How To Advocate For Your Loved One In The Hospital

[ photo by Kampus ]

Learn to be an advocate for your loved one.

I have many years’ experience doing rehabilitation consultations for patients in the acute care hospital. I also have spent many hours on phone calls with clients, family members and friends who have loved ones in the hospital. One of the most frequent questions I receive is, “How can I best advocate for my family member that is in the hospital?”

That is a pretty broad question, as oftentimes, the family member is very happy with the care their family member is receiving. However, there are also many cases in which the family member is concerned their loved one is not receiving the care he or she needs. In either situation, I think it is good to advise how to best approach being an advocate for your loved one. 

How to advocate for your loved one in the hospital.

The biggest thing, when it comes to being an advocate for your loved one, is the approach.

I understand everyone’s personality is different in how we approach tough situations, however, if you walk in shouting and demanding answers and updates, the likelihood of getting the information and assistance you want and need in a timely fashion is diminished.

On the other side of this, however, is the person who has legitimate concerns for their loved one’s care but does not speak up; this can be problematic, as well.

If you have genuine concerns about your hospitalized loved one, then it is completely reasonable to be firm in your request for information, but doing so in a respectful manner will get you much farther with the care team. Understandably, some care situations are much better than others, but the approach, at least initially, to obtaining information and treatment for your loved one is of utmost importance. 

Speaking from experience, the care staff, including the nurses, treating physicians and case managers, are much more apt to freely update on any progress, test results, medications, etc when he or she does not feel they are walking into a hostile situation from the family member.

I do want to say, however, I have seen situations in which there have been legitimate issues in patient care that have been addressed by the family member but changes have yet to be made. In these cases, letting your frustrations be known is reasonable, but even these situations should be handled in a step-by-step manner.

How to proceed when concerns not addressed.

So how do you handle a situation in which you feel care has not been as it should? If you have addressed the issue with someone but have yet to see a change, I recommend moving up the chain. If it is a nursing issue, request to speak with the nursing supervisor and from there, the unit manager. If you are not getting results and have gone this high up the chain, request to speak with someone above that person until you have reached the top of the chain to get the action you need in regards to nursing/patient care.

If it is a concern with the physician caring for your loved one, I recommend requesting to speak directly with that physician. Again, try to do so in a firm, but respectful manner. If you are still not satisfied with the answers/care after the conversation, then it is reasonable to request a second opinion or a change in physician for your loved one. 

Tips to advocate for your loved one with the treating physician.

On the topic of speaking to the physician, I strongly recommend you ask someone from the care team the general time the physician rounds. Unless it is a surgeon who often does her or his rounds in between surgical cases, thus making that less predictable, the majority of inpatient physicians round at a fairly regular time each day. More often than not, these rounds occur in the mornings, sometimes quite early.

Personally speaking, I am happy when a family member is present during my rounding of each patient because I can readily answer questions the family member and/or patient might have as I am examining the patient. There are times I might not know the exact treatment plan I have in mind if I am still waiting on lab studies or test results, but for the most part, I will be able to provide any available results, status changes and any new treatment plans, including medications and tests.

If your loved one has multiple physicians treating him/her, which is often the case, you might not be able to be present for every physician’s rounds, but I would encourage you to stay for as long as possible to catch a representative from every treatment team involved in your loved one’s care. This does not need to happen on a daily basis, but I do encourage you to try to do it as often as possible.

If you have multiple family members in the area, you could have family members take turns being present for the rounds. For those of you who are out of town, I recommend you request a call from the primary physician managing your loved one’s care to obtain updates. 

Be an effective advocate by establishing a family representative.

If you have multiple family members involved in the care of your loved one, it is best to choose one family member as the representative/main point of contact for your loved one’s care. This person should be listed on the contact list in your loved one’s chart. This will be the person that is called if there are any acute changes or necessary updates on your loved one. This allows for consistent communication between the care team and the family member. The point of contact in the family member should then communicate the changes in status of your loved one amongst the remaining family members. 

(Related blog post: Communication Breakdown? Request A Family Conference)

In addition to getting updates from your loved one’s treating physicians, get to know your loved one’s nurse. He or she is the one providing direct care to your loved one throughout the duration of his/her shift. The nurse is generally the first one to note any acute changes in the loved one and is the one responsible for carrying out the orders made by the physician, so requesting updates on your loved one’s status from his/her nurse on at least a daily basis is very important.

(Related blog post: Options For Medication Management)

The final thing I recommend in advocating for your loved one is getting to know the case manager assigned to your loved one. Case managers are tasked with arranging any sort of after care your loved one might need following hospitalization from therapies to ongoing intravenous medications to rehabilitation. If you have a good communication line established with your loved one’s case manager from early on, you are less likely to have to make a quick scramble to make decisions for the post-hospitalization care. The case manager can be met with face to face or over the phone, as well. 

(Related blog posts: Where Do You Go After Acute Rehab?, Top 5 Things To Do When Selecting A Short Term Rehabilitation Facility, Acute Rehabilitation Versus Subacute Rehabilitation: What’s The Difference?)

This is not an easy job. You can do it!

It is hard to have a loved one in the hospital, especially for those of you without formal medical training. The hospital is often an overwhelming place. The medical jargon can be difficult to understand. You, however, likely know your loved one better than any of the medical professionals providing care for your loved one. No amount of formal training can trump that. In general, medical professionals can appreciate that knowledge of the patient that loved ones can provide. If your loved one seems to be displaying a change in him or herself, let the care team know. When you don’t understand something, don’t be afraid to speak up and ask for an explanation. If you have concerns, don’t be afraid to let them be known. 

For further questions or assistance in how to advocate for your loved one, do not be afraid to reach out for further support. 

© 2021 Jessica Kluetz, DO