Planning for Emergency: Be ready to coordinate a loved one’s medical care plan

That feared call can come at any time – informing you of a car accident in the middle of the night or an elderly loved one’s fall at home. Many of us will be faced with navigating a medical emergency on behalf of a loved one, and the complexities of today’s health care system can cause a myriad of challenges. Are you prepared?

It was a Sunday summer evening and I was in the midst of cleaning up after a quiet dinner at home. Little did I know my phone ringer was set to silent and I had missed a few frantic calls from my mother, informing me that my 89-year-old father had just suffered a fall at home. I arrived at their home within the hour to find him scared and injured and in dire need of medical attention.

Over the subsequent days and weeks I came to learn a lot about preparations that should best be made ahead of a potential emergency – not under duress and with time working against you. Some steps can be taken in advance; others, you will want to be prepared to act decisively on when needed.

Based on what I learned, below are 10 important things to know to help you respond effectively to a medical emergency.

Assessing the situation

The first few hours after a health event can be dizzying and fraught with emotion, especially when things start out with an ambulance and a trip to the ER. Today’s families often are scattered across the country, and sometimes those with decision-making authority may not be nearby when needed.

  • Know who has legal authority for health care decisions for those close to you, as noted in an individual’s medical power of attorney. Have at least one backup person named in the event the primary decision-maker is unavailable. Save these documents digitally.

**It is often overlooked that when children turn 18, parents can no longer legally make medical decisions without a formal power of attorney.

The days after a medical event often are filled with testing, exams and specialists. During this phase it is not uncommon to receive conflicting details and the risk of a mistake is high if the wrong course of action is taken. A study by researchers at Johns Hopkins Medicine says preventable medical errors should rank as the third-leading cause of death in the United States, behind heart disease and cancer.

  • Keep a journal of conversations with doctors and nurses and ask a friend or close family member to help keep track when possible.
  • Ideally, enlist the help of an independent patient advocate/care manager.

In my personal experience, I found that the help of a care manager would have been invaluable to orchestrate the information presented along the way. These managers speak the same language as caretakers and can navigate test results, spot errors and coordinate care much faster than someone without medical training. Leveraging this expertise would have allowed me to spend more quality time with my father in what ended up being his final days.

Assembling a care team

An injury/illness will most likely require some degree of hospitalization and potentially longer-term care. Coordinating the maze of doctors, specialists, diagnosis and treatment plans can be complicated and often creates a distraction from comforting the patient through the days that lie ahead.

  • In larger families, communication will be important to preserve family harmony and keep everyone informed. Assigning this task early will go a long way toward keeping the family at ease. There are now numerous resources available online to assist with this task.
  • Care coordinators can be enlisted to help advocate for the patient and educate the patient and family on next steps.
  • A geriatric care manager/geriatrician can be lifesaving. An older patient is more likely to be treated by multiple specialists, none of whom oversee the patient’s total care.

My father sustained many broken bones in his fall. Given his age and length of hospital stay, the trauma caused other complications that his care team did not initially catch. Geriatricians are not always part of a trauma team and can be vital in treating the elderly. If a loved one currently suffers from multiple medical conditions, is experiencing functional decline or has a disease associated with aging, a geriatric specialist can be integrated to maximize a patient’s physical functioning and well-being.

Longer-term treatment

For more serious illnesses or injuries, the treatment and care plan may continue after discharge from the hospital. Some patients will not be able to return to their homes and will have to find an alternative living arrangement quickly.

The care plan for my father included a surgery and subsequent discharge to a local rehab facility. His home had stairs and only limited access for a wheelchair, which prevented him from returning there as he wished. Given his age and condition, many care facilities in the area did not have the proper resources and some were simply full. It took me many days and countless phone calls and site visits to find the best fit.

  • Seek out local care managers near an elderly loved one before the need arises. Care management providers are familiar with the expertise and reputation of local care facilities. Risk assessments can also be done in the home to determine how best to implement care and modify living arrangements when needed.

Concurrently, I also was faced with the task of sorting through my father’s medical benefits to identify the costs of his long-term recovery. Social workers and other hospital staff can be helpful in reviewing insurance benefits but may have a limited view of a patient’s available resources.

  •  As a proactive measure, conduct a comprehensive review of current health insurance coverage, long-term care policies and other resources available to aging family members and those with more complex medical needs.
End-of-life discussions

Many times, an injury or illness is short-term and the patient will return to their full capacity in a matter of days or months. But there will be times when an injury or illness results in the death of a loved one.

  • Take the time to understand end-of-life wishes before the need arises. When the time comes, the decision-maker should be able to act with certainty and not guess how their loved one would want to be treated.
  • The best choice for a health care agent may not be the closest family member. An agent may have to make life-or-death decisions under extremely emotional conditions, often with pressure to act quickly. Empowering someone who will keep your wishes in mind while weighing a doctor’s options is extremely important.

Everyone deserves the best efforts of well-prepared family members or loved ones to help them navigate a medical crisis.  Altair Advisers can help you better prepare for the “unplanned.” As an additional resource, please refer to our past special report on Caring for Aging Parents.

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The material shown is for informational purposes only and should not be construed as accounting, legal, or tax advice.  Altair Advisers LLC is a registered investment adviser with the Securities and Exchange Commission; registration does not imply a certain level of skill or training.  While efforts are made to ensure information contained herein is accurate, Altair Advisers cannot guarantee the accuracy of all such information presented.