Handing over responsibility for health and healthcare

Implications

In this Mott Poll, parents evaluated their progress in preparing their young adult children to assume responsibility for their own health and healthcare. These two responsibilities are related but distinct.

Managing one’s health is something that happens every day, and parents have endless opportunities to prepare their child to take on that responsibility. In this Mott Poll, parents indicated that behaviors and lifestyle are more likely to cause health problems for their child, more than chronic medical or mental health conditions. Therefore, teaching teens and young adults to make healthy choices is key to them learning to manage their health. An everyday opportunity could be involving them in grocery shopping and meal planning, to get them thinking about the components of a healthy diet. Another strategy is for parents to describe their own health-related behaviors, from scheduling time for exercise to limiting their screen time, to help young adult children understand the steps to maintaining a healthy lifestyle.

In contrast, managing healthcare centers on interactions with the healthcare system, from health insurance to the variety of healthcare settings and providers. This system is complicated, even for parents, and navigating the different components requires a considerable amount of knowledge. Furthermore, many healthcare tasks (such as signing up for health insurance, finding a provider, or scheduling a preventive care visit) occur infrequently, so there are limited opportunities for youth and young adults to gain experience and confidence. Parents should take advantage of these limited opportunities to teach their children about how the healthcare system works, starting with the teen years, so that by the time that child reaches adulthood, they have a basic understanding of how the system works. For example, when renewing the family health insurance coverage, parents can show their child the information and give a brief explanation of the options.

Findings from this Mott Poll suggest that parents have had the most success preparing their young adult children to take an active role during health care visits; this includes communicating with the provider about symptoms and questions, as well as understanding and following provider instructions. Less often, young adult children are prepared to determine when a visit is needed, or how to schedule that visit.

A key time for young adults to gain knowledge and experience about the healthcare system is when they move from a pediatric provider to a provider that serves adults. Often this occurs between 18 and 21 years of age. Parents should explain the difference between a primary care provider and a specialist, and involve their child in selecting their adult provider. The first visit at the adult clinic offers an excellent opportunity for young adults to practice managing their healthcare; often the first visit requires filling out information about health insurance, family history, and personal health history (e.g., allergies, medical conditions). These forms should be completed by the young adult child; the appropriate parent role is explaining what the forms are asking, without taking over. If parents attend the first visit, they should take a back seat, allowing their young adult child to handle scheduling, check-in, and interactions with the provider.

For parents whose child has a medical or mental health condition, it is particularly important to ensure that child understands the nature of their condition, the names of their medications and how to obtain their prescriptions, the frequency of visits to monitor their condition, and the things that alleviate or trigger their symptoms. This education should begin early, with the child gradually taking more ownership, so that by young adulthood, they are ready to be fully responsible.