Managing Your Parents' Chronic Conditions

When the Roles Reverse

India has over 140 million people aged 60+, and that number is growing rapidly. Many are managing multiple chronic conditions — diabetes, hypertension, heart disease, kidney problems. And increasingly, their adult children are realizing they need to step in.

You might be part of what demographers call the "sandwich generation" — caught between raising children, building careers, and suddenly realizing your parents have become vulnerable. One day they were invincible — the people who fixed everything, who knew everything. Now you're looking at lab reports, talking to doctors, making decisions.

The roles have reversed, and nobody gave you a manual. This article is that manual.

The Challenges Nobody Prepares You For

The Information Black Hole

Your parents' health information is scattered everywhere:

• Diabetes reports from Hospital A
• Cardiac tests from Dr. B's clinic
• Thyroid results from Lab C
• Prescriptions stuffed in kitchen drawers
• Insurance papers in a file nobody has opened in years
• No one connecting the dots

When an emergency happens, you're scrambling to find which medications they're on, what their last test results showed, and who their doctors even are.

The Communication Gap

Parents often don't share what's really happening:

• "I'm fine, don't worry" becomes the default response
• They minimize symptoms to avoid being a "burden"
• They nod at the doctor but don't fully understand the instructions
• Medication changes happen without you knowing
• They stop taking medicines due to side effects but don't tell anyone

The Distance Problem

You might be in Bangalore while your parents are in Coimbatore. Or in the US while they're in Delhi. Managing health from afar requires systems that most families don't have in place.

The Generational Gap

Your parents grew up in an era of paternalistic medicine — the doctor knows best, don't ask questions, take the medicines and trust. They may resist your involvement, see it as interference, or feel infantilized by your attempts to help.

Step 1: Build the Information Foundation

Before you can manage anything, you need to know what you're managing.

Create a Health Dossier for Each Parent

Collect and organize:

Medical History:

• List of all diagnosed conditions (diabetes, hypertension, thyroid, arthritis, etc.)
• Year each condition was diagnosed
• Any surgeries or hospitalizations
• Known allergies (medications, foods, contrast dye)

Current Medications:

• Name of each medicine (generic and brand)
• Dose and frequency
• What it's for
• Time of day it should be taken
• Any recent changes

Lab Reports (last 2-3 years minimum):

• Complete blood count
• Kidney and liver function
• Blood sugar and HbA1c
• Lipid profile
• Thyroid panel
• Any disease-specific tests

Contact Information:

• Primary care physician
• All specialists (cardiologist, diabetologist, nephrologist, etc.)
• Pharmacy they use
• Nearest hospital emergency room
• Ambulance services in their area

Insurance and ID:

• Health insurance policy number and company
• ABHA ID (if created)
• Aadhar card copy
• Emergency contact list

Step 2: Understand Their Conditions

You don't need a medical degree, but you need to understand the basics of whatever your parents are living with.

If They Have Diabetes

Numbers to know:

Marker	Target for Elderly	Why It Matters
HbA1c	7.0-8.0% (relaxed for elderly)	Overall control; tight control risks hypoglycemia in elderly
Fasting glucose	100-140 mg/dL	Morning sugar levels
Post-meal glucose	Below 180 mg/dL	After-meal spikes

Watch for:

• Hypoglycemia (low sugar) — more dangerous than high sugar in elderly
• Signs: sweating, confusion, shakiness, irritability
• Kidney function changes — diabetes damages kidneys over time
• Foot problems — check for wounds that aren't healing

If They Have Hypertension

Numbers to know:

Reading	Target for Elderly	Concern Level
Systolic (top number)	Below 140 mmHg	Above 180 = urgent
Diastolic (bottom number)	Below 90 mmHg	Above 110 = urgent

Essential: Get a home BP monitor. Train your parents (or their caretaker) to check BP at home. A single clinic reading is misleading.

Watch for:

• Inconsistent medication taking — "I felt fine so I skipped it"
• Postural hypotension — dizziness when standing up (BP drops when standing)
• Warning signs of stroke — facial droop, arm weakness, speech difficulty (call ambulance immediately)

If They Have Heart Disease

Numbers to know:

Marker	Target
LDL cholesterol	Below 70 mg/dL (if had heart attack/stent)
Blood pressure	Below 130/80 mmHg
Resting heart rate	60-80 bpm usually

Essential medications: Make sure they're actually taking aspirin, statin, and any prescribed blood thinners. These are lifesaving and often skipped.

Watch for:

• New or worsening chest discomfort
• Unusual shortness of breath
• Swelling in ankles/legs (may indicate heart failure)
• Sudden weight gain (fluid retention)

If They Have Kidney Disease

Numbers to know:

Marker	What to Watch
eGFR	Track the trend — is it stable or declining?
Creatinine	Rising creatinine = declining kidney function
Potassium	Can get dangerously high in kidney disease

Critical: Many medications are cleared by kidneys and need dose adjustment. Alert all doctors to kidney status.

Watch for:

• Reduced urine output
• Swelling in ankles and face
• Fatigue and weakness
• New medications that might harm kidneys (NSAIDs like ibuprofen are especially dangerous)

Step 3: Establish a Monitoring Routine

Chronic conditions require ongoing monitoring, not just crisis management.

The Weekly Check-In

Whether you're in the same city or across the world, establish a structured weekly health conversation:

• "How are you feeling this week?"
• "Any new symptoms or changes?"
• "Are you taking all your medicines?"
• "Did you check your BP/sugar this week? What were the readings?"
• "Any upcoming doctor appointments?"

Don't accept "I'm fine" as the complete answer. Ask specific questions.

The Monthly Review

• Review any home monitoring data (BP readings, glucose levels)
• Check medication adherence (are pills being finished on schedule?)
• Note any symptoms that have persisted
• Schedule necessary doctor visits for the coming month

The Quarterly Deep Dive

• Get updated lab tests based on their conditions
• Review reports yourself (don't just accept "doctor said it's fine")
• Compare with previous tests — are trends going the right way?
• Medication review — is everything still necessary? Any side effects?

Step 4: Build Your Support Team

You can't do this alone. Build a team:

The Local Point Person

If you don't live in the same city as your parents, you need someone local who can:

• Check on them physically
• Accompany them to doctors when needed
• Respond in emergencies
• Communicate with you regularly

This might be a sibling, a trusted neighbor, a hired caregiver, or a relative.

The Primary Care Doctor

Your parents need ONE doctor who knows the whole picture — not just specialists who see parts. This generalist coordinates care, catches drug interactions, and is the first call for non-emergencies.

Establish a relationship with this doctor yourself. Introduce yourself, share your contact information, and ask to be informed of significant changes.

The Pharmacy

Build a relationship with one reliable pharmacy that knows all your parents' medications. They can flag interactions and help with refills.

Emergency Services

Know in advance:

• Which hospital to go to for emergencies
• Ambulance numbers in their area
• What to tell paramedics when calling

Step 5: Handle the Difficult Conversations

Managing your parents' health often requires conversations nobody wants to have.

"Let Me See Your Reports"

Many parents resist sharing health information. Approach it gently:

• "I want to help you stay healthy for longer"
• "I need to understand so I can support your doctors"
• "This is about us being prepared, not about me taking over"

"We Need to Talk About Future Care"

While they're still healthy enough to participate:

• What are their wishes if they become seriously ill?
• Do they want aggressive treatment or comfort care?
• Have they made a will?
• Is there a power of attorney for healthcare decisions?

These conversations are uncomfortable but essential. Having them before a crisis is far better than making decisions in an ICU waiting room.

"You Need to Take Your Medicines"

Non-adherence is common among elderly patients. If your parents aren't taking medications as prescribed:

• Understand why — side effects? Confusion? Cost? Denial?
• Simplify the regimen — work with their doctor to reduce pill burden if possible
• Use pill organizers — weekly boxes with AM/PM compartments
• Set phone reminders — or use a medication reminder app
• Get help — a daily caregiver can ensure medicines are taken

Step 6: Prevent the Preventable

So much of elderly healthcare is reactive — waiting for something to go wrong. Be proactive:

Fall Prevention

Falls are the leading cause of injury in elderly Indians. A hip fracture can be the beginning of a steep decline.

• Remove loose rugs and cables
• Install grab bars in bathrooms
• Ensure adequate lighting, especially at night
• Review medications that cause dizziness
• Get their vision and hearing checked
• Consider a walking aid if balance is impaired

Vaccinations

Elderly adults need:

• Annual influenza vaccine
• Pneumococcal vaccine (one-time or boosters depending on age)
• COVID-19 vaccines and boosters
• Tetanus booster every 10 years

Cancer Screening

Don't assume screening stops at a certain age. Discuss with their doctor:

• Colonoscopy (colorectal cancer)
• Mammography (breast cancer) for women
• PSA discussion for men
• Annual skin checks

Cognitive Health

Monitor for early signs of dementia:

• Repeating stories or questions
• Difficulty with familiar tasks (cooking, managing bills)
• Getting lost in familiar places
• Personality or mood changes
• Poor judgment (giving money to strangers, not dressing appropriately)

Early diagnosis allows for planning, even if treatment options are limited.

Step 7: Take Care of Yourself

Caregiver burnout is real. You cannot pour from an empty cup.

• Accept that you can't do it all. Get help — professional caregivers, sibling support, community resources.
• Set boundaries. You have your own life, career, family. It's okay to not be available 24/7.
• Don't feel guilty. You're doing your best. Perfect doesn't exist.
• Find support. Talk to others in similar situations. Support groups for caregivers exist.
• Watch your own health. Caregivers often neglect themselves. Don't skip your own checkups.

The Emergency Protocol

When something goes wrong, you need a plan:

Back to Anita

After her father's stroke, Anita rebuilt her approach to her parents' health from the ground up:

• She collected all medical records and digitized them
• She created a shared folder with her brother in the US
• She bought home monitoring devices — BP machine, glucometer
• She hired a part-time caregiver for daily checks
• She established a relationship with a geriatric specialist who coordinates her father's care
• She schedules video calls with doctors when important decisions need to be made

Her father recovered, with some residual weakness. But more importantly, Anita now has visibility into both parents' health. She knows their numbers, their medications, their appointments. When something seems off, she catches it early.

"I can't undo what happened," she reflects. "But I can make sure we're never blindsided again."

That's all any of us can do. Be prepared. Pay attention. Show up.

Your Parent Health Management Checklist

Task	Frequency	Status
Collect all medical records	One-time, then ongoing	□
List all current medications	Update when changed	□
Identify all doctors and contacts	One-time	□
Establish local support person	One-time	□
Set up home monitoring	One-time	□
Weekly health check-in call	Weekly	□
Review lab reports	Quarterly	□
Medication review	Every 6 months	□
Fall prevention assessment	Annually	□
Vaccinations	Annually	□
Advanced care planning discussion	Once, update as needed	□

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Manage your parents' health with ExaHealth. Create profiles for each parent, upload their lab reports, track medications, and see their health trends over time — because organized information is the foundation of good care.