Is your young adult ready to manage their healthcare?
“Hello? Dr. Smith? Yes, I’m calling about my son Tod. He said that you saw him about a football injury. His kneecap dislocated during a practice today, and you put it back in place. Tod tells me that you’re sending him to physio, and he has to wear his knee brace. I want to know when it’s time to consider surgery; Tod says the two of you didn’t even discuss that possibility. He’s had problems with his knee for forever.”
“I’m sorry, Mrs. Johnson, I can’t discuss these details with you. This is his personal, private health information.”
“But, Dr. Smith, I’m his mother!”
“Yes, you are, Mrs. Johnson, but he’s eighteen, and so I cannot discuss this with you, even though you are his mother.”
* * *
“Hello, I’m glad to see you, Mr. and Mrs. Thompson. I’m Dr. Carmichael. As you know, your daughter Sally had a skiing accident today. She has been stabilized, but a brain injury means she is unable to make decisions in her current condition. She is an adult now, so you require official documentation to be able to make decisions about her care. Does Sally have a Personal Directive?”
“No, she doesn’t, doctor.”
“I was afraid of that. I’m afraid you will have to apply for guardianship.”
“How do we do that? How long will that take?”
“It depends. Typically, the paperwork and court ruling for guardianship takes 3-6 months…”
“3 to 6 months!?!”
“I guess we’ll have to try. Even a week seems a long time to wait under the circumstances.”
“You will want to seriously consider hiring a lawyer to help you with the application process, especially if you’re applying for an urgent case. “
This fall, as high school graduates transition to university, college, work, or wherever their pursuits take them, the young adults and their parents may be startled to discover that their rights and responsibilities have changed when it comes to healthcare. For a start, once an individual turns 18, they are now responsible for making their own medical decisions. But as the above scenarios show, there’s more.
As Tod’s mom learns, a young adult’s health information cannot be discussed with anybody else, unless the young adult provides consent. Some young adults may be pleased with their new-found privacy and independence; others may be overwhelmed by the level of responsibility they now carry. For example, if Tod didn’t feel confident on his own, he could include his mom in conversations with the doctor about knee surgery by providing written consent – Albertans can complete the Consent to Disclose Health Information form to give that permission. Note: written consent may or may not be required if the parent attends the medical appointment with the child – some doctors accept that consent is implied when another person shows up to the appointment, some want the signed form. Consent is always required for medical experts to share print documents.
As we saw with Sally, when she unexpectedly lost the ability to make decisions, now she needs someone to be named as official decision maker. Under ideal conditions, the young adult has an Advance Healthcare Directive – in Alberta the document is called a Personal Directive – where they name a substitute decision maker, such as one or both of their parents. As in Sally’s case where she had no Personal Directive, parents don’t automatically get the right to step in and start making decisions, but rather they have to apply for it – in Alberta that role is called guardianship. Completing the Personal Directive (and Enduring Power of Attorney for financial matters) will cost less money, less time, and ultimately less anxiety, than having to apply for guardianship (and trusteeship). A Personal Directive might seem like a really big commitment for a young adult, but know that it can be updated as priorities and circumstances change.
When parents are used to discussing health matters and making decisions on their child’s behalf, these changes at the 18th birthday can come as a surprise to parents and the young adult alike. With a bit of awareness and planning, they can be prepared for all circumstances, including knowing how to prepare for situations where extra support is needed, as well as good self-management strategies for their day-to-day health and healthcare!
The truth is, most of us could learn better healthcare management habits and skills. Regardless of age, if you would like to figure out what you are doing well for personal healthcare management, and how you might improve it, call or e-mail us at Navigate Your Health. Ask about our upcoming educational workshops, or ask about one-on-one education and support. Either way, you will receive support from a trusted health navigator and advocate to make sense of healthcare management, and to navigate the next steps in your health journey.