A good advocate is an informed advocate. The first thing you should know: how involved does your loved one want you to be in their health care decisions? It is important that you respect their wishes when it comes to talking to doctors, choosing among treatment options, or choosing between health plans.
Your loved one may be at a point in life where they feel like they are losing control over many things; you can make suggestions to help your loved one make medical decisions, but as long as they are competent, the decisions are their to make. However, your loved one may want or need your assistance. Or they may simply be open to advice on how to obtain the best possible care.
It is very important that you talk to your loved one about creating health care proxy and power of attorney documents. Such documents allow them to name someone they trust to make decisions about their health and finances in the case that they can no longer do so themselves.
If your loved one has named you as health care proxy, if they become unable to speak for themselves (incapacitated) you will have the right to access almost any information and records that they could, and make treatment decisions on their behalf.
If you do not have legal authorization, in many states you will be limited in what treatment decisions you can make. You may also be limited in what information you can get; doctors can talk to you if they think it is in the patient’s best interest, but they are not required to.
If you have power of attorney, you can manage some or all of your loved one’s financial affairs. Issues like Medicare and nursing home payments are considered financial matters.
Explain to your loved one why you would like to be involved. Assure them that you want to help, not intrude. The more you know about your loved one’s condition, the better you can help them explore their health care options.
Here are some advocacy tips:
- Read the fine print. If you are signing up for a health care plan, make sure you understand exactly what you are getting. If you are reviewing a doctor’s bill or a Medicare Summary Notice (a quarterly summary of claims for health care services processed by Medicare) make sure you understand each of the charges. Make sure that insurance is covering what it is supposed to be covering.
- Ask questions. If you do not understand something the doctor says or you disagree with a medical bill, do not be afraid to speak up. It is better to find out answers sooner rather than later.
- Consider the issues ahead of time. If you know you are going to be speaking to a doctor, nurse, pharmacist, insurance representative or anyone else who may give you important information, figure out what you want to ask beforehand if at all possible and have a list of questions with you. This way you can help ensure that you won’t have to call or visit more than once.
- Take notes. When you ask questions, the answers may be complicated. When you speak to a doctor, nurse, pharmacist, insurance representative or anyone else who may give you important information, make sure you have a pen and paper. Take notes and make sure you can repeat what you are being told. Write down the name of the person you are talking to and the date on which you speak.
- Offer information. Whether you are seeking medical treatment or shopping around for an insurance plan, the person assisting you can only help in as much as they understand your needs. Don’t wait to be asked! Make sure you share all relevant background information.
- Get it in writing. Whenever someone tells you something about what will or will not be covered, whether it is a doctor or an insurance representative, ask for that information in writing.
- Keep track of medications. Makes sure that any prescribing doctor has a full list of medications your loved one is taking. Make a system for ensuring that medications are taken correctly.
- Do the research. There are many things you can find out on your own. Libraries, bookstores and the internet are all great sources of information.
- Seek second opinions. If a doctor is telling you that a surgical procedure is necessary, have that opinion confirmed by another medical professional. If an insurance representative is telling you which plan is the right one for you, ask friends who have the plan what they think of it, or go to an independent review source.
- Keep records. You should have copies of any letters or documents you receive from health care providers or insurance companies. If you are sending a letter to an agency, keep a copy for yourself. If possible, send letters by certified mail to make sure they are received.
- Consider your options. Pay attention to whether the doctor respects and follows your wishes. Notice whether your insurance company is holding up its end of the bargain. If you do not feel that you are getting quality service, you may want to consider making a switch.
- Be a team player. If you are calm and respectful, you are more likely to get the help you need.