Caregiver's Handbook--Part 6 of 9

Medical Aspects of Caregiving

Medical Aspects of Caregiving

Overview
Keeping Records and Managing Medications
Current Medications List
Daily Medication Set-Up
Choosing A Doctor
Planning For Emergencies


MEDICAL ASPECTS OF CAREGIVING

Overview

As a caregiver, you are in a position to help your carereceiver along the road to good health care by encouraging routine physical examinations. You are valuable in helping the carereceiver talk to their doctors and other medical personnel. You can follow through with their medical treatment at home.

However, it is important to remember that the primary responsibility for medical treatment rests between the doctor and the patient. If there is any doubt about what you should or should not do, the doctor should be consulted. You can help your carereceiver to understand his/her medical treatment and encourage the carereceiver to be involved in making decisions. In medical treatment, it is often tempting to decide what is best for the patient, but it is best to recognize the carereceiver's need to choose. We all need control of our lives, and this is especially true for a person who needs the help of others. If there are serious concerns about decisions being made, caregivers should discuss the matter openly with the doctor.

Keeping Records and Managing Medications

  • Caregivers can help older people maintain medical records for use by the doctor. Arrangements can be made through the doctor's office to send for previous records that could be helpful in treatment. This may require getting Releases of Medical Information signed by the carereceiver. You also should keep a list of all medications (both prescribed and over-the-counter) being used. The same medications that are helpful in easing pain, stopping infection, controlling heart rate and keeping people healthy can also cause serious problems.
  • Because many older adults take several medications at one time, it is possible that these drugs can interact with one another and be a danger. If more than one doctor is prescribing medications, it is important to keep each doctor aware of the drugs that are being taken. You can keep them informed by taking all your drugs in a paper sack or a list of all your drugs to each doctor. Having one pharmacist that fills all of your prescriptions is a way to prevent taking drugs that interact and cause problems. Over-the-counter or non-prescription drugs also can cause problems. Talk with your pharmacist before using them.
  • If you find the medicine schedule confusing or difficult to follow, ask your pharmacist about preparing all medicines in blister packs.
  • Below is a sample of "current medication list" which includes the essentials: name of medication, sample of the medication taped beside its name, the reason for the medication, the dosage and the time the medication is taken:

    Current Medications List

    Medication Name (Tape Pill Here) Reason Dosage Take At...
    Estrogen Osteoporosis Morning
    Acetaminophen Joint pain Each meal and bedtime
    Warfarin Atrial fibrillation Bedtime
    Calcium Osteoporosis Morning

    If your carereceiver is taking several medications at different times throughout the day, it may be helpful to develop a second list to assist you with daily medication set-ups; this list may be color coded, or may have the names of the medications grouped in the times to be taken each day. For medications taken several times a day, their names will appear several times on your list as in the example below:

    Daily Medication Set-up

    Morning

    Noon

    Evening

    Bed Time

    Choosing a Doctor

  • If you don't have a doctor, choose one carefully. There are several referral sources you can utilize: 1) a friend who is satisfied with his/her physician for a referral; 2) your County Medical Society; 3) Physician Referral Service; 4) A neighborhood hospital (some offer a physician referral service.)
  • The doctor is a valuable resource. If you are having a difficult time managing your carereceiver at home, or an acute illness occurs, the doctor may assist with related health care concerns. Your carereceiver may have to be hospitalized. The doctor may assist by making a home health care referral. Once hospitalized, the doctor can assist in placement issues or home health care upon discharge. If he/she doesn't offer it, you may request it.
  • If you are dissatisfied with your doctor, consider:
  • 1. What do you want from your doctor?

    2. Are these wants realistic (e.g., cure of an incurable disease)?

    3. Have you discussed them with your doctor and/or staff?

    4. Do you have a primary physician (usually internist or family practitioner) who oversees your overall medical care? (Often, sub-specialists such as cardiologists or orthopedists focus on one organ system, and do not try to coordinate the patient care.)

    5. Do you keep your appointments?

    6. Do you take medications as prescribed, contact the doctor if you change, and discuss your concerns with him/her?

    Remember, physicians are human beings, with individual personalities, enormous responsibilities, and only 24 hours in one day. No doctor will be right for all patients. Find a doctor whose skills and style of practice suits your current needs. All patients should have one physician to coordinate their care. Frequently changing doctors is likely to result in poor quality care of chronic or complex problems.

    Older individuals with multiple medical problems or difficulties with memory or intellectual functions may benefit from a comprehensive geriatric assessment program. (This guide identified one program in the San Diego area as the UCSD Seniors Only Care Program (SOCARE). Your physician or local Area Agency on Aging may have information on comparable programs in your community.)

    Arranging the Doctor Appointment. Some questions to ask when you make a first appointment:

    On the first visit to the doctor, the patient's list of current medications (Table 4) and previous medical records should be given to the doctor. If the visit is for a specific problem, have the following information for the doctor:

    1) the symptoms,

    2) how long they have been present,

    3) how often they happen, how bad they are.

    Reviewing this information before the visit will help. And remember, it is important that the patient have a chance to visit with the doctor privately to discuss confidential information. Before leaving the doctor's office, meet with the doctor or the nurse to find out how you can help with treatment and what your role as caregiver should be.

    It is useful to look at the following three areas:

    1) What can be done now to help in the treatment of current medical problems,

    2) How to recognize problems that may arise,

    3) What to do in emergencies.

    Planning For Emergencies

    Having an emergency plan is important, especially when a substitute caregiver occasionally takes your place in the home. (Post phone numbers for the following agencies next to your telephone or a conspicuous place where they can easily be seen by anyone. This sentence modified for readers outside San Diego County.)

    1) The 911 number for emergencies (Medical, Fire or Police), 2) The physician's number (emergency and office number),

    3) The name and number of the hospital the physician and the patient prefer,

    4) The number of the home health agency, if one is currently making visits to the home,

    5) The Poison Center phone number,

    6) The 24-hour number of the medical or oxygen supplier, if one is being used,

    7) The telephone number where you (caregiver) can be reached.

    Remember, observe changes and signs of illness in the carereceiver. They can help detect a medical problem. But if any doubts about health arise, CALL THE DOCTOR FOR ADVICE--

    DO NOT PROCRASTINATE!

    End of part 6


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