[This article was written by Patti Jo Turner  a long-time case manager with Marshall, Parker and Weber]

 6 Tips for Advocacy for your Senior Loved One

(through the lens of an adult child who works in elder law)

It is terribly difficult to face the fact that someone you love needs more care and attention than you are able to provide.  You fight your own feelings of sadness and guilt.  You worry about your loved one’s actual physical care and safety as well as their general happiness and well-being.  And then COVID-19 comes along and ramps up all those concerns.  It can be a heavy burden.  Our family struggled with this 3 years ago.  But we have been able to come to a place where our Mom is content, and we have great peace of mind.

There are many things you can do to help ease your mind, and even improve day to day circumstances in the care setting. We share 6 tips on what has worked for us.  Try some (or all) of these and notice when there are especially good results – and do them again.

1. Make sure you have a good, solid Power of Attorney which covers financial and health care decision making and insist that the facility knows who to contact (and how) with any and all questions and concerns.  Let them know you want to be contacted.
2. Medical stability is going to be a priority at first.   Be familiar with your loved one’s medications.   Keep a list of the medications by actual and generic name.  (Staff tend to use those names interchangeably and it can be very confusing!)  Know specifically WHY a med is being prescribed. Note dosages and frequencies.  Maybe you want to control the refills as a way to keep on top of any changes or additions.  Granted, it is a lot easier to let the facility handle med ordering but that puts you out of touch with this aspect of care. Insurance coverages often mandate that one drug be exchanged for another. You will want to know when it happens, and watch for any side effects.
3. Be there – a lot!  Try to become familiar with the staff caring for your loved one.  Learn their names and always greet them with a smile.  Think of them as part of your “team” rather than people who are employed to provide care.  Remember, most of these folks have a heart for care-giving and they work really hard.  A kind word is always appreciated.  And you know what is really appreciated?  Be vocal about positive things!  Our mom loves having her nails done, and one of her caregivers often offers to change color and give a few minutes of pampering.  Another staff member always tends to the plants in the room and chats about gardening.  We notice.  We thank the staff for their small kindnesses.  And we randomly share (in writing) nice comments with the Supervisor, the Director, and even the Board. This has opened the door for many positive conversations, and has made it much easier to deal with the bumps in the road that will inevitably occur.
4. What if there is a medical set-back?  There is no easy way to handle this situation.  You will have hospital doctors, a family physician, facility staff, and sometimes rehab help all handling a portion of the care.  Someone needs to be the coordinator/translator/wrangler of all of it. This is a considerable amount of work.  Communication is the key here.  If something seems off, ask for clarification.  You may have to ask more than once.  You may have to get a couple of professionals together at the same time to be sure everyone is on the same page. When our Mom was getting rehab, we knew that she was to be using her walker to get to meals.  But we noticed that she was in a wheelchair during dinner.  So, we had to be sure that the therapist’s orders were being conveyed to the rest of the team.  We asked to attend some of the therapy sessions to see progress, encourage our parent, and learn how we could assist.
5. Try to approach difficult situations with calm.  If your loved one is complaining about something in particular, try your best to get an accurate picture of what is really going on by asking questions rather than starting with accusations or demands.  For example, our Mom was constantly frightened at night.  She said people kept coming in and moving around and it was very scary for her.  We found out that resident laundry was gathered by 3^rd shift staff.  We asked if that particular task could be done right at bedtime rather than the deep of the night.  And we asked if the overnight staff checking in on her would gently say “Just looking in on you” when they pop in.  Over time she became very accustomed to the routine, but it didn’t happen right away.  The facility has much care to provide for many people, but your loved one is an individual and should be treated as such to the greatest extent possible.  While you are trying to resolve the issue, be sure to let your loved one know you hear them when they are unhappy, and that you are working to make the situation better.  Then let them know when a change is in place.
6. Be a part of the community at the facility.  Get a copy of the monthly activity calendar.  Look it over with your loved one with an eye for things that might bring extra enjoyment.  We always look at the week ahead and circle things Mom likes.  For instance, bingo games and yoga are high on her list, but not the trivia.  We make sure we know when they happen and remind Mom.  We also make a point of telling the staff which events are important for Mom to be included in.   When we feel that Mom needs additional stimulation, we work with the administration to increase the activities available to her.  We have also become friendly with other residents’ families and worked with the facility to start a quarterly check-in meeting that allows everyone to share concerns and kudos.

Advocacy for someone you love is a labor of love.  Practice makes progress!

Patti Jo Turner has been a non-attorney Case Manager for 22 years with the law firm of Marshall, Parker & Weber, LLC. She can be contacted at 1-800-401-4552 and PTurner@paelderlaw.com.