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En español | During the years I cared for my mother, I was quick to call her primary care provider for any and every health-related question. The thought of depending on my own judgment and possibly making a mistake made me nervous; I feared I could possibly cause her harm. Whenever she had a stomach bug, I'd reach out to her doctor to ask if I should bring her to his office. Whenever she fell, I'd ask him whether I should take her to the ER for an X-ray. His quick and direct responses were a comfort.
But we are soon entering a (hopefully short) period when the health care providers caregivers rely on will not be so readily available. As we keep reading in the news or seeing online, they are gearing up to throw nearly all their resources and energies into a fight against a potentially deadly viral menace. Their offices and ERs are likely to be filled with patients with COVID-19 and their family members. For these PCPs and other providers, stomach bugs and minor falls may not rise to the level of warranting attention.
That doesn't mean the health care system is turning its back on caregivers or any non-COVID-19 medical concerns. But you may have already received a notice from your health care provider that all care will now be triaged — that is, strictly prioritized — by illness severity. Providers may insist on using other means and perhaps other members of their staffs to provide caregivers and others with reassurance. They may also encourage caregivers to handle more of the health care questions on their own — and rely on their own expertise and good judgment.
Will that further burden caregivers who are already feeling more isolated and unsupported during this crisis? Quite likely. But it also presents an opportunity for caregivers to step up and do more — with appropriate caution and direction. Here are some ideas for how caregivers can successfully manage these new responsibilities:
Telemedicine is technically defined as health care delivered using a method of telecommunication for remote patient monitoring or videoconferencing. If you've never used telemedicine before, this is a great time to start. It is essentially using video technology with a laptop computer or smartphone to visually connect with a provider, ask questions and get answers, and even undergo physical examinations. Its primary advantages are safety (no more sitting in an office where sick people gather) and time (no more traveling back and forth to an office and then waiting forever). Not every medical intervention can be conducted via telemedicine but many can. More states are encouraging this form of care, more providers are using it and many health insurance companies are paying for it. The Department of Health and Human Services has loosened telemedicine regulations during the COVID-19 national emergency, so even providers who did not use telemedicine before may be using it now.
Accept alternative providers
Your beloved PCP may be too busy in the days ahead to speak with you or even respond to your email through a patient portal. Your doctor may ask you to pose your question to a nurse or medical assistant so they can research the information you need and get back to you. If you have a question regarding medication, it may be best to ask your pharmacist, who might less encumbered during the COVID-19 pandemic than physicians and nurse practitioners. Many pharmacies offer phone consultations; some have video conferencing as well.
Seek medical parameters
Many providers will be willing to give you clinical parameters for judging how to handle your loved one's health condition. It could be something as simple as suggesting you call the office back if the care recipient's throat still seems sore in three days or recommending that you give your loved one an extra pill if he or she is especially agitated at night. You can ask for additional guidance: What types of symptoms should I report to you immediately and which should I manage on my own? What are the blood pressure or blood sugar readings that are causes for concern and which are the ones I can likely manage with dietary changes and extra medication? When is an ER visit truly warranted? Parameters give caregivers permission to make reasonable decisions with greater independence. That doesn't usually increase caregivers’ anxiety but rather boosts their confidence that they can help their loved one on their own.
Respect your own expertise
We are all on alert for the primary symptoms of COVID-19: fever, cough and shortness of breath. Certainly, if your care recipient experiences any of those, it is crucial for you to confer with a health care provider. For most other matters, though, now may be the time to test your wings. You already know your care recipient — eating habits, pallor, moods and thinking skills — better than any provider ever will. Be the expert eye on his or her appearance and behavior. Be the master of the pillbox. Trust that you can be an effective extension and partner of our hard-pressed health care providers.