An advocate: 5 reasons to have one

“An advocate can be a family member, friend, trusted coworker, or a hired professional who accompanies you to your appointments and asks questions, writes down information, and speaks up for you so you can better understand your illness and get the care you need.” [Source: AARP]

As an Aging Life Care Professional (also known as a geriatric care manager), I have so many case studies of what went well (or what could have gone so wrong) because I was at my client’s bedside during her hospitalization or his rehab stay. If you have spent time recently at an Emergency Department, you have experienced first hand how busy the staff members are. You may have felt overwhelmed by the number and type of staff the patient interacts with, the depth and breadth of information that is collected and verified, and how important it is to engage with the healthcare team, ask questions and confirm information that is being conveyed.

Here are five reasons it is important to have an advocate in the room during medical crises, ED visits, hospitalizations and times of transition (discharge to rehab or to home following hospitalization for example):

  1. Current medications and other important medical information: even if the patient is at a hospital that is part of her/his “in-network” and the MyChart “should” contain a complete and accurate record of all current medications (medical diagnoses, allergies, surgeries, etc.), do not assume this is always correct. The patient may or may not be coherent enough to be an accurate self-reporter about her/his current medical status. Recently, we discovered that one of my clients receives his medications in convenient, daily Pill Packs. This is a great innovation that many pharmacies provide at no charge. It replaces the older approach of filling weekly medications boxes and reduces the chance of errors when a pill may be dropped or one prescription is inadvertently omitted. The downside may be that the patient no longer keeps a current list of medications in mind because the pills are pre-packaged by the pharmacy. I support the idea of pre-packaged daily pill packs. Additionally, it is important for a care partner, adult child, friend or professional care manager to maintain a current list of medications that can be easily provided to the EMS first respondor or ED nurse.
  2. Second set of ears: a trip to the ED is rarely quick as it takes time for the healthcare team to thoroughly evaluate their patient. Lengthy stays in unfamiliar surroundings along with feeling unwell are great reasons to have a buddy (advocate) in the ED bay or room with the patient. Reminders to the patient about why he cannot have anything to eat or drink, and eventually to advocate to the healthcare providers that maybe he can have food or ice chips, as well as reminders not to get out of bed without assistance are important for all the obvious reasons. Listening well to the nurse’s instructions make the advocate a valuable partner to the patient as well to family members or friends that are worrying about their loved one from a distance.
  3. Information conduit: whether the patient’s loved ones are in the waiting room or waiting in another city or state, everyone is eager for updates and to know next steps (will there be a hospital admission? observation status? discharged to home at 2:00AM?) so that plans can be made and coordinated.
  4. Note taker: good documentation practice is never a bad thing and sometimes, weeks or months down the road, as insurance and billing issues arise, it is beneficial to have a written record of events: healthcare providers’ names, lab work done, medical tests ordered and performed (or refused), follow-up orders, follow-up appointments scheduled, etc.
  5. It’s all going to be okay: being sick is scary and waiting for a diagnosis can be anxiety-producing. An advocate is that additional member of the team that knows when to ask the nurse for a fresh warm blanket, how to work the television remote, when to be available for a chat and when to be a quiet, reassuring presence with a hand to hold.