What’s a Patient Advocate for Aging Adults?

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

Patient advocates play an important role in assuring that older adults are treated fairly and can understand the healthcare system. As people age, they often find themselves dealing with more than just doctors, but also home health and home care companies, skilled nursing, and hospitals. 

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An advocate wears many hats, and regardless of their degree, certification, or position, they are here to help you with health challenges. The best advocates are those people that can put all the pieces together and help you make decisions that are in your best interest.

They do all of this in a patient-centered way that respects your wishes and gives you the best chance for long term wellness.

What’s a Patient or Health Advocate for Aging Adults?

A patient or health advocate for aging adults is someone who provides guidance and expertise to someone navigating the healthcare system. If you or a loved one has been in the hospital, rehab, or nursing home, you know how complicated it can be.

Each system seems to have its own set of rules, payment options, and discharge requirements. When you aren’t feeling your best, it can be overwhelming trying to understand it all.

A health advocate may not have all the answers, but they know how to get the information necessary to make informed decisions. A health advocate “has your back” and your best interests at heart.

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What Do Patient or Health Advocates Do?

Much of what health advocates do depends on the circumstances. If you are in a hospital, advocates (also called patient navigators) can be a bit different than if you are an aging adult who needs a geriatric care manager. Regardless of the setting, there are some shared characteristics of advocacy.

A healthcare advocate knows how the healthcare system works

They can advise you on the projected costs of care and help you make financial decisions as well.

Even an estate planner or care management consultant is considered a healthcare advocate as they assist you in navigating long-term care planning. It is far easier to plan for the care you need in advance than to wait until a health care crisis.

Healthcare advocates help you choose the best care

For example, if you are in the hospital and a short-term rehab is an option, an advocate will walk you through the pros and cons of that decision and what to expect.

If you are in rehab and need to know what to do next, the resident advocate will help you set up services upon your return home.

Insurance issues are very complicated and challenging to understand

Your advocate may not have all the answers, but they should take the time to investigate what your plan pays for and what will be your responsibility.

Advocates ask lots of questions

There are few things as frustrating as being in a doctor’s office for the 15 minutes you have and forgetting to ask what was on your mind! If you have an advocate with you, they will be prepared with a list of questions in advance of the visit.

A good health advocate is not afraid of other professionals and will calmly and patiently get all questions answered.

Advocates think ahead

As a patient or resident, you may be thinking of what is happening currently and how to deal with it. It is an advocate’s job to think ahead and consider “what ifs.” Being prepared saves money, time, and emotional distress.

Are There Different Types of Patient Advocacy?

There are many different types of patient advocates, and some you will have to pay for. Others are part of your healthcare team, and there is no cost to you. Below, we break down the types of patient advocates, how they do their work, and if they charge for their services.

Other family members

Yes, family members can be outstanding healthcare advocates and should be recognized for the tireless work they provide. A healthcare advocate for an aging adult is usually an adult child, but it could be another family member. These family members act as the eyes, ears, and managers of their loved one’s healthcare.

They do so by attending healthcare appointments, keeping track of medications, arranging for in-home care, and managing said care. To do this work effectively, they need advance healthcare directives naming them as a healthcare power of attorney.

Otherwise, due to privacy laws, it is quite complicated to get healthcare information. Some family members may wonder how to advocate from far away, but as long as they have the right legal paperwork behind them, they will be able to help. 

Non-profit

Non-profit advocacy groups provide a valuable service to aging adults, and some of these groups are undoubtedly very familiar to you. They include but are not limited to the American Cancer Society, American Heart Association, Alzheimer’s Association, AARP, and the American Diabetes Association.

Although these organizations do not offer personalized service, they do offer the following resources:

  • They advocate for policies that benefit the group they represent. 
  • They push for and report on medical advances.
  • They provide a wealth of information and resources on the specific conditions that affect their audience. Some have videos, fact sheets, and referral to your local sources of information and assistance.

For-profit

Are you looking for concierge patient advocacy? More and more companies are jumping into the business of providing personalized healthcare advocacy. Some companies contract with insurance companies or other healthcare providers and others are membership services for individuals.

In some cases, it can be like having your own personal case manager. Private healthcare advocates can cost thousands of dollars a year unless covered by your health insurance or employee company.

Depending on the company, these are the services offered and many of them are available 24-hours a day.

  • Compile all medical records in an easily understandable format for your family.
  • Advocate by coordinating all aspects of care.
  • Facilitate access to top medical providers.
  • Centralized medical records, and billing making it easier for patients to understand

Geriatric care managers

Geriatric care managers, also known as aging life care professionals, are private advocates and consultants for aging clients and their families. The advantage of geriatric care managers is that they are local. Therefore they know and understand local agencies, companies, and healthcare providers.

As consultants, geriatric care managers conduct complete medical, emotional, financial, and housing evaluations and make recommendations based on their findings.

Hospital or skilled nursing

Hospitals and skilled nursing have patient advocates on staff to help patients navigate the system while they are there and upon discharge. In some cases, these patient advocates are dedicated to resolving payment and insurance issues. 

In other cases, these advocates may be known as case managers, but their role is still the same. It is to assist families with a smooth and affordable transition home or to another healthcare setting. They also help patients with understanding how insurance works and what potential co-pays they might expect.

Insurance companies

Some insurance companies contract with or hire patient advocates to help their members navigate the healthcare system or resolve billing issues and questions.

These services are usually at no cost to the insured individual.

Outpatient physician services

Patient advocates in geriatric practices are a great asset, but not every practice uses them. These advocates are usually social workers or nurses who help patients who need to be connected to resources. But, their other role is to coordinate care between systems.

For example, if you break a hip and go to rehab, the advocate that works with your doctor makes sure that all relevant information is shared between systems.

Governmental

You may not think of the government as being in the advocacy business, but they are. Some examples include the Department of Health and Human Services, the Centers for Disease Control and Prevention, and the Food and Drug Administration. 

Other governmental agencies with a robust and valuable presence are Aging and Adult Services, the Ombudsman Program, and Adult Protective Services (APS). In particular, APS has the role of investigating allegations of abuse, exploitation, and neglect in the community, where the Ombudsman is tasked with advocating for and protecting residents in nursing homes. 

These agencies are constrained by the funding they receive, and therefore they are easy targets for criticism because people don’t feel like they do enough.

How Do You Become an Advocate for Aging Adults in the Hospital or a Nursing Home?

To become an advocate in a hospital will probably require a degree in social work or a nursing license. The other option is to become a board-certified patient advocate. To obtain that certification, you must be working in the field of patient advocacy and pass an exam. Some healthcare entities work with volunteers as patient advocates.

Nursing homes do not usually have patient advocates on their staff except as part of the admissions or discharge process. An example would be if a person is discharging from a nursing home, there is a social worker to assist with that process. The same holds true of admissions.

The biggest advocacy program for nursing homes and assisted living communities is the Long-Term Care Ombudsman program, a local and state entity investigating complaints. The Older Americans Act requires each state to have an ombudsman program, and the states determine training requirements. Many ombudsmen are volunteers, but some are paid.

Patient Advocates for Aging Adults are a Valuable Resource

Now that you have a better idea of what a patient advocate is and how they can help, don’t hesitate to ask for one.

If you are in the hospital or skilled nursing and need assistance, ask if there is a patient advocate available. If you have the funds to hire a private company or geriatric care manager, consider the benefits and decide if that is the right choice for you.

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