Caregiving Planning Step 4 Research: Medical Visits

Now that you know what you and the care recipient want to achieve, it’s time to determine how to make that happen. That means finding resources, talking to people and then making a decision about which approach to take. Below is a quick list of resources to start your research regarding Managing Medical visits. This is not an exhaustive list, but rather something to get you started.

Medical Visits

To get the most out of a medical visit it requires planning and coordination:

1. Arranging Transportation for Medical Visits and Tests

i. Contact the local Community Senior’s Programs to see if there is a medical visits transportation services run by volunteers. There may be a nominal cost. If the care recipient is attending the Cancer Centre, contact the Canadian Cancer Society to see if they provide a volunteer transportation service in your area.

ii. Commercial Transportation Services for Seniors. These services not only offer to drive the person to and from their appointment, but may also attend the appointment as well.

iii.Taxis. Call in advance and find out how much it will cost. You can also request that it be the same person who drops off and picks up.

iv. Para Transportation Services. These are municipally funded busing services that will transport the care recipient and a caregiver from one location to another. You will need to get your family doctor to complete a form to be eligible for the service, but once you are eligble, you can call and book your trip. A word of caution, when you take this service, it is inexpensive compared to the other options, but you may have to wait up to an hour for the transportation to arrive. Some municipalities also allow those with para transportation eligibility to purchase taxi chits at a reduced price.

v. Driving and using Hospital Parking Most hospitals have a campus map online so you can determine where you want to park and where backup parking can be found in a pinch. Also find out how much a monthly pass would cost. It might be worth getting one if you are visiting the hospital at least twice a week.

vi. Using a Ride-Sharing Program Ride sharing programs such as Uber can provide a less expensive option, however because it isn't regulated, I don't recommend this option for a vulnerable population.

2. Arranging for Someone To Go With The Care Recipient.

i. Family Members/Care Team Set up an on-line Calendar, such as a Google Calendar and ask your care team who can attend the appointment with the care recipient. Make sure the person knows what information they need to obtain from the appointment.

ii. Contact the local Community Senior’s Programs to see if there is a medical appointment companionship service run by volunteers. If the care recipient is attending the Cancer Centre, contact the Canadian Cancer Society to see if they provide a volunteer medical appointment companionship service in your area. Usually this is paired with transportation services.

ii. Commercial Transportation Services for Seniors. These services not only offer to drive the person to and from their appointment, but may also attend the appointment with the care recipient as well.

3. Preparing for the Visit.

Before attending any medical appointment, it is important to take note of the questions you and the care recipient may have, and any changes in behaviour or physical changes that you may have noted since the last appointment. Physicians and specialists see a lot of people and do not always have access to all the care recipient's medical appointment notes. It becomes your responsibility to ensure they are aware of what other medical appointments the care recipient may have had, what the outcomes were and if there have been any changes in medications, food or exercise. I use the 4ward Health Tracker to prepare for appointments by writing notes to myself to remind me what I need to ask about and what information I need to tell them about.

Managing Medical Records

Studies have shown that more than 50% of what is discussed at a medical appointment is forgotten shortly afterwards. Additional studies have shown that proactive patients and caregivers who are prepared for appointments, follow instructions and pay attention to symptoms and issues have a higher health outcome than genetics, diet and medications combined. So keep track of your medical information and be prepared for appointments. Don’t be afraid to ask questions.

i. Hospital Electronic Records

Many hospitals are now providing electronic medical records that you can download. Contact your local hospital for more information.

ii. Electronic Medical Record Applications

This topic could be a blog post unto itself. This is just a brief outline of things to consider when looking for an electronic app. There are many electronic applications that you can download to your phone or tablet or access online to keep track of medical information. These are called mobile apps. Some of these apps enable you to monitor symptoms, connect directly with the physician, and share information with the care team. Know what features you would like to have. For example, do you want a calendar to keep track of appointments, do you want to be able to share this information with others, do you want information abut prescriptions, do you want to easily search the information. If you are dealing with a specific illness, check to see if there are applications that can provide additional features to help with managing that illness or disease. Conduct your search on-line and look for reviews before you commit to a product. Ask the care recipient's physician for suggestions. My recommendation is to find one that reduces your burden of entering, updating, retrieving and sharing the information. There may be some compatibility issues between the electronic information the hospital provides and the application. Also, you may want to consider whether the product stores your information online. If it does, consider if it is stored in Canada or the United States. The United States has different laws regarding privacy and usage of information, meaning that your information, if it resides on a computer located in the US, is subject to US privacy and usage laws. Ensure you know how the company intends to use your information before signing up or downloading it.

iii. Family Doctor, Specialists Records

a. Many doctors are moving to electronic information. Ask if you can get a copy of the records.

b. Ask if you can record your discussions with the doctor or specialist and use a smart phone to record the meeting. It means having to transcribe the meeting information afterwards, but at least you have a reference and can focus on the discussion.

c. Take the 4ward Health Care Tracker with you to the meeting and write down the instructions you are given, or ask the doctor to write them down for you in the Tracker. Make sure you have prepared for the appointment in advance by writing down the questions and symptoms you want to discuss. This helps ensure the issues that are important to you are addressed during the appointment.

iv. Test Results

a. Many diagnostic testing facilities now provide on-line access to test results. Ask the test facility how you can obtain the results.

b. If the diagnostic testing facility forwards you to the doctor, ask the doctor for a copy for your records and store it in the 4ward Care Tracker.

Sharing Medical Information

Sharing medical information comes with it's own challenges. Below are some suggestions on how to share this information effectively, otherwise you can spend hours updating different members of the family and repeating yourself countless times when talking to external care providers.

i. With Family

a. If you are downloading or receiving electronic information you can create a OneNote File to store visit information by doctor and date. Test information can be stored by date or type of test. You can also link this to a Microsoft Calendar and then share this information with family.

b. Find an app that works for the whole family

c. Use the 4ward Care Tracker to print out and store the e-records in one place that everyone can access when they visit the care recipient.

ii. With Care Providers

The challenge with many care providers is that the person who comes to the house to provide services can change at any time. Providing them with access to your electronic health information is not recommended, unless you are working with only one facility and the care staff are consistent. Instead, print out the relevant information and store it in the 4ward Care Tracker which is available for the care provider to review.

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