teen at the dr.

Transition From Pediatric to Adult Health Care

Preparing for change is a challenge. In corporate America, an entire cottage industry has sprung up around teaching executives to lead change. As caregivers for children, we all lead change frequently. We prepare for transitions. With children, these milestones include the first day of kindergarten, the liberty of being a licensed driver and the-going-off-to-college day, just to name a few. We get the right books and uniforms and paperwork. We give the necessary “talks” about responsibility, risk and behavior. We look at these transitions as rites of passage. We are good at it. We take it seriously. We know what to do.

The place where we often fall short as parents or providers is in prepping our children for their entry into adult health care. At some point, nearly every person will become responsible for maintaining and managing their own health issues. And yet, many young adults are totally unprepared for this transition. Why? Likely it’s due to a multitude of factors.

Navigating the world of health care is complex and is usually steered by a child’s primary caregiver for many years. There may be a lack of realization that this transition requires preparation and education for the child over a number of years to be able to handle it. There may be some variability in maturity of young adults in that not everyone exits adolescence at the same chronological age. There is agreement among adolescent specialists that many patients are in teen phases sometimes into their mid-20s.

Preparing kids to captain their own health care should begin early, to avoid a sudden provider breakup.

Knowing the perfect time for transition is a difficult art. Perception of familial caregivers may also be skewed in understanding when the adolescent or young adult may indeed be mature enough to “cut the cord” on managing his or her personal health care. Timing may also contribute – so many major life decisions occur at the onset of adulthood that the young person may already be overwhelmed and willing to put off taking control of his or her medical management.

From a provider standpoint, there may be several factors contributing to delaying a patient’s entry into the world of adult health care. Knowing patients all their lives is one of the perks of treating children, but it may also impair the ability to see them as adults. Not knowing who will catch the patient on the other side, or if those providers are as keenly aware of issues for younger people, especially those with chronic or rare health conditions, may contribute to procrastination in sending patients to the adult stage of health care.

So how do we as the responsible parties make strides in successfully launching our young adults into the world of health self-management? Specialists nationwide have developed many tools and hints to help plan for this transition, in conjunction with patient and family advisory councils. To that end, they have identified six critical elements that will impact successful transition:

Doctor with a patient on a white background
  • Establish a policy
  • Track progress
  • Administer readiness assessments
  • Plan for adult health care
  • Transfer to an adult-based practice
  • Integrate into an adult health care environment

To successfully accomplish these six elements, specialists recommend that practices have a formal policy and plan for transition. This should include a timeline, portable health summary that will accompany the patient as he or she moves forward and multiple tools for assessment of readiness and knowledge of health issues to address timing of the transition. These activities should occur at an early age, around 12 years old, per the American Academy of Pediatrics. Different studies have shown that physicians generally start the process later than that, usually about a year before the expected transfer to the adult realm of health care. Most transition scholars agree this is a bit too late for full effectiveness, especially in those with chronic health conditions. So, when should we start and how?

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The original article was posted on http://health.usnews.com/health-news/patient-advice/articles/2015/10/05/building-bridges-the-transition-from-pediatrics-to-adult-health-care?int=98e708

Photo Credit: brainsil and asierromero

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