Probably one of the most distinct aspects of eldercare is that you'll have to handle an increasing number of health-related situations. These events can be quite stressful, so you'll want to do everything you can to plan your schedule so that they go as smoothly as possible.

To do list

  • Introduce yourself to the staff at your elder's doctors' offices

  • Purchase an accessory that makes it easier for your elder to get in and out of your vehicle, if your elder and you can benefit from such a device

  • Make sure you understand your elder's medications

  • Create a chart of your elder's medication schedule, if he's taking multiple medications

  • Set up a system to remind your elder to take and reorder her medications

  • Write your own step-by-step instructions for filing your elder's medical insurance claims

  • Plan ahead for medical emergencies

Making Doctor Appointments

You can develop a real ally by getting to know the people in your elder's doctors' offices who handle the appointment scheduling. Help them to help you by

  • Letting them know that you need to be included in any appointment changes because you're the one who'll be bringing your elder

  • Explaining what days and times work with your schedule

  • Giving them your phone numbers so they can reach you with a minimum of effort

  • Telling them if a particular time of day is more difficult for your elder


Take as much relevant information as you can when you go to the doctor:

  • Make a list of any problems or concerns your elder is having so that you don't forget to mention them.

  • Get a printout from your elder's pharmacist of all of the medications that your elder is taking. You may need to have your elder sign a medical release form before the pharmacist will give you this information. If you can't get your elder to sign the form, ask the pharmacist to fax the information directly to the doctor's office.

  • Get your elder's medical records from other doctors whom she's seeing. Again, you'll probably need a signed medical release form, or you'll need to have the information faxed directly to the doctor.

  • Have your elder's medical insurance information. Ask your elder if she has an insurance card. If she's not able to supply you with current information, keep a watch on her mail for statements from the insurance company.

If your elder has decreased mobility, transporting him to and from the doctor—and on errands—can require added time, energy, and patience. You can purchase an accessory to make getting into and out of the car easier for both of you. The accessory can be as simple and inexpensive as a seat cushion that swivels or as sophisticated as a factory-installed seat designed for the mobility impaired. With the growing population of senior citizens, new and more innovative products are becoming available all the time.


The Swivel Car Seat is a covered soft-foam cushion that rotates 360 degrees on a swivel base so that the passenger can get in or out of any car with greater ease. Suggested retail: $24.95. Website: www.aidsforarthritis.com

Tracking Medications

The elder for whom you're the caregiver is likely taking multiple medications. The instructions for taking them may be quite complicated. You'll want to know the answers to all of the following questions:

  • How many of the pills should the patient take?


    General Motors offers the Sit-and-Lift Power Seat, a remote-control–operated fully motorized rotating lift-and-lower passenger seat, as a dealer-installed accessory on several of its minivan models. Suggested retail: $4,590.00. Website: www.gmmobility.com.

  • How often should he take them?

  • Must they be taken with food? If so, is the frequency such that your elder will be eating at the right time?

  • Must the pills be taken with water, or is another liquid okay?

  • What are the likely side effects? Which ones require you to notify the doctor?

  • Will there be any adverse reactions with other medications the elder is taking?

  • Can the elder drink alcohol while on this medication? (If no, let the doctor know if this restriction will cause a conflict.)

  • Should the elder curtail any activities while on the medication, such as driving, being in the sun, or eating certain foods?

  • What should the elder do if he misses a dose: skip it or double up?

  • Is there an alternative way to take the medicine if the elder has trouble swallowing it?


    The www.epill.com website, which specializes in the sale of medication reminder devices, features a medication reminder product selector. You indicate whether your elder

    • Needs a reminder only or a reminder with a pill container

    • Will use the system at home or away from home

    • Has normal hearing or is hearing impaired

    • Takes medication once, a few, or many times a day

    Then the selector indicates which products will meet your elder's needs.

  • Is there anything else the doctor thinks you should know about the medication?

When you understand the intricacies of the medication regimen, you may find it helpful to create a visual schematic of it along the lines of the one illustrated in Table 1. For the medication plan in the illustration, we needed a chart two days long to cover all of the combinations because Med C is taken only every other day. Your chart may be even more complex if your elder is taking any medications that alternate between a higher and lower dosage or that cannot be taken in combination with others.

Table 1. Sample Medication Schedule
MedicationMed AMed BMed CMed DMed E
InstructionsWith water onlyWith foodWith liquid2 hours after eatingBefore bed
DosageTwice a dayTwice a dayEvery other dayOnce a dayOnce a day
Day 1     
Before breakfast  X  
With breakfast X   
Mid-morningX  X 
Mid-evening with snack X   
BedtimeX   X
Day 2     
With breakfast X   
Mid-morningX  X 
Mid-evening with snack X   
BedtimeX   X

Next, you'll need to ensure that your elder is taking the medications according to the schedule. If your elder is still living by himself and handling his own medications, you'll want to be confident that he's remembering to take the medications at the right time—and that he's not forgetting when he's already taken the medicine and double-dosing. You can purchase medication reminders and timers for just about every situation from a simple alarm that reminds the patient it's time for medication to a computerized dispenser that releases only the proper pills at the prescribed times. You can even subscribe to services that will phone you automatically if the elder doesn't take the pills out of the dispenser. Figures 1, 2, and 3 show a range of the timers that you can buy.

Figure 1. You can set this pill case (shown here from both the front and back) to ring or vibrate up to five times a day.

Figure 2. The alarm clock in the top of this bottle reminds the patient when to take the medication; the voice recorder in the bottom can be used for special instructions, such as “take with a full glass of water.”

Figure 3. When it's time to take medication, this device sounds an alarm and rotates into position dispensing the appropriate pills only.


The Casio TMR200-2, shown in Figure 12.1, is a combination pillbox/alarm clock with five compartments and up to five alarm settings per day. Suggested retail: $19.99. Website: www.casio.com


The Beep 'N Tell Medication Reminder pill vial, shown in Figure 12.2, has an alarm clock in the lid that automatically resets for the next dosage when the cap is replaced. The bottom of the vial contains a voice chip for recording personalized instructions about the prescription. Suggested retail: $69.95. Website: www.epill.com

Another scheduling aspect of a prescription medication regimen is making sure that the patient always has a supply of the medications. You can keep track of the refill schedule by making the following entries in your planner as soon as you have the prescription filled for the first time:

  • A reminder one week before the medication will run out to order a refill, together with another reminder the day before it will run out

  • A reminder two weeks before the last prescribed refill will run out to contact the doctor for a new prescription—and to schedule an appointment if necessary—together with a backup reminder one week before the prescription will expire.


The Med-Time Personal Medication System, shown in Figure 12.3, has 28 compartments and a built-in timer that allows it to dispense pills up to four times a day. Suggested retail: $249.00. Website: www.amacalert.com


If you use a mail-order prescription service, you still need to put reminders in your schedule so that you're alerted if the delivery has been delayed or misdirected.

Submitting Insurance Claims

Filing health insurance claims can eat up a lot of your precious time unless you invest the time upfront to create a smooth-flowing tracking system. Your goal here should be to decipher the system once and record step-by-step instructions for yourself so that you won't have to repeat your efforts every time you're faced with a new claim. One way to develop your procedures is to track one claim from start to finish, writing lots of notes to yourself as you go, as follows:

  1. Find out what insurance coverage your elder has in place. Chances are, he'll have a primary policy and a secondary policy. Check what the coverages are. If you're having trouble figuring out the coverages, start by asking your elder's doctors' office staff and pharmacist. If you're still not clear, call the insurance carrier. Don't hesitate to call back if you're still confused; maybe you'll get a different representative who will explain the system more clearly. Set aside several hours for this process.

  2. Find out how much of the claim process the doctor's office staff or pharmacy will handle. Will they file no claim, only the claim to the primary carrier, or all claims? Make a note about when in the process you'll need to get involved and what the paperwork you'll have at that time will tell you.

  3. Get blank copies of all of the claim forms you'll have to file and make several copies of them.

  4. As soon as your elder receives a medical service or fills a prescription, enter it, with the date, into a log.

  5. Figure out what information goes on what line of the form. Feel free to make yourself notes such as “This figure is found around the middle of the sheet from the doctor's office and is preceded by the letters 'XXYM.'”

  6. File the claim and keep track of how long it takes to get a response from the insurance company. When you file subsequent claims, schedule a follow-up reminder in your planner at this interval.

  7. If you need to file with subsequent carriers after you receive a response, repeat steps 5 and 6. Save yourself the aggravation of having to decipher the calculations each time by making your own set of instructions with notes such as “Line 8 on the statement from Company A is 80% of the amount allowed, which is shown on Line 3. Enter the amount from Line 8 on Line 12b of the claim form for Company B.”

  8. If a claim is denied—or comes back for less than the full amount you expected—and you believe the service should be covered, check to make sure that the doctor's office staff coded the service correctly. If they didn't, ask them to recode it and resubmit the claim.

  9. After the claim has gone through all of the insurance channels, pay the balance due, if any.


    Some older people get nervous about having outstanding medical bills, but it's important that you not pay until you have the absolute bottom-line figure because it's too hard to try to get money back that you've overpaid.

  10. Most important is that you create a checklist of the steps you must follow with the insurance coverages your elder has in place and that you keep a log of each claim and where it is in the process.

Preparing for Emergencies

When a person's health is in decline, emergency medical situations are inevitable. Emergencies, by definition, require immediate attention and a departure from whatever you had scheduled. You can minimize the disruption to your schedule—and reduce your stress—by preparing as much as you can in advance. You should

  • Have emergency phone numbers—doctor, ambulance, hospital, family, neighbor—in your individual planner and with you at all times

  • Make sure several people have access to your elder by giving house keys to trusted and caring neighbors

  • Keep an up-to-date list of all of your elder's medications with you and posted on your elder's refrigerator so you can tell emergency personnel where to find it

  • Have on file with your elder's doctors and hospital whatever legal documents are appropriate to your situation—durable powers of attorney, living wills, and the like

  • Know what your options are for home-care providers if they are needed

Take time now to schedule these preparations into your planner and actually make the preparations as soon as you can.

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