A good friend called last week saying she had a rather embarrassing tale she thought I’d be interested in. She’d recently received one of those automated calls from her health maintenance organization (HMO), saying “last call” for flu shots. She was about to hang up (she and her teen daughters had gotten their shots), when the recorded voice continued: “Seniors and young children are especially urged to get vaccinated.”
Dang, she thought. “I don’t know if Mom got her shot this year.” She quit the robocall and dialed her 80-something mother who lives in a small apartment nearby. “Yes I got my flu shot,” her mom announced. “Well, I think I did. Maybe."
“Which is it?” my friend asked, eager to get on with her day. “Gimme some time,” her mom answered with annoyance, ending the call.
Thus began what I’m calling the “Case of the Flu Shot Mystery.” It could also be called fading-senior-memory meets fading-middle-age-memory, meets the totally understandable yet insurmountable rules of patient confidentiality. Or, as my friend says, “A major headache.”
It would seem easy enough to find out if a family member received a flu shot. But medical records are protected by patient privacy laws, and the only way to access someone else’s records is if they’ve given you legal permission to do so -- even for a flu shot.
Here’s how it played out for my friend. There are lessons here, I think, for anyone caring for a senior.
My friend’s mom’s dementia is escalating. Making matters worse, Mom denies her memory loss, accusing everyone else of being confused. Deciding it best to take matters into her own hands, my friend set out the next day to learn if her mom needed a shot.
First stop, the flu clinic on her lunch hour. “Sorry, no can do,” the receptionist said politely, citing patient confidentiality. After work, my friend stopped by her mom’s doctor. Ditto to the big no. Again, patient confidentiality. She eventried calling her own doctor (in the same HMO) thinking maybe he'd help, as he knew her mother's situation. Nope.
Off she went to her mom’s house, where she handed her the phone and asked her to call the doctor. “Oh you’re being silly,” her mother said. “I can look after my own affairs.”
It’s fair to ask why my friend didn’t drop it, and cross her fingers for the duration of flu season. The answer: She dreaded the thought of her mother being hit by a bad flu bug. Dreaded it on two levels: the impact on her mom’s health and the caregiving it would require. Prevention was her aim.
Someone suggested she contact the HMO’s business office. And so she did. “The only way you can access your mom’s medical records is if you have legal authority, such as in an advanced healthcare directive.”
The light bulb flashed! The term was familiar. Weren’t advanced health directives covered in a class she’d taken with her mom on organizing life papers? Sure enough, there it was on file with the HMO. Her mom’s healthcare directives. And indeed, my friend had legal access to her mom’s medical records
The irony: My friend’s own middle-age memory had taken time to boot into gear. Embarrassed? Well, yes, my friend was, as she recounted this saga. All the driving, all the phone calls that could have been avoided if only she’d recalled….
Oh, and the answer: No. Her mother had not had a flu shot. Off to the flu clinic they went and just in time: It was closing the very next day.