Some of you have asked how you can speak with your parent’s physician or go to the doctor’s office with them. This all depends on the age and mental capacity of your parents. If your parents are young and/or mentally able (competent), they make those decisions for themselves. However, this is the point at which you need to talk to them about future issues.
First I would approach them about whether they have a will and documents to appoint a durable power of attorney and a health care surrogate to step in when they are unable to act. For my parents, it was the need for a will that brought us to see the lawyer.
A family member had implored me to get my parents to have a will drawn up. He knew that like 70% of retirees, my dad had chosen to have his retirement in his name only. This raised the amount of monthly income but meant that when he passed away mom would not get anything from his pension. That is, it would end with his death. At my retirement seminar we were told that 70% of retirees choose that option and often supplement it with extra term insurance though it was not an ideal option.
Dad had retired early and needed as much as they could get in monthly income. My family member suggested that mom had no protection for when dad passed away and my parents should discuss the situation with an elder lawyer who might have suggestions on how to deal with this.
My brother and I accompanied mom and dad to the lawyer at their request. The lawyer then said that mom and dad also needed to have a durable power of attorney (POA) and a health care surrogate (also called a Health Care Power of Attorney (POA)). At this point mom and dad were in their 80’s and had no objection to the planning or to signing these documents.
The health care surrogate has been the most used document to date though mom and dad have both had theirs replaced (updated) to make me the primary surrogate in the years since the original document was made. At first, my brother was named as he lived with them and would be closer in an emergency.
Over the years, I have been the one to accompany mom to her medical appointments and to telephone insurance and doctors on her behalf. Therefore we first changed her documents to appoint me as the primary POA and health care POA. Later, when dad had some illness, we changed his as well. Basically, my brother didn’t want the responsibility and work involved in the day-to-day financial and medical affairs of my parents.
Gradually I began to call my mother’s doctor after her appointments to help her clarify what her diagnosis was and what she should be doing. She knew she was confused and needed help and she told her doctor that I would be calling. Later when I was with her in the south, I accompanied her to her appointments whenever possible. She came to depend on me for this.
Later when dad had an emergency and had to go by ambulance to the hospital, I was the one who rode in the ambulance and stayed with him in the ER. He was already in early Alzheimer’s and there was no question that he needed family help in answering questions, etc.
Neither mom nor dad ever objected to having me talk to their physicians either in their presence or over the telephone. It gave them some confidence to have me help them with this stressful task.
This would be a different matter if they were younger and felt totally competent to handle their own affairs. US Privacy laws would prevent their physician from telling me anything without their permission. Some people think HIPAA is the reason for this. However, HIPAA is only one of many privacy laws that protect patients’ personal information. Both state laws modeled on the “Uniform Health Care Act” and earlier federal laws also protected patient’s privacy. The “Uniform Health Care Act” is a state law which many states adopted to guarantee patients access to their own medical information and protect their privacy. This was before HIPAA took effect and many states have amended their state laws to make them more consistent with HIPAA.
In addition, there are Federal and state laws that give extra protection to mental health and substance abuse patients. These laws were designed to encourage such patients to obtain medical help without fear that their diagnosis will be used against them by employers or family members (say in a divorce case).
So, to get back to the original question – How Do you get your parent’s doctor to communicate with you? The answer is that your parents have to give permission for their doctor to give you information unless they are incompetent and you are their guardian or unless you already have a health care proxy signed before they show signs of dementia.
Alternatively, there is no law to prevent you from giving information to their physicians. If you believe they are doing things or taking medication that would be detrimental to their health, you can write a letter and send it to their physician. However, you may not be able to keep the physician from sharing this information with your parent. It is up to the discretion of the physician. Also, the physician can’t tell you any more in response to the letter than he could before. That is, your parent still must approve the release of their information or have signed a health care power of attorney giving you that permission.
I do have experience with this as it was one of the areas I worked with before I retired. That was awhile ago so I don’t necessarily have the most up-to-date information on all Federal and State laws. I do know my rights though as my parents’ representative and I have fought to get copies of their medical records, etc. Legally, if you are the appointed health care representative, the physician and the records office must treat you as if you were the person you represent. You then have the same rights they do to their medical information.
I suggest you discuss this with your parent. In a crisis, you need to know where they are (if in the emergency room, etc.) and their condition. Often hospitals and doctors will not tell you anything if your parent has not already listed you as a person who should have access. Tell your parent(s) that you want to be able to help them in an emergency and ask that they list you and that they prepare a health care surrogate form. You don’t even need a lawyer as the forms can often be found with a search on the Internet. The format is set by state law so you need to be sure to have the right form. And, from personal experience, it does help to have a lawyer prepare it and defend your right to information when hospitals or others refuse to honor your signed form.