Your grandchildren are visiting for a few days and you're having a delightful time, until one of them crashes into a bookcase and bangs his head. His unceasing screams — and the gash on his head — convince you to get him to the emergency room. The parents aren't around. You're on your own. Are you ready?
The Papers You'll Need
You probably don't think about visits to the ER when you agree to watch kids. You may focus more on choosing great books, shopping for dinner, or planning a park outing. But when you assume responsibility for another person's children — even your grandchildren — you must have the information and documents to get them the medical care they need, says Jay Berkelhamer, M.D., past president of the American Academy of Pediatrics and chief academic officer of Children’s Healthcare in Atlanta.
Doctors always do whatever they must to care for sick or injured children, especially when the kids face life-threatening injuries. But having the right documents, information, and attitude can make things go more smoothly.
A signed permission letter. Hospital officials will want to know whether you’re authorized to seek care for your grandchildren. "It would be a good idea to carry a letter authorizing [you] to seek care and make decisions on the child’s behalf," Berkelhammer says. The letter should include your name, the child's name and a parent's signature. If possible, it should be notarized.
Without this authorization, care might be delayed while the hospital tries to contact a parent. The call will probably have to be recorded and witnessed by an employee of the hospital.
A health insurance card. Having the children's insurance cards — or at least a photocopy of them — helps ensure that all or part of the cost of your visit is covered and spares parents the challenge of a billing problem later on.
Medical history. Whether it's a peanut allergy or a recent bout of the flu, it's important to know your grandchild's medical history when you see a doctor. A good history includes allergies, prescriptions for existing conditions, and details of significant recent illnesses. "An informed caretaker is going to get the child help more effectively," Berkelhamer says. "The more you know, the better you'll be able to care for your grandchild."
If you don't have a child's medical history — parents could leave you a copy of the forms they send to the children's schools or day-care centers — make sure you have contact information for the children's pediatricians so you or the hospital can call for the records. Click here for more emergency information parents should always leave for you when you sit or when kids stay over.
What to Do at the Hospital
Be reassuring. Rushing off to the hospital is upsetting for children, especially young kids. It's your job to soothe their anxiety. If the visit involves a ride in an ambulance, ask to go along. If that's not possible, find out exactly where the ambulance is going and follow in your car. Once you're at the hospital, stay at your grandchildren's side, holding their hand, as long as possible. Tell them what will happen: A doctor and nurse will examine them to see what can be done to make them feel better. Some of these things might hurt, but reassure kids that it will be okay in the end.
Be an advocate. You need to act as your grandchild's advocate at the hospital. "Be assertive, so your grandchild gets what he needs," Berkelhamer says. On the other hand, making comments like, “Did that mean doctor poke you?” can make things worse, especially if unpleasant procedures or treatments are involved, in part by lessening your grandchild's confidence in the doctors. "It may actually frighten the child more or set up the next visit to the doctor as a very negative experience," Berkelhamer says. "The doctor should always be cast as the nice person trying to help."
Know when to step away. Anxious grandparents can make it difficult for doctors to care for children. Some might ask too many questions; others might simply talk too much. "You want to be a calming influence, not a disruptive one," Berkelhamer says. If you're too nervous to help keep your grandchildren calm (or if a doctor asks you to), step out of the room and take a moment to collect yourself.
Get help. If you think you’ll have a hard time keeping your cool, or dealing with the doctors and nurses at the ER, ask someone you trust to drive you and the child to the hospital and stay by your side.
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