Becoming an Adult: Taking Responsibility for Your Medical Care

Every pediatric patient will eventually need
to transition to an adult provider. The age of transition varies between different facilities.
Some pediatric facilities will allow you to stay in their hospital or in their office
for an undetermined length of time, but it’s really important to start to identify that
you need to transition to an adult provider, so that you are in a more age-appropriate
setting. Every family can start to encourage their child to be more independent in their
care; so they can make sure that the child will tell mom or dad when they’re having symptoms,
when they don’t feel well. We can make sure they register themselves when they go to visits,
but then we want to make sure that families start to encourage them to be autonomous in
other aspects of care. So for patients with more complex medical conditions who are on
chronic medicines, or medicines they take everyday, families can start to encourage
their child to be more autonomous in accessing those things. So that means having them call
pharmacies and getting their own refills. And you can do it as young as the patient
is developmentally-appropriate. In order to get ready for the transition to adult-centered
care, patients can start in their pediatric offices, practicing the skills that they need
to know. I recommend that the patient sits next to the provider, making sure that mom
isn’t sitting next to the provider anymore,and that the patient now asusmes that role next
to the provier, so they can be the person answering the questions. If the provider asks
a question that they don’t know, that they ask the provider to help them give them the
information and then practice it at home so that the next time they come for a visit they
will know the answer of what are their medications, what are their allergies, what is their surgical
history. Also the patient should be checking themsleves into the appointment so mom and
dad don’t need to give their name, the patients can go up directly and give their information
saying, “I’m here to see my provider,” that way the provider knows that they’re starting
to be more autonomous in their care. Ideally we want to encourage patients to start to
be autonomous at the earliest age that is developmentally appropriate and families and
parents should be encouraging them. When patients come to a new appointment physicians expect
that they’ll know their own medical information; they know what their problem list is, they
know what chronic conditions they have. They know what medications they take when they’re
sick and what medications they take everyday. Understadnging their baseline signs and symptoms
is really important when they see a new provider, so if they normally have a high heart rate,
they can express that “no, that’s my baseline, that’s not something you need to work up,”
especially when they’re seeing a new provider. They should know who their specialists are.
They should know who their physical therapist is. They know what pharmacy they use. They
should be aware of their allergies to medicines and their previous medical history, including
their surgeries. It’s really important that young adults start to carry information with
them that will help them access health care should they need it. Families aren’t always
with our patients and our young adults needs to carry their own medical information. That
includes an insurance card, a list of their medications and allergies and the phone number
of their providers. When you’re transitioning from your pediatric provider to an adult provider,
you have to be patient in establishing that relationship. Our patients have had 21 years
or so to establish a really good working relationship with their current providers and they often
expect that relationship to be instant when they meet a new adult provider, so be patient
with you new adult providers. You’re going to be teaching them as much as they’re going
to be taking care of you. Often finding that adult provider is a challenge. Probably the
best resource is other families who can give you their experience and let you know what
providers have been advocates for their patients and their families. Even asking your friends,
“what adult providers do you use?” If you are using multiple specialists, I often get
recommendations from that pediatrtic specialist, “what adult providers should I go to?” Oftentimes,
pediatric patients are seeing multiple specialists and the specialists actually assume the role
as the medical home for the patient, when they transition to the adult side, the patient
themsleves becomes the captain of that medical home, along with their primary care provider
on the adult side. I have noticed that there’s been a difference between teenagers still
being in the pediatric environment and still seeing young kids and toys, and they really
want to be in a more age-appropriate environment so oftentimes they are looking forward to
getting into that older setting. It’s very hard for me to let her go and let her mature
and be independent. One of the things that I struggled with is that I always try to help
her and helping her all the time is making her kind of not be independent the way that
she should be. So part of what we have done in the transtion program is for me to let
her go and for her to start doing it by herself. And it’s been wonderful, she’s doing good
and the support that we have with everybody is wonderful. I would say just try to do your
best, try hard, never give up, don’t matter what happens.

1 thought on “Becoming an Adult: Taking Responsibility for Your Medical Care

  1. Very good video. Good ideas about becoming independent with your health care. I especially like the comments of the young woman and her parent at the end.

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