Colorectal Patients: Transitioning to Adult Health Care
Jul 29, 2019
Transition of care from the pediatric to the adult medical system can be difficult and challenging for patients with chronic illnesses and their caregivers. A transition of care model to help teens and adults with colorectal diagnoses helps patients receive appropriate care as they move from the pediatric to the adult health care setting.
What is Health Care Transition?
Health care transition is the process of changing from a pediatric to an adult healthcare system. The health care environment for children and teens is typically different from the health care environment for adults. The adult health care environment tends not to be as inviting and rich in resources as the pediatric setting. The transition process prepares children and teens for this change. The goals of health care transition are to improve teens and young adults’ ability to manage their own health care needs and learn to use health services independently and effectively.
Why is it Important?
Health care transition is important, as it helps children and teens become engaged adults who own their health care and can be independent. Patients with complex health problems often require additional medical attention, especially during teenage years and young adulthood. During this time patients may experience changes in fecal and urinary continence as well as psychosocial development.
Nationwide Children’s Hospital and the Ohio State Medical Center Transition Model
Around the ages of 12-14 years-old, the process of transition to adult care should begin. Initiation of transition in care begins at the first appointment with the pediatric team, with information given about the transition process. During this time, patients will to see the Nationwide Children’s colorectal team and other multidisciplinary team members as needed. This may include: urology, gynecology, gastrointestinal, social work and/or psychology.
This team will work with the patient each visit to help prepare them for the health care transition. A general health knowledge tool kit is used to assess the patient's understanding of their medical condition. Patients and caregivers are also asked to complete yearly readiness assessments, which will help track their readiness for transition to adult care and self-care skills.
As the teen gets closer to transition to the adult team, they will have a clinic visit at Nationwide Children’s with the colorectal surgeon who is trained in both pediatric and adult colorectal. This allows the patient and family to meet the adult colorectal provider in the pediatric setting before being seen in the adult health care setting.
When the patient, family, and Nationwide Children’s team all feel the patient is ready to transition to the adult team, which is usually between the ages of 18 to 22 years old, transition of care will occur. For their next visit, the patient will be seen in the adult health care setting at OSU. This will be an appointment with the colorectal surgeon they previously had met at Nationwide Children’s. The adult multidisciplinary team at OSU will be included as needed, with the addition of fertility specialists and obstetrics when indicated.
Our teams are committed to helping patients make a smooth transition from the pediatric to the adult health care setting.
Tips for Preparing Your Teen for Transition to Adult Care
Start to have more frequent conversations about transition to adult health care. Information should be shared in a developmentally appropriate way, in small increments, and over a long period of time.
Encourage health literacy skills including conversations around how your teen can access their medical records, details about their insurance plan/coverage, and their medication regimen.
Set expectations about what they may experience at their medical appointments. For example, questions may be directed to them as opposed to you the caregiver. Additionally, they may be asked questions regarding Health Care Power of Attorney/Guardianship along with conversations about medical adherence.
Discuss how the transition to adult care may impact your teen emotionally, including changes in the parent/caregiver relationship and changes in the relationship with their current medical team.
Center for Colorectal and Pelvic Reconstruction (CCPR)
Dr. Gasior is the medical director of Colorectal Transitional Care at Nationwide Children’s Hospital and she is a surgeon with The Ohio State University Wexner Medical Center’s Division of Colon and Rectal Surgery to help ensure that patients with colorectal conditions have a smooth transition of care once they reach adulthood.
Kristina Booth, MSN, CFNP
Center for Colorectal and Pelvic Reconstruction (CCPR)
Kristina M. Booth, FNP, serves as an advance practitioner nurse at the Center for Colorectal and Pelvic Reconstruction (CCPR) at Nationwide Children’s Hospital. She has a special interest in caring for patients with complex colorectal and urological conditions.
Charae Keys, MSW, LISW-S
Center for Colorectal and Pelvic Reconstruction (CCPR)
Charae Keys, MSW, LISW-S is a clinical social worker for the Center for Colorectal and Pelvic Reconstruction. Charae’s role includes case management, care coordination, facilitation of support groups and collaboration with other professionals on the CCPR team, to provide best outcomes to patients and their families.
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