[88sunflower]

What is a patient advocate exactly? What do they do and are they helpful? Do all health care facilities have to have one? My father is in a nursing home and it was suggested to me to pursue the patient advocate there. Anything learned with this question will be helpful. I am clueless.

[Rivka]

A patient advocate is someone who acts as a liaison between the patient and the health care facility. Usually this is necessary when the patient has some degree of inability to advocate for themselves (coma, dementia, etc.) The advocate makes sure that the patient's needs are well looked after (medically, socially, physically)and will often step in if there are concerns that the needs are not being met.

The patient advocate may be a professional (nurse, lawyer), patient's relative or even just a concerned neighbor. The field is not well regulated, so anyone can hang out a shingle and call themselves a patient advocate.

[88sunflower]

Ok that is exactly what I thought it was. But I was under the impression all medical facilities must have one. I am guessing this is not true then. My brother is the main go to person for any concerns with my father. This will mean he is the patient advocate? There isn't one as for the nursing home as a whole? I could just call them direct but I want to understand it better myself. I also don't want to step on brothers toes and cause family drama. This is not the same as health care proxy right?

[smearcase]

This link may help with some of your questions: Patient Advocate Nursing Home Regulations | eHow.com

But, in the course of finding this info I saw some other input from a few people who said that they contacted a nursing home "ombudsman" for a confidential discussion and soon found out that the ombudman had immediately reported everything to the home administrator.
But in my opinion, even though the ombudsman in that case may have violated the rules, it could still be helpful to get the concerns brought to the attention of the administrators.
In my experience when my mother was in a home for about 5 years, frequent visits by family and friends is the most important type of advocacy.
In my state, there have been recent articles about the nursing home crisis.
70% of patients here are Medicaid patients and the homes say that they are losing $ 20 per patient per day which translates to $2,000 to $ 4000 loss per home per day. And more cuts to Medicaid are being made every year. The whole outlook is not very promising --and I am gettg off the topic a bit, so I'll stop here.

[88sunflower]

Well I am sure there are no perfect nursing homes. But my brother has reported several issues. When he walks in those doors they cringe. I guess I am just wondering basically about this patient advocate thing. I have never heard of it before and wanted to get information on it. I read the article and saved it for him to read also. Thank you. We do visit often. So that is a plus side for my dad and his well being.

[Lia1]

It's complicated. Many facilities have someone who is a patient advocate, ombusdman or somehow involved in patient/family relations. It depends on the facility, and the employee, how actively they can be involved in advocating specifically for the patient, or optimizing care provided.

Then, there are privately paid patient advocates, who work for the patient/family, and try to solve specific problems. As noted, the field isn't regulated. There is a site, called Advo-Connection, run by a private advocate, on which you can put in your zip code, and find the individuals or firms doing advocacy in your area.

Your brother is doing advocacy work, in helping care for your father. He may need more information or support to do a better job. He may need help with clinical, legal, financial, insurance or other issues. A good advocate should be able to help you sort out what the issues are. In evaluating the advocate, you can ask what their particular background and experience is.

There is also something called a Geriatric care manager. These are typically nurses or social workers with expertise in issues of the elderly. They will understand the issues related to nursing homes, and can be hired privately, too. You can find one in your area by going to the National Association of Geriatric Care Managers.

[Lia1]

A health care proxy is the person nominated by the patient, through a document, to make health care decisions for the patient if he/she can't make decisions for him/herself. Your brother may be the proxy, but there would have to be paperwork to that effect. Patient's typically do this in advance of becoming ill. Facilities will usually ask who is the proxy in advance of major medical procedures.

Facilities will usually want something in writing before discussing any aspect of a patient's care with anyone but the patient. This is often called a HIPAA authorization. HIPAA is a federal law governing patient privacy and confidentiality.

[88sunflower]

Thank you for that Lia. I will check out the site for sure. Everything I learn is so helpful. My brother is doing a great job. I just happened to hear about this and wasn't sure if its something I should look in to more or let him be and do his thing.