Saturday, April 25, 2020

Being a Patient Advocate During Covid-19


Patient advocacy is critical to helping people get the care they need. This is particularly important if people are older, have a chronic condition and/or are in an emergent situation. In the Covid-19 era, this has become a bit of a challenge. However, the following tips can help in seeing patients get the care they need.

Emergent Situations: Encourage them to go to the hospital if they are experiencing an emergency, such as shortness of breath, chest pain etc. Assure them that the best place is the emergency room. Some people are afraid if they go to a hospital they could become infected with Covid-19. Hospitals have separate tracks for such patients.

• Help them prepare by making sure they have the connectivity and conditions for a successful visit.
• Go over what they want from the telehealth visit, clarify questions etc.
• Take notes while they have their visit. This can be such a different way for them to see their provider it’s easy for them to miss things. Be in the room with them, or if you are not in the same house,  see about joining remotely. You will need to arrange to be part of the telehealth visit before it occurs if you are going to join remotely. Don’t expect to be able to do that at the last minute.
• If the provider needs them to do things like weigh themselves, taking a temperature etc. assist as appropriate.  
• Review the visit with the person afterwards.
• Help the person compile a personal health notebook, which includes necessary information like medications, allergies, power of attorney for health care, living will, medical providers. Download forms at Create Your Own Health Notebook.

Hospitalization: Visitors, with a few exceptions, are not allowed to visit hospitalized patients. While this is anxiety provoking for patients and their families, it is the best way to reduce risk of infection.
• Most hospitals have set up Covid-19 information at their website. Read through it to understand policies and procedures and to know what they have put in place to support communication and connectivity.

• If the person doesn’t have a smart phone or tablet, get one that has video conferencing such as Face Time, Skype, Facebook Messenger, Google Hangouts, Google Duo or Zoom that allows face to face communication. It helps a lot to see how the person looks. If it’s an emergency admission, you’ll have to leave the devise with the hospital staff, along with other items they’ll need such as glasses, extra socks, toiletries, notebook and pen etc. Do not drop off money or other valuables. Note, some hospitals are providing iPads and tablets for patients to use during their stay so check to see if that’s an option. 

• Use phone calls, texts, and video chats to stay connected with the person. This can be their lifeline and will most likely be your primary means of communicating. Tell them to call as often as they like, but make sure they call after the doctor makes rounds, if medications are changed, new tests ordered etc. Calling them will give them a boost.

• As you discuss with them their medical situation, keep a hospital diary-write down what they tell you. Make sure you list the names of the medical teams that are caring for them.

• Writing letters and sending cards are good ways to cheer up a patient.

• Ask the nurse to write contact information of a family member on the whiteboard in the patient’s room and at the nurses’ station. Asked that this person be called if there is a change in the patient’s condition, after doctor’s visits etc. This is particularly important if the person is in critical condition and can’t communicate.

• Identify who is the lead provider, “the quarterback,” who is caring for the person. These are usually “hospitalists,”  or critical care specialists. The patient’s primary provider most likely will not be involved in their hospitalization.  Speak to the primary hospital provider daily.

• One person for the family needs to be the designee who talks to the medical team daily and shares that information with everyone else. It helps if this individual has some medical knowledge.  It’s frustrating and disruptive for staff when a family can’t organize themselves and end up having various people calling throughout the day. Note that some hospitals are setting up apps to help families stay connected with the patient.

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