If You Are a Family Member BE AN ADVOCATE

©  Imelda Maurer, cdp

If you are a family member or a friend of someone who is receiving aging services in any environment -- home, assisted living or nursing home setting -- it is so imperative for the well-being of that person or those persons with whom you have this relationship that you see your role as an advocate for that person or those persons.

Acting as an advocate is a work of Mercy. Pope Francis has reminded us during this Holy Year of Mercy that true mercy is not practiced by words only, but by actions.

My suggestions here do not imply that staff is not maintaining clinical standards, or that things in the aging services organization or not what they should be.  Rather, I urge a healthy collaboration with the interdisciplinary team, providing a second pair of ears and eyes as well as a loving heart. What I suggest and urge are three aspects of advocacy for your family member

1)  Informed consent. Never take the direction or interpretation of any healthcare provider as the final word without an adequate explanation. If a new medication or therapy is prescribed, or if a change  in either is recommended, an advocate should have sufficient information to either consent to or to refuse the recommendations. It goes without saying, of course, that if a family member is capable of making decisions, then s/he should receive the information necessary to make such an informed decision to accept or to refuse treatment. In such circumstances, the advocate can best serve by listening to the desires and needs of the family member and by helping to answer his/her questions if there are any.I

2)  Know the standards of care. To be an effective advocate, you must know the standards of care. You cannot advocate for another if you don't know "what the rules are."

I'll give an example from my early days as an advocate, embarrassing as it is to reveal!  I was in my beginning weeks as an ombudsman. The daughter of a nursing home resident told me that her mother complained that on mornings when she needed to use a bedpan, if she were eating her breakfast (from her tray on an overbed table) no staff member would bring her a bedpan, telling her she had to wait until after breakfast.  When I approached the administrator about this, she told me with great confidence, authority and good humor why no bedpan was offered under the circumstances at hand: "If the CDC got wind that we were doing that, we'd be fined like you wouldn't believe!"

I remember being puzzled, but I didn't know what to do with the answer I had received.  This administrator, one with a great lack of integrity in this instance, got one over on the advocate -- because I couldn't answer her explanation.  I wouldn't have had to quote a regulation, I would only have to say that this nursing home resident has a right to have her needs accommodated -- whenever they arise.

3.  Be that second pair of eyes and ears.  As a family member you visit often and take time to sit and listen to your family member.  Because you really know that person you pick up nuances of mood, physical and/or mental changes.  You may well become aware of issues that even good staff may miss merely because you know the person so much better.  So discuss these observations with the charge nurse, or with the home health nurse that comes in.

I saw a chart that is recommended for nurse aides to use for this very purpose.  I offer it here  for your use as a guide, not to be checked and handed in, but to be used as a guide and as talking points if you detect changes in your family member.

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