Healthcare has a long way to go in assisting youth and their families move from the pediatric world to the adult healthcare team. According to the 2017/2018 National Survey of Children’s Health, several families report many barriers to transition from pediatric to adult healthcare, including not being comfortable moving to a new doctor, finding a doctor that they can talk to, understanding how to make appointments or how to determine insurance coverage.

In a previous blog, we addressed how pediatricians can help adolescents move into a more responsible role in healthcare as they grow into adulthood. In this article, we’ll offer tips to help guide parents through some of the challenges and changes that come along with this transition. We have identified three primary points to help create a smooth transition into the adult healthcare environment by considering the child, the parent(s), and the healthcare team.

Explain the Difference Between Pediatric and Adult Healthcare Setting

Parents' anxieties may be decreased if they understand the differences in care given in the pediatric and adult setting. Some of the more notable differences include:

• Parents accompany the child to a pediatric appointment, but as an adult, their child sees the doctor alone.
• Parents are involved in decision making concerning their child’s health when they are young; after 18 years of age, the child makes their own choice about their care and schedules their own appointments.
• Once a child reaches the age of 18, parents don't have legal rights to the test results unless the young adult allows them access.

Even if the young adult is going to stay in the same family practice, the rules change. This can be a hard transition for some parents since they have been privy to all information prior to this and may feel left out of the process. If they understand the reasons for the changes, they may adjust to the process easier.

Guide the Parents in the Process

A best practice is to begin the shift from pediatric care to adult care in the early teen years. There are many ways that you can prepare parents for this transition. Got Transition, a federally funded program intended to help transition from pediatric to adult healthcare, offers these suggestions to parents:

• At age 12-13, teach your child about their health conditions, medications and allergies, and encourage teens to ask questions about things they don’t understand.
• At age 14-15, have the adolescents make their own doctor appointments and order prescription refills. Encourage teenagers to see the doctor alone for part of the visit.
• At age 16-17, work with your child to make a medical summary that can be taken to the new healthcare provider. Together with your child, ask the doctor for any recommendations for an adult practitioner.
• After age 18, encourage the new adult to keep appointments and have medical insurance cards with them at all times.

Offer Support to the Parent

Even the most supportive parent who encourages the independence that comes with being an adult can have a rough time adjusting to the healthcare changes when their child turns 18. Some parents find it hard to accept that although their child is still in school, on the parent’s health insurance, and lives in their home, the parent has no right to the results of a simple strep throat test. It is important that the healthcare team understand the parent’s challenges and support the transition as much as possible.

Here are some ways to foster this change:

• Encourage the parents to keep the lines of communication open, especially during the early phase of the transition.
• The parent may offer their assistance to the child when healthcare decisions need to be made.
• The parent may discuss the possibility of the child giving the parent permission to access healthcare records temporarily, until the young adult feels confident about handling themselves.
• When the young adult decides to handle things on his or her own, explain to the parent that this is a normal part of maturing – taking responsibility for choices.

Becoming an adult is one of the most important milestones in one’s life. It carries many changes and responsibilities for the young adult, the parent and the healthcare team. By educating, communicating and planning for the changeover with the teen and the parents, you are paving the way for a smooth passage into their future healthcare environment.