How Empowering Your Clients Makes You a Better, and Stronger, Health Advocate

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Those of you who know me beyond my work with AdvoConnection may know that my roots – the reason I started AdvoConnection – came from patient empowerment – specifically the recognition that when we are sick and debilitated, or scared or worried, most of us are unable to process the information we need to assess in order to make the wisest choices for ourselves.

I experienced it myself, and I’ve heard stories over and over again – where the illness and emotion just don’t allow for even the most intelligent, rational thinkers to conduct themselves the way they would in any other aspect of their lives. From the very human reaction to illness of wishing Mom was there to take care of us, to the ingrained-from-an-early-age attitude that “the doctor is smarter than I am, the doctor is always right, the doctor knows what’s best, the doctor knows everything there is to know….”  — the natural default is to yield discussion and decision-making to the doctor.  But doing so can wreak havoc on our health.

Most recently the subject has popped up in the AdvoConnection Forum – based on an article in the New York Times called Afraid to Speak Up at the Doctor’s Office.  The point being that as patients, with difficult symptoms, a new diagnosis, or ensuing problems, are afraid of asking questions that make us appear as “difficult” patients.  As a result, we don’t get the information we need, we aren’t empowered to make the right decisions for ourselves, and we are therefore simply defaulting to what’s being expected of us – not making smart, rational choices.

It’s what I call the “If I Ask Too Many Questions, the Waiter Will Spit In My Soup” fear. Except in this case, it can be life and death.

The discussion in the AC Forum is very much about this phenomenon as the basis for needing an advocate by one’s side in the doctor’s office.  And to that I say a loud “Amen!” Discussing with a potential client this fear of discussion with the doctor can certainly help him or her decide that you are exactly the right person to help them out – as if you have read their minds and truly understand them.

But I also see a broader picture – one that can not only help your clients improve their experiences, but can move your health advocacy practice forward, too. 

The truth is, much of what our clients need is confidence:  confidence for holding up their side of a conversation with (even intimidating) providers, confidence to leave a provider who just isn’t doing right by them, confidence to make the decisions they know need to be made – and more.

You can be the person who helps them build that confidence, and as such, you will build their trust and appreciation for the work you do with them.  For many clients (and potential clients) you will not only strengthen their abilities to manage their own medical situation, but you will expand the work they rely on you to do.  And when they tell others about how you helped them, it will be in glowing terms (great marketing!)

I’ve written up a list of possible ways this can be done – a springboard for your own ideas as well.  Improving client confidence will make you a better advocate, and will help you grow your practice, too.

AdvoConnection members can find this list by logging in to their membership dashboard, finding the Client Services Center, then Client Relations. Look for NEW!

Not a member?  Join us!

 

• • • • • • LEARN MORE • • • • • •

FOR PATIENTS | FOR ADVOCATES | FOR POTENTIAL ADVOCATES

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Client Discussions: Where Do Spirituality and Religion Come In?

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My travels over the past two weeks have ultimately taken me to Florida where I’ll be staying for awhile to spend time with my dad.  It’s the latest in many, many visits, which I mention only because that means I have gotten to know many of Dad’s friends over the years, too. In fact, I’ve gotten to know a handful of them very well, so that I actually seek them out once I get here to be sure I have the opportunity to spend some time with them.

One such friend is a gentleman I’ll call Jim, who lives next door to Dad. A retired lawyer, Jim has now become a Eucharistic Minister who calls on many sick people and leads services on a Sunday morning.  He is well-respected and admired by so many, a man who balances his sense of fairness with his religion and spirituality. He puts a great deal of effort into making sure that anyone who would like to attend his services, regardless of their religious affiliation, is welcome to do so.

The three of us enjoyed brunch together today, and as it frequently does, the conversation turned to how life experiences were affected by our spirituality, the meshing (or repelling) of religion and politics, other people’s experiences as seen through a spiritual lens, and more…. Since Dad and Jim both live in a senior transitional-type community, where friends are often undergoing medical treatment, and where too many friends pass away, some of the discussion centered on healthcare and spirituality.

Midway through this morning’s conversation I realized (duh!) that perhaps spirituality is a topic advocates should be addressing with their clients. Considering the tendency of most human beings, whether or not they are religious (part of a specific religion), to turn to prayer and pastoral support when they are faced with a health crisis (their own, or a loved one’s), it seems that at least discussing spiritual needs with clients could be useful in at least three ways: Continue Reading →

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Getting Your Clients Past Magical Thinking

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Today’s post is very personal, reflecting a situation I believe many families go through, brought on by any number of attitudes and fears.  I’m hoping that by sharing it, you can find a role for your advocacy work.

It’s about providing a gift to some of your patients and their families – in effect, giving them permission to say no to further treatment.

As I thought about the situation, I remembered back to a blog post I had written almost four years ago called “When Is It Time to Just Say NO to Further Treatment?”  When I wrote it, I was referring to my mother who at the time was in her 10th year of her Alzheimer’s diagnosis and had little or no cognition left, yet my father kept insisting she be treated for every urinary tract infection (UTI) she acquired (or, perhaps more like, never really got rid of.)  It made no sense to me, yet Dad was just so desperate to keep Mom alive.

My post was based on this article from the New York Times:  In Cancer Therapy, There Is a Time to Treat and a Time to Let Go which talks about patients desperately insisting on treatment, even though it not only won’t prolong their lives, but will actually cause them more distress. In effect, helping them get past (what many experts call) Magical Thinking.

The question is:  Who suggests to the patient and family that a treatment isn’t magical?  Who helps them get past wishful thinking and into reality?  Who says to a cancer patient, “Chemo is toxic, and while you might get an extra week or two on this earth, you’ll be sicker for that time – your quality of life cannot be improved. Are you sure you still want to put yourself through that?” ??? Continue Reading →

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What’s a Bad Outcome? And Where Does the Fault Lie?

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Scenario:

Joan, age 75, living in Ft. Lauderdale, was diagnosed with Stage IV Ovarian Cancer.  Joan’s daughter, Beth, who lives in Kansas, contacts Maxine, a private patient advocate and RN who works in Ft. Lauderdale, to help her mother.  Joan, Beth and Maxine have extensive conversations about the care Joan will need. The decision is made that Joan will need surgery and chemo.  Maxine is hired to oversee the care since Beth lives so far away.

The surgery goes well.  The hospital stay is typical. Joan is discharged from the hospital, but three days later begins to show signs of an infection at her incision location.  Sure enough, it’s a staph infection which is already running rampant through her body.  Joan dies less than a week later.

A bad outcome – no question about it.

And now Beth is furious, an emotion only heightened by her grief.  Further, Beth blames Maxine for the loss of her mother because, after all, Maxine is an RN, a private advocate, who was expected to make sure her mother came through her diagnosis, surgery and chemo so she could go on to lead a quality life for many years to come.

………………

This scenario is an extreme, I grant you.  But bear with me while you see how it influences every step you take, every conversation you have, as a private health advocate.

Continue Reading →

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Setting New Standards for a New Profession – Your Chance to Help

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As announced to AdvoConnection’s members last week, we have been working on a prescribed process for advocates who find it necessary to terminate their work with a client – in effect, to “divorce” that client, professionally, legally, and with the least amount of difficulty for both parties.  (Members will find access to that protocol in this coming week’s Monday Member Mail.)

One step in the process is the recommendation about sharing the notes you’ve kept with the client you’re divorcing, and the question about whether or not you, as the professional patient advocate, should be keeping those notes after you have terminated the relationship with the client, and if so, for what period of time.

(Please note – I’m talking about the notes and records YOU keep – not medical records which are being kept by their medical providers. You may choose to keep those, too – but here we focus only on your own notes.)

So that’s the question – how long, if at all, should private health advocates keep those notes?

Continue Reading →

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