It is not uncommon to hear my patients and their family members comment on the challenges in navigating our country’s complex health care system. More importantly, I hear many of my patients state it is impossible to remember all the recommendations or requirements necessary to meet their desired health care needs.
To compound older adult patients’ concerns even more is the fact that the Centers for Medicare and Medicaid Services (CMS) is strongly encouraging all health care systems to move to electronic medical records. The electronic record system means future communications between health providers and their patients will be done through email messages, such as receiving laboratory reports, X-ray reports and letters from consulting physicians, and scheduling follow-up appointments. For individuals who are unfamiliar with email, this may cause anxiety.
Since it isn’t likely our growing complex system of health care will change within the foreseeable future, it is all the more important for every older adult to establish a health care advocate or partner, someone who can help navigate through the health care system.
The most rapidly growing segment of the American population are those 85 years of age and older. With people living longer, it isn’t unusual for 85-year-old active adults to be receiving treatment for multiple medical problems and seeing four to eight consultants. Most of these consultants have no contact with each other except through written correspondence. If a patient forgets to inform his/her consultants of a recent medication change made at the emergency room a week ago, the omission could create unforeseen adverse outcomes which frequently lead to unnecessary hospital admissions.
These kinds of situations arise among thousands of older adults every day, reinforcing the need for a health care partner or advocate. A health care partner can be anyone who is willing and interested in working with you when receiving medical care. It can be a daughter or son, a grandchild or spouse. If you do not have access to a relative living in your area, a good friend, neighbor or a member of your faith community can also serve as your health care partner.
The list of partnership commitments, listed below, can be expanded or shortened depending upon your needs and wishes. Most importantly, don’t wait until a serious medical problem occurs before realizing you need a health care partner. The time to establish a health care partner is at the time when you believe you don’t need one. Remember, a fall with a hip fracture, a stroke or heart attack or a serious motor vehicle accident is never planned or expected. But, in all of these situations, the most important person you may know will be your health care partner and advocate. A health care partner should:
- Ensure medical appointments are scheduled and kept.
- Accompany you at the time of the appointment if possible.
- Understand the nature of your medical problem and the plan of care the doctors have recommended.
- Assist in managing medications to assure correct dosages and schedules are followed.
- Maintain a copy of your personal health record which includes copies of reports, correspondence and any other important health care information.
- Watch for significant changes in your health which should be brought to the attention of the doctor.
- Contact you daily to assure you are okay.
- Encourage you to complete a living will/advance directive if one wasn’t done.
- Advocate for additional health care services if appropriate and desired.