Planning ahead for medical emergencies

CAROL HOGAN

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Here are some steps you should take before a hospitalization or crisis to make sure your medical situation is in order.

FIRST, FIND A FAMILY DOCTOR

If you�re new to the community, establish your primary physician right away.

�Don�t wait until you are sick to find a doctor,� advises Dr. Barry J. Landau, a neurological surgeon at Cascade Brain & Spine Center. If you have a family doctor, ask him/her for a referral to a specialist. �In the Bellingham medical community, and the way it works in most communities, the family doctor does the initial assessment,� Landau says, adding that patients don�t usually know what kind of physician they need.

Make an appointment with the Northwest Regional Council on Aging. They have a list of doctors who take new Medicare patients. If you�re not eligible for Medicare, they list doctors who are taking new patients. They can also advise about supplemental medical insurance and financial expectations.

Or call the Whatcom County Medical Society referral service (see resources list).

HAVE MEDICAL RECORDS AVAILABLE

Make sure you have your medical records available or have your caregiver get them. Bring these records to your first visit or when you check in to a hospital.

The records should include: X-rays and MRIs; medications, vitamins and herbal supplements with accurate dosages of what is currently being taken; known allergies to medications or anesthesia; medical history with dates and details of previous operations; and any major illness.

�People should also carry this list with them when they travel. ... That�s a big one,� Landau says.

Also bring to your first appointment, or when you check into a hospital, copies of your advance directive and durable power of attorney.

Neurologist Zeljka Chobonov of St. Joseph Neurology Associates � who deals with issues such as memory loss, dementia and Alzheimer�s � recommends compiling behavioral observations. Along with the list of medications, the caregiver should bring a record of symptoms observed such as: depression, inability to learn new information, anger, forgetfulness � including forgetting names of common objects, dates or place in time � lack of concern for appearance or hygiene, and any other unusual signs noticed.

�It�s important to discern if it�s part of the early aging process or dementia,� she says. �It�s especially important to diagnose the Alzheimer�s dementia very early because there are things to do to slow down the progression of symptoms and improve the quality of life to help maintain independence. These things require medical help to determine if the patient has early stages of dementia or Alzheimer�s that we should approach with medication.�

One way to organize health records is by enrolling in the Shared Care Plan, a free, easy-to-use, personal health record that lets you organize and store vital health information.

This information can be shared with family, physicians, hospitals, caregivers and others. It organizes and stores all of your health information in one place and can be accessed via any computer with Internet access or printed out on paper. For more information, see www.sharedcareplan.org.

BRING YOUR CAREGIVER WITH YOU

�When I have an older adult, they usually come with somebody else, like their spouse or children,� Landau says. �The older the person, the more likely the children will come with them. I think that�s a really good idea, there�s a lot of information that has to be transmitted with that visit.�

Landau recommends that other family members be present to make sure the information he�s relaying gets across to the patient, who might be overwhelmed because of nerves, sickness or pain. A caregiver can be more objective and help with the decision-making.

Chobonov concurs. �It�s important that a spouse or caregiver accompany the patient to the first appointment because the patient is not always aware of things the family sees,� she says. �We have a lot of elderly patients now. People are living longer and the baby boomers are reaching retirement age, so we actually see more patients with memory difficulties.�

Once the specialist�s visit is over and the patient or caregiver has a diagnosis, the doctor�s office will schedule future appointments, referrals or hospital visits.

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Sunday, Jan. 13, 2008

Planning ahead for medical emergencies

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