Many kids and families are positively impacted by the care from their pediatrician or pediatric specialists. After all, many get to grow up with them!
But like any good rite of passage, there comes a time when kids will need to make the transition to managing their own healthcare and prepare to graduate to an adult provider.
Here, Reny Partain, manager of the Adolescent to Adult Bridge (A2B) program at CHOC, gives parents age-by-age tips to help smooth the transition from pediatric to adult healthcare.
Why is preparing my child to manage their own medical care important?
As your teen has grown, you experienced many different transitions: watching them go from infants to toddlers, starting school, or adjusting to a new diagnosis. Adolescence and the transition to adult care is the next step. CHOC patients will eventually graduate from their pediatric care team and need to have the knowledge, skills and ability to be responsible for their medical needs.
For some, this transition can be difficult. Many teens are used to their parents’ help making appointments, asking questions and knowing where to go for care. The transition to adult care should not happen overnight. Instead, families do best when they start preparing early and teach their teens skills slowly over time.
We recommend families start talking about transition around the age of 12, with the goal of teaching your teen more about managing their health each year, says Reny. All of those little pieces add up and by the time you are ready to graduate to adult care, your teen will have practiced and learned many of the skills they need to be independent.
If your teen is not able to be independent in their care, there are ways to ensure they have the support they need in adult care. Supported decision-making, power of attorney, and conservatorship are a few of the ways families can continue to be involved in medical care and medical decisions. It is important to think about these options early and agencies like Orange County Regional Center can help you learn more.
You do not need to plan for transition alone! Talk with your doctor about how your teen can practice being independent during appointments and when they recommend switching to an adult provider.
How is adult healthcare different from pediatric healthcare?
In pediatric healthcare, families are at the center of all medical decisions and treatment plans. Parents and caregivers are the ones asking questions, attending appointments, and making medical decisions for their child. It is also common for whole care teams to see a family at once, including dieticians, social workers, physical therapists and child life specialists.
In adult healthcare, it is more common for patients to meet with a single provider and be referred out if any other support is needed. Adult providers will look to patients to make decisions, ask their own questions, and share symptoms or concerns without as many prompts.
When young adults transition to receive adult healthcare, they’ll be responsible for:
- Making their own appointments.
- Advocating for their own treatments and care.
- Understanding how their insurance works and how to find the care they need.
Make sure your teen knows that as they grow and mature, their healthcare will too. They will be treated like an independent adult by their adult-focused providers.
When and how to give your child more medical responsibilities
To help ease the transition from pediatric to adult care, you can start talking to your teen about their medical care and give them some responsibilities early and gradually. By the time your child is 12, they are probably aware of certain aspects of their healthcare. If not, it’s the perfect time to start showing them the ropes.
You can start teaching them how to talk about and get the medical support they need. The goal is for them to know how to make appointments, refill prescriptions and manage their own medical care before the graduate to new adult providers
For kids around age 12:
- Use simple words to explain any medical conditions that your child has. Ask them to repeat them back to you to be sure they understand.
- Encourage your child to spend time alone with their provider and nurse, without you in the room. This helps them build a trusting relationship and practice asking their own questions.
- Look at your child’s medications together and talk to them about what they take and why. Tell them if they have any medicine allergies.
- If your child has a chronic condition, have them sit with you the next time you order any medical equipment, prescriptions or supplies they need so they can learn the steps.
- Spend time together looking at your child’s health records. If you keep a file of their medical information, show them where you keep it and what information is included.
- Talk about how your family makes healthy decisions and how alcohol and drugs can impact their wellbeing.
For teens around age 14, also:
- Tell them about their health history, including medical conditions, hospitalizations, operations and treatments. Use the 3-sentence health summary to help them practice telling others about their medical needs.
- Share your family medical history, including any diseases that run in the family.
- Give your teen the contact information for all their current and past doctors.
- Show them how to fill a prescription and refill a prescription.
- Gather a current list of your teen’s medicines and dosages.
- Have your teen check themselves in when arriving at the doctor’s office.
- Encourage them to ask and answer questions during medical visits.
- Teach them what to do in an emergency and if they have a chronic illness, what signs or symptoms they should look for.
For teens around age 18, also:
- As legal adults, make sure your teen knows who can access their health information and how they can continue to include parents or caregivers. If your teen wants you to still have access to their health information, have them complete a release of information at your next visit.
- Start thinking about options for a new primary care provider who cares for adults. This could be an internist or a family doctor. Involve your teen in the decision because they’ll need to develop their own relationship with their doctor.
- Explain how to get a referral to see a specialist.
- Help your teen get set up on their provider’s patient portal, CHOC Link, if available.
- Discuss how health insurance works. Explain your teen’s coverage and how to contact customer service. Tell them when their coverage will expire and that they’ll need to plan to get new coverage then.
Download this checklist so your child so can track their progress on the way to adult-focused care.
Teens who have special health needs or chronic conditions (like asthma or diabetes) may need extra support as they learn to take on new responsibilities for their healthcare team for advice. When possible, include your teen in the discussions.
Although the transition to adult care can be overwhelming for you and your child, it’s worth it! By spending time building a foundation, you’ll set your child up to feel comfortable seeking healthcare and advocating for themselves.
CHOC’s Adolescent to Adult Bridge Program (A2B) guides youths and young adults as they transition to adult care. This program helps adolescents prepare to make healthcare decisions and see an adult doctor.