Advance Preparation Helps Avoid a Crisis

Last month, my mom experienced a fall in our home that resulted in left-sided fractures of her shoulder and foot.?As I ran to assist her, I tried to calmly assess the situation; I determined that she needed emergency care. That’s when I went from daughter to?Care Partner mode.

Fortunately, she is on the mend and, all things considered, it was a positive experience. But it didn’t happen by accident (no pun intended!).?Much of our success can be attributed to our preparation before the event and to steps taken once it occurred.?I share these with you now, in the hope that you will also be prepared for such an incident.

Effective and Efficient Communication

I called?911?and gave a description of what happened?to the phone dispatcher and to emergency responders who quickly arrived. I shared critical information about my mom, her baseline of health, and her functional abilities, all of which allowed them to do a thorough assessment and to begin treating her immediately.

For example, a key comment was, “Mom wears hearing aids and she does not have them in. Please speak directly to her and watch her face to promote communication.” That helped tremendously.

Grab-n-Go Kit

Fortunately, I had a copy of mom’s?“Grab-n-Go Kit”?— a preassembled packet of information about an individual that you can access at a moment’s notice.?I quickly retrieved several key documents from it. The emergency team wanted to know about mom’s medical conditions, her medications, and allergies. The man doing the intake saw what I had in my hands and said, “Wow, we never get this. This is incredibly helpful!”

Some of the contents of a Grab-n-Go Kit include:

• “Face Sheet.”?Demographic information and things one should know. For example, mom’s hearing impairment was noted in bold letters at the top of the page.
• Medication list.?Both prescribed and over the counter, including dosage and how often taken
• Medical Conditions, Past Surgeries, Past Hospitalizations List

Some clients resist my suggestion for a paper kit and insist that all their information is in their electronic record or available on their?Patient Portals. That may be true, but not all medical record systems are shared and when an emergency occurs,?the speed with which information can be extracted and communicated is critical.

Emergency Room

In the current COVID-19 environment, accompanying anyone to the emergency room is often prohibited.?As you might imagine, I went anyway!

As mom was taken in through the rear entrance, I introduced myself to the personnel at the front desk. Although they suggested I leave, I stated that I had mom’s identification, insurance information, and quite a bit of medical information that might be of value to the physicians examining her. I was then asked to wait. Soon, a nurse came out asking many questions that were critical to mom’s care. Before I knew it, I was asked to join the assessment team.

I’m certainly not suggesting that you should ignore the rules.?However, I am saying that when you have valuable information about your loved one, you must find a way to share it expeditiously.

Insurance Company

After mom was thoroughly assessed by multiple medical personnel, a treatment plan was developed that included splinting her left arm and casting her left foot with the recommendation that she be?non-weight bearing?on her upper left AND lower left extremity for?12 weeks!?That meant working with the hospital-based case manager on a transition to a?Skilled Nursing Facility.

When I got home, I immediately did the following…

… I went onto mom’s insurance portal to review the benefits for skilled nursing care

… I began to assess the facilities in our area that were considered in-network under her Florida-based?Medicare Advantage Plan

… I called the insurer early the next morning to verify my understanding

By the time the Case Manager called me, I had five facilities listed that had high quality care ratings. When the facility that was my first choice said “no” — based on their belief that mom was not covered under her plan — I called and facilitated a three-way conversation between myself, the business manager at the facility, and the insurer, to clarify that mom did indeed have coverage. She was transferred that afternoon, 24 hours after the incident occurred.

The lesson here is to be familiar with your insurance coverage and that of vulnerable loved ones in your life.?Do your own homework, both in advance and in the moment, and verify your understanding. When someone tells you something different than what you know to be true, politely and assertively?Challenge the Process.

Documentation

I’m someone who documents everything — in these circumstances, I suggest you do the same.?I quickly organized a notepad and within 24 hours, I made entries from interactions I had with the following professionals:

• Physician and nurses at the hospital
• Hospital Case Manager
• Insurance company customer service personnel
• Admissions and financial personnel at the Skilled Nursing Facility
• Medical, nursing, social work, and rehabilitation staff at the Skilled Nursing Facility
• Insurance Case Manager

Within those first 24 hours,?so much happened that I needed to remember, much of which was critical in setting the course for mom’s plan of care.?Having the names and phone numbers of everyone with whom I interacted has helped me tremendously over the past five weeks. I could not have done it without my notebook!

It’s All About the Relationships

In working with all the professionals along the way,?I tried hard to create positive and collaborative relationships. Each individual had their role and their perspective, all of which helped to inform me.

Not everything went smoothly. But when I needed to challenge the process, and when I knew it was the right thing to do on mom’s behalf, the positive relationships I built helped us to get the best care possible.

Final Thoughts

Many times over the past several months I have mentioned that our role at Health?assist?is to be a “futurist” —?anticipating how illness and aging can impact our clients’ functional abilities and capacity to care for themselves.

With my futurist hat on, I’m as prepared as I can be to care for my mom and dad. And yet, this incident continues to test me and my parents. When mom mentions, as she does often, how bad she feels about making so much work for me, I say,?“That’s what families do for each other. Isn’t that what you always taught me?”?I would not have it any other way.