This topic of advocacy has been whirling in my mind for some time. Advocacy is defined by Webster's dictionary as: “advocacy: the act or process of supporting a cause or proposal : the act or process of advocating something”. Most of the time we do not think of our elderly loved ones as a “cause” to be taken up. They are simply the people that we love and we want the best for them. If we were to go around “advocating” for every person that we care about, our loved ones would feel more like charity cases than like friends. It is not advisable to make everyday issues into causes to be borne on your shoulders. But when a loved one undergoes a major mental, emotional or physical difficulty in their life, we may well take up a cause to advocate. That cause could be advocating for their health, their well-being or their very life. When they are no longer able to speak for or stand up for themselves, we may need to be there to offer support or even to try our best to do for them what they'd normally do for themselves.
This issue is something that is a major struggle all throughout American culture. In extreme examples, we see it manifested in legal cases where someone is being kept alive by machines in a hospital and their loved ones need to make decisions for them based upon what they think the person might want. Thankfully, these cases are becoming less common as people are more proactive about making living wills and letting others know their desires in advance of anything happening. If you have not done so previously, now is an excellent time to set up such a will. It is a kindness to your loved ones who should not be expected to discern what you might have wanted & then spend several months or years afterward wondering if the decision they've made on your behalf was the correct one.
In situations that are less extreme, advocacy can come in many forms. Oftentimes it comes when dementia sets in with older relatives. People begin to recognize that reality is harder to grip and things are becoming mixed up. In these situations, it is imperative that they begin to set up how they want to be treated in the future, because their lucid moments might be far between. Family members who take on the responsibility for making decisions for them find that they are much calmer if they know the person's wishes in advance. Other times, a major illness or injury might make advocacy necessary for a limited time until the person can speak for themselves again. Whatever the case, there are a few guidelines that advocates ought to be aware of when standing up for another.
First, you are speaking on their behalf. It can be tempting in these situations to become so focused on the person you're speaking for, that you forget who you're speaking to. Whether they are in hospital or home situations, be sure to be respectful in all your interactions with the staff that is caring for them, just as they would be respectful of those people. If you become short and easily angered by the situation going on and fly off the handle at each turn, the professional caregivers are less inclined to listen if there is a serious problem. You need everyone to put their best effort forward in order for your loved one to see progress, so make it easier for everyone involved and remain reasonable.
Next, if there is a serious infraction that could be a danger to life, speak up! Do not be afraid to talk with the person and their supervisor about your concerns. There is no reason for you to keep your mouth closed in those situations. You can still do it in a way that is not haughty or rude, but make it clear that it will not be tolerated and that you are committed to the best care possible for your loved one. Be sure that they understand the severity of the situation and also talk through a plan of how that situation will NOT happen again. Be specific. Be direct. If a medication was not administered when it should have been, or if a medication was given that the person was allergic to, find a way to be sure that that never happens again.
Educate yourself on all of the medications your loved one has been on, their medical history, and what types of protocol they are currently under. If they are in treatment with medicine currently, be sure that you have looked up and understand the side effects of those meds and if there are any things that they should not be having at the same time. Especially if they'll be discharged from the hospital, be sure that you understand whether they need to limit certain types of foods or avoid alcohol because of possible interactions with medicine. They may not be fully cognizant of everything a doctor or pharmacist tells them if they've been through a major medical battle.
Know that as you go through this process, there are going to be things that are out of your control. You are not a specialized doctor. You cannot perform the surgeries that your loved one needs, nor can you prescribe medications or intuit all of their interactions. You cannot take their pain away. But you CAN speak for them by asking questions. Do not feel bad for getting as much information as you can to make a reasonable decision for them. Sometimes in the process of conversation with doctors and other caregivers, new and pertinent information will come to light that offers better care to the patient. When dealing with elderly individuals who do not understand medical terminology, this is even more important as you'll be called upon to translate the information into a form that they can hopefully understand and abide by.
In all of these things, remember that you are not them. You can do your best to figure out what they might need and want, but you may never know for sure if the choices you're making are beyond shadow of doubt the absolute right ones for them. You are not meant to know that. You are simply doing your best to keep them and their needs in front of those who can do something about them. You cannot meet their needs, and neither can they, but they also cannot speak to ask for help. Your job is not to fix their health. Your job is to ask for help on their behalf so that they can get the best possible care available to them. You may never know just how important your role is in improving their lives!