Perhaps you’re getting to an age when it would be nice to have some additional support keeping track of appointments. Maybe you’ve received a health diagnosis that you need to share with your family. As we age, it often becomes important to communicate about our health to our loved ones.
Tryon Medical Partners internal medicine specialist Dr. Reshma Vora provides some guidance on how you can start to incorporate adult children or other caretakers into your healthcare plan.
When should I think about looping others in?
Dr. Vora says, as a general rule, 65 is an appropriate age to start thinking about bringing in the support of family or caretakers. Turning 65 often means retirement and a change in health insurance, which offers a natural moment to reflect on your health and what kind of support you might need.
However, major health events may necessitate a change in this timeline. With an event like a cancer diagnosis, heart attack, or dementia onset, loved ones may need to be involved at an earlier age.
“If I have a patient and something major happens, like a heart attack, some new illness or an increase in illness severity, I ask: ‘Have you talked to your children or family about this?’ Often they don’t want to stress their family out by telling them but it’s important that there is some planning in place to prevent additional stress on the family.”
Why should I incorporate friends and family into my healthcare?
The biggest reason Dr. Vora recommends discussing your health with your loved ones: it will help ensure a smooth and easy process for your family if something were to happen.
“When I worked in the hospital setting, I would see patients come in with heart failure or a bad stroke and the family would have no idea what the patient wanted for their goals of care. Now they’re in a crisis, asking, ‘Would they want to be resuscitated? Or on hospice care?’ That type of situation is the worst time for the family to make those decisions, they are often under duress, and differing opinions among family members can create discord between them. If the patient has clearly laid out what they want, this can be avoided.”
Dr. Vora recommends considering the following, regardless of how healthy you are, so you’re prepared for any health changes:
- Prepare DNR (do not resuscitate) and DNI (do not intubate) orders. “Resuscitation” is the medical term for the treatments or actions that healthcare providers perform to save your life. DNR and DNI orders tell medical providers not to attempt CPR or resuscitation measures. A DNR/DNI order is a legal document signed by you (or someone you elect to make decisions for you) and your healthcare provider. It tells all medical providers that you do not want certain treatments if your heart stops beating.
- Write a living will. This is a specific type of advanced directive in which you clarify the medical treatments, procedures and medications you do or don’t want to receive to keep you alive. If you can’t speak for yourself, your providers can refer to healthcare instructions in your living will document that will cover several items, often including your DNR and DNI orders and specificities around end of life care. This process may require some straightforward legal assistance to create.
- Designate a healthcare power of attorney. Whether or not you have a document that explains your wishes, it can be helpful to appoint someone to make decisions for you if you are unable. They can communicate your preferences and enact the DNR/DNI orders. This is often as simple as writing it down and getting it notarized.
How should I start that conversation?
Patients often feel concerned when bringing up their healthcare with their adult children, families and caretakers. One of their fundamental concerns is that they are burdening their children or family members with their health information.
Dr. Vora, however, validates the importance of doing so, “Although it may be nerve-racking to bring this up with your family, and you may want to shield them from it, ultimately you are helping them by making sure everything is clear and laid out in the event of an emergency.”
To set yourself up for a successful conversation, Dr. Vora recommends writing down what you would like to share with them and making sure you’re grounded before engaging them in the conversation. Tell them what is going on as clearly as you can, and frame it as: “I’m sharing this with you because I trust you and want you to be aware of it when the time comes around so you’re prepared.”
If you need guidance around what kind of healthcare support you might need or how to have a conversation with family, reach out to Tryon today to check in with your clinician.