and depending on service, may only pay a portion of the service. Medicare can be supplemented by either Medicare supplemental plans (provided by private insurance companies) or Medicare advantage plan (pools of Medicare premiums re-organized to provide different benefits to subscribers). And there is a prescription drug piece to Medicare, called Medicare Part D. Depending on the drug plan your parents choose, the costs can be significantly different.

Medicaid is NOT Medicare. They are two different things. Medicaid will be covered in Chapters 4 and 5, financial and legal issues.

Find out whether your folks have a Medicare advantage plan or Medicare supplemental plan and which Part D (prescription drug) plan they have. What do they pay for those? If they don’t have one and can afford it, they should enroll in a supplemental plan. It will help cover the costs of what Medicare doesn’t cover. www.medicare.gov is the government’s web-site relating to all things about Medicare. It will discuss what Medicare covers and what it does not cover.

Make a list of their drugs. Look them up as to what they do and what are the side effects. Talk to their doctors/nurses/pharmacist regarding the medications. Make sure your folks are taking the drugs recommended and taking them appropriately (with/without food, time of day). Count the pills when you visit. Or talk to the pharmacy for packaging options to make it easier for your parents to keep track of their medications. Keep the list of drugs with you at all times. This document becomes critical when an emergency happens. They may be taken to a hospital or an emergency center and their normal medical team is not handling them there. The doctors/nurses need to know what the medications are that they are taking.