How to Be a Hospital Advocate for a Friend or Loved One

Having a patient advocate at your side increases your confidence and reduces some of the fears associated with communication with health care providers.
Having a patient advocate at your side increases your confidence and reduces some of the fears associated with communication with health care providers. | Source
Oftentimes, people in the hospital have enough on their minds with ongoing tests, treatments and the illness itself. It can be helpful and reassuring to have a caring person to be a healthcare advocate for the patient's best interest.
Oftentimes, people in the hospital have enough on their minds with ongoing tests, treatments and the illness itself. It can be helpful and reassuring to have a caring person to be a healthcare advocate for the patient's best interest. | Source

What Is a Patient Advocate?

A hospital, health care or patient advocate are terms used interchangeably to describe a person who supports, backs, promotes or is a spokesperson for either his/her own self or for someone else.

In the best sense of the word, an advocate is someone you trust who is willing to act on your behalf, in your best interests in your total health care. Yourself, a friend or loved one can act as an advocate, not only in a hospital setting, but also at doctor visits, with home health care, or in long-term settings such as assisted living or nursing homes.

There are also professional patient advocates, often social workers, nurses, clergymen or other allied health workers who can be hired privately; oftentimes, these professional individuals are titled case managers.

Role of a Patient Advocate

How You Can Be Effective as a Patient Advocate

It's important to understand that a patient advocate, whether for yourself, a friend or a loved one, is not an adversary to the health care team. The role of the patient advocate is to ensure the best care is given and that decisions reached by the health care professionals is in the best interests of the patient. The best patient advocates have good communication with the health care team and build a relationship of mutual respect and trust.

Individual circumstances vary, based on the patient's health history and experiences, religious or spiritual beliefs, as well as his/her outlook on short and long-term outcomes. For example, you may be advocating for someone with a terminal illness who wishes to spend the rest of his life at home, rather than in a hospital setting. Doctors may advise against this, for whatever reason. If the patient's wishes remain steadfast, it will be your place to ensure the doctor and the health care team begin to plan for the patient's discharge to home.

Strengthforcaring.com, a support site for caregivers, advises that there are questions you can ask as a patient advocate to receive better care for the patient:

  • How do we know this is my loved one's diagnosis?
  • Is the treatment moving forward towards my loved one's goals?
  • Are there new treatments we might consider?
  • Are there lifestyle choices that support my loved one's health goals?
  • Are there new products and services that could help?

Additional questions and things you can do to advocate for the patient:

  • Ask nursing staff about any restrictions on physical activity, diet, and fluid intake for the patient; ask daily if there are any changes in these areas
  • Find out what you can do to be involved in your loved one's care
  • Keep pen and paper handy to write down questions you or your loved one may have as you think of them. In this way you'll be prepared to ask the appropriate person when you see them. Write down the answers you receive
  • Remember that the nurses are a wealth of information. Questions and concerns you may have can be first addressed to a nurse. If an answer or solution can only come from the attending physician, the nurse can either query the doctor on your behalf or suggest you can do so -- whatever makes you the most comfortable
  • You may want to keep a journal of daily activities, tests and treatments for future reference

Hospital Patient Advocate/Patient Representative

Most hospitals have one or more persons on staff whose job title is "Patient Advocate" or "Patient Representative." The role of the Patient Advocate employed by the hospital is to aid in the solution of problems related to in-patient care, as well as any concerns and unmet needs. These advocates generally work diligently to find both the patient and the hospital solutions and answers that will meet both parties' needs.

If you, as a patient or advocate for a friend or loved one, have any concerns or questions not met by the nursing staff, physicians, or social service staff, it is the hospital's Patient Advocate/Patient Representative to whom you will address those concerns or questions.

When contacting the hospital's Patient Advocate, be sure to put your concern/complaint/question in writing. If your first contact with the hospital's advocate is verbal, follow-up with a note in writing and carbon copy that same note to the head of the department with whom you are having issues, or the hospital director of nursing if you are unsure what department(s) is involved. The note can be on paper or by email; either will serve as proof of your concern and your contact.

This proof may never be needed, but it is better to err on the side of caution. When it is all said and done, the hospital's Patient Advocate is still a hospital employee, and s/he may not be able to find an amenable solution.

Your next step may be to contact your health insurance company, the hospital administrator, a private attorney or seek a professional patient advocate or case manager, depending on the severity and immediacy of the issue.

Patient Advocate Foundation

Earn a Patient Advocacy Certificate Online

If you're interested in learning how to become a patient advocate and online learning works for you, the University of Wisconsin provides patient advocacy classes through the Center for Patient Partnerships through which you can earn a certificate as a patient advocate by attending classes on campus or online.

Patient Advocacy Doesn't Stop at the Hospital Doors

The Robert Wood Johnson Foundation released a study in February 2013 that provides insights into the frequent re-admissions of seniors back into the hospital within 30 days of discharge -- such a common occurrence that 1 in 5 seniors who are discharged from the hospital are back in the hospital within 30 days.

Communication between doctors and nurses and patients was identified as a major factor in these rapid re-admissions and focused particularly on the discharge planning and instructions that precede discharge from the hospital.

In 28 interviews conducted by PerryUndem Research and Communication with both health care providers and patients, a great divide was identified between the two groups. Health care providers feel frustrated that patients say they understand the discharge instructions when they really don't and often fail to follow through with the instructions, including scheduling an appointment with their primary care provider after leaving the hospital.

For their part, patients explained that being in the hospital is an overwhelming and terrifying experience. They feel they are asked to make important decisions while being emotionally and mentally overwhelmed not to mention in pain or under the influence of medications. Discharge instructions are often written in language that is plain to the health care providers, but not to the patients.

Hospitals will need to do more to improve their discharge planning and instructions, but this report points to the very real need for a patient advocate for patients, especially seniors. It is often those older adults who love alone or who have limited financial means who experience the rapid hospital re-admissions, but it is not an issue of means or social support alone.

As an a patient advocate, responsibility needn't stop at the doors of the hospital. Follow-up after discharge, when the patient has returned home, can make the difference in whether that patient continues on the road to recovery or needs to return to the hospital for further care.

More by this Author


Comments 20 comments

duffsmom profile image

duffsmom 3 years ago from Pacific Northwest, USA

Very important information. Great hub.


L.L. Woodard profile image

L.L. Woodard 3 years ago from Oklahoma City Author

Duffsmom, I appreciate your read and comment. With patient satisfaction ratings now affecting some of a hospital's reimbursement money from Medicare, hospitals will be working even harder to do what needs to be done to make each patient's hospital stay as pleasant and healing as possible. This should make a personal patient advocate's responsibilities a bit easier.


Vickiw 3 years ago

This is a very informative and useful Hub. Many people are overawed when they get into a hospital situation, and feel unable to advocate for themselves. Another powerful way to help a friend is to stay with them until admission, and advocate for them as they go through admitting procedures. I have done this on at least three occasions. This is often a time when the person is at their lowest and most fragile. Great hub


L.L. Woodard profile image

L.L. Woodard 3 years ago from Oklahoma City Author

VickiW, how fortunate your friends/loved ones were that you were there for them. You're right; admission time is fraught with anxiety and often an overload of paperwork and information. Having someone to aid in getting successfully through the process can be a Godsend.


rajan jolly profile image

rajan jolly 3 years ago from From Mumbai, presently in Jalandhar,INDIA.

L.L., I learnt quite a bit about this area of patient care. It is something which has to be addressed correctly and your hub tackles many aspects of this very important area of hospital/patient care.

Voting it up, useful, interesting and shared.


rebeccamealey profile image

rebeccamealey 3 years ago from Northeastern Georgia, USA

This is good information that most anyone will probably need at one point in time. Voted very useful and shared.


Marcy Goodfleisch profile image

Marcy Goodfleisch 3 years ago from Planet Earth

Such great advice - many people truly need someone who is there when the doctor gives orders and who remembers what is supposed to be happening. I have sat with the dear mother of some close friends, and it's amazing how many small (and sometimes not-so-small) mistakes are made.


moonlake profile image

moonlake 3 years ago from America

We found out with our son someone needs to be there. There were so many mistakes made. One day two men came in to take him to surgery. My husband told them he wasn't going to surgery. The men didn't listen to my husband they took hold of his bed and tried to move it into the hall, my husband held onto the other end and wouldn't let them move him. They had the wrong patient and they weren’t going to listen to us. Voted up on your hub.


PegCole17 profile image

PegCole17 3 years ago from Dallas, Texas

You've compiled an impressive list of resources to help those, like me, who have served or will serve as patient advocate to family members. I can't tell you how many times I questioned nurses who came in with a syringe about to jab the patient until I asked "Why?" More than once, on both my Mom and my husband when they were hospitalized, they attempted to give insulin due to high blood sugar readings. I reminded them that the blood was drawn either during or shortly after food intake and that would explain the abnormally high readings. In my Mom's case, the improper injection sent her into convulsions and nearly snuffed her out. That was pretty scary. It is critical to question things that do not seem right.

Thanks for writing this important and worthwhile hub.


L.L. Woodard profile image

L.L. Woodard 3 years ago from Oklahoma City Author

Rajan Jolly, I'm glad to learn you found the information about patient advocacy to be interesting and useful. It's not something most of us think about until we are in a situation that calls for it.

Thank you for reading and Sharing.


L.L. Woodard profile image

L.L. Woodard 3 years ago from Oklahoma City Author

@Rebecca Mealey: I believe you've hit the nail on the head with your comment. I think most of us will at one time or another either benefit from having someone advocate for us in health care, or we will be called upon to advocate from someone close to us -- or both. Thank you for reading and Sharing.

@Marcy Goodfleisch: No matter how educated or experienced health care professionals are, no one can care as much about our friends or family as we do. I believe that in most cases, the medical team welcome someone acting in behalf of the patient's best interests. Thank you for your read and comment.


ib radmasters profile image

ib radmasters 3 years ago from Southern California

Patients especially the elderly need people to watch over them during their stay in the hospital. The most crucial time is when the patient is released from the hospital, usually because insurance says they can't stay there any longer. They either go home or to a care center until they go home. These care centers are where a patient needs an advocate most of all. Many of these care centers are ill equipped, poorly staffed and doctors that can't find a better place to practice.


L.L. Woodard profile image

L.L. Woodard 3 years ago from Oklahoma City Author

@moonlake: Thankfully your husband was more persistent than the men who grabbed your son's bed by mistake. You've provided an excellent example of the importance of a patient advocate. Thank you for the read, comment and vote.

@Peg Cole17: It sure sounds like your Mom and husband had a great advocate in you. I'm glad your Mom made it through the low glucose episode due to too much insulin. Everyday people like you and I can make a positive impact on the health care our loved ones receive. I appreciate your read and your comments.


L.L. Woodard profile image

L.L. Woodard 3 years ago from Oklahoma City Author

ib radmasters, you've brought up a valid point about those living in rehabilitation or long-term care centers. The staffing ratio at such places is much less than in a hospital setting, so each resident only gets so much attention. After working in long-term care myself for more than two decades, I can verify that although the staff works to treat everyone fairly, those with frequent visitors or advocates receive extra attention.

Thank you for the read and your comments.


ib radmasters profile image

ib radmasters 3 years ago from Southern California

LLW

I was referring to the level of doctor care in these facilities.

Many of these people get to these facilities not because they are well enough to leave the hospital, but because the insurance company forces them out.

The doctors at these facilities, at least the ones that I have seen, are contract doctors. They don't really have the time to profile the patients properly, and many seem to look at it like a timeclock job.

During the weekends, and especially the holidays these doctors are replaced by the second team. These doctors don't know the patients, they only know what is on their chart.

Unless there is a family member or advocate for these patients, the doctors just breeze in, punch the time clock and make some entries in the chart.

The hospitals are not much better in these instances. This is especially true if the patient goes to a hospital where their family doctor doesn't practice or even visit.

Some hospitals have great trauma teams, and other special purpose emergency teams, put the patients are at risk when they leave these teams for followup care.

I am not inditing anyone, I am just recounting my experience in these matters.

Thanks


L.L. Woodard profile image

L.L. Woodard 3 years ago from Oklahoma City Author

ib radmasters, thanks for commenting back. Your points are well taken; I wasn't offended by your earlier comment, but agreeing with the point you made.

In the hospitals around here, instead of your family physician seeing you in the hospital, you are assigned a "hospital specialist," which is what I think you are describing. These are doctors who treat in-patients, but don't know a one of them from Adam. It's a trend I don't agree with, and like you, see an increased need for a patient advocate in such circumstances.


visionandfocus profile image

visionandfocus 3 years ago from North York, Canada

Surely there's an inherent conflict in interest in the role of a Patient Advocate employed by the hospital? I would not trust the care of my loved ones to a hospital-employed advocate. After all, they know who's paying them, and it's not the patient. Then again, some people don't really have the luxury of that choice.

When my father had to stay several nights in a hospital, we hired a private night nurse to watch him overnight and made ourselves very visible during the day. You're absolutely right--the patient who has visitors gets the most attention from the regular staff. It's an unsavoury situation, but that's reality.

Thanks for an informative hub about a very important topic. Voted up!


RTalloni profile image

RTalloni 3 years ago from the short journey

It's so important to share information and start discussion re patient advocacy. The variety of comments this hub has already generated highlights the need well.


L.L. Woodard profile image

L.L. Woodard 3 years ago from Oklahoma City Author

@visionandfocus: I see the hospital-provided patient advocate to be a helpful resource in instances that involve issues related to hospital staff, but only in certain circumstances. I've had to request that a certain nurse, who for whatever reason had a burr in her panties regarding how she interacted with a family member who was to receive initial chemotherapy treatment. She was abrasive and rude; the family member nearly walked back out the door instead of going ahead with treatment. The hospital's patient advocate handled the situation post-haste.

But for issues such as quality of care or perhaps even errors, it is much better to contact an outside source, such as an attorney.

I appreciate you sharing your experiences and voting.


L.L. Woodard profile image

L.L. Woodard 3 years ago from Oklahoma City Author

@RTalloni: It would be great if we could just feel safe in the knowledge that we ourselves, or those for whom we care, are in the hands of trained and experienced folks when in the hospital, but staffing shortages, human nature and so many other factors intervene and make it necessary to be vigilant to ensure the most positive outcome.

Thank you for reading and commenting.

    Sign in or sign up and post using a HubPages Network account.

    0 of 8192 characters used
    Post Comment

    No HTML is allowed in comments, but URLs will be hyperlinked. Comments are not for promoting your articles or other sites.


    Click to Rate This Article
    working