Why do you need an advocate?

Why does anyone need an advocate? Advocacy has been around for a long time in education.  No one is surprised when a family hires an advocate to help them with their child in the school system. Yet when a private advocate shows up in the hospital there appears to be fear. At least that is what I experienced years ago when I first came in with my first client. Questions as to why anyone would possibly hire an independent patient advocate. Afterall the hospital has all that a patient would need to understand the system and get through the system.

There are lots of reasons to hire an independent patient advocate; especially one that has medical knowledge. Getting sick is a crisis. Not just for the patient but for the family. I know that first hand having had my husband hospitalized for 4 months and 4 surgeries while working full time; in school and raising a family.  It didn't end there he came home with a feeding tube and didn't go back to work for another year. No one I mean no one in the system ever asked how I was doing. His care was exemplary for the most part but no une understood for a moment what this was doing to our family.

That's one of the reason's I believed in the need for an advocate. Someone who is separate from the system yet understood the needs of the family. Could take some of the burden off of having to monitor  and track the information that was exchanging among many people in the hospital without every sharing it with me. The ever changing staff that no one person seemed to be in charge. It was and still is the responsibility for the family to keep track and ask the questions. Often questions you don't know what to ask.

No one in the system wants to hurt you No one. But when you have staffing that is wrapped around the needs of the hospital and not the needs of the patients there is a lot that is missed.  An example of that is when a nurse is assigned to a unit it doesn't mean she/he is guaranteed to be on the unit. So that nurse isn't a nurse for a medical unit or a surgical unit they were hired for I think they become a hospital nurse. That means when census is down that nurse is called and cancelled. In order for that nurse to get the hours she/he was hired for they will have to use their vacation time. OR...and this is a big OR they can go to another unit.  When they agree they go to a unit that they know nothing about that's creates a problem for them because they know nothing about the culture of the unit, where the supplies are, the ancillary staff on the unit. Nothing. But they need to work so they get through their one shift. But wait sometimes it isn't that one shift. They may work 8 hrs there and the other 4 hours get floated yet to another unit to make up the 12 hours they were hired to work. This is an example of the disconnect that can happen and does happen on a daily basis in most if not all hospitals. So who is in charge? You are in charge. 

Being in charge of information is a big job. There are bedside nurses, nursing assistants, hospitalists that rotate in a group every 3-4 days, discharge planners, social workers and perhaps you are transferred to different units during your stay. Based on need? Not always. Sometimes based on space. They need your bed so you go to another unit. Who is in charge? Again if it's the patient that's a problem. It it's the family that may also be a problem. If the family doesn't know how the system works; how to get information; in what format the information should be given and what rights you have to access the information that's when a patient advocate is very valuable. What if family lives out of town? Out of state? Out of the country? Now you're in charge of your brother, sister, mother, father, uncle, aunt who may have always depended on you and now you get the call.

An independent  is just that. Independent. Independent of the system which is important. They are dedicated to the patient and family who hires them. Yes it is a private payment. I agree that sometimes is a problem and should be something covered by insurance. Long term care insurance does cover independent care managers but they have to be licensed in some profession. Not all advocates are licensed in a profession. I always wondered why insurance wouldn't look to cover this valuable resource for families? Especially when it is a licensed person. 

For us we have never had a readmission of one of our clients in 30 days in the 9 years of practice. That's an important statistic that not many can state. What costs have been saved by not getting readmitted? Or not being admitted at all. We recently had a client for 4 years who passed and was never hospitalized. These are some of the issues that patient advocate practices provide for families. Peace of mind, information gatherers and communicators with all involved.

Think about what your needs would be if you or your loved one was hospitalized? What would a crisis do to your family when this happens? Who is in charge? What do you need to know? That's exactly what a good patient advocate would help your family with. All of the above.


Ask an Advocate is an educational series provided by:

Sharon  Gauthier RN/MSN/CGM

Certified Dementia Practitioner