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How To Be A Self-Advocate And Why It Matters

10/9/2020

 
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By: Dr. Beth Templin
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I’ve mentioned previously the importance of being a self-advocate. It’s something I strive to teach and instill in the people I work with every day. Let’s take a closer look at the definition to have a better understanding of the term.

Self-Advocacy
noun the action of representing oneself or one's views or interests.
When think about an even better way to describe it as it pertains to being a self-advocate for healthy aging, it is the ability to verbalize your needs and make informed decisions about how to best meet those needs as you continue to age.

I’m going to share a story about a recent experience I had in the medical system with needing to be a strong advocate for myself.  

In July of this year, I showed up to the Emergency Room with worsening abdominal pain, knowing that I would probably need to have my gallbladder removed. They decided to give me pain medication to help me feel more comfortable.

When they told me they were going to give me Dilaudid, I asked if it was a very strong medication. I told them that I was a “light weight” when it came to pain meds and they assured me it was a very low dose. They didn’t give me other choices and I didn’t ask. I assumed they knew what was best for me.

It knocked me out. I had trouble staying awake and even felt myself stop breathing a couple of times as I drifted off to sleep. My heart rate dropped into the low 40’s. I was a little scared that I would stop breathing if I fell asleep. Luckily my husband was in the ER with me to keep an eye on my heart rate and breathing, but he was nervous too. 

They offered me another dose of Dilaudid at the next scheduled time and I refused. I told the nurse about my reaction and asked requested a medication that was not as strong. I received Toradol which gave me the same pain relief, but I felt like a normal person. I asked the nurse to remove the Dilaudid from my chart. He didn’t.

When I got admitted to the hospital and taken to my room, the nurse on the floor offered me pain medication. I said yes, then before she administered it, I asked what the pain medication was. It was Dilaudid. I refused and again asked them to remove it from my orders.

Each shift change I had to refuse that medication and asked to have it removed. It wasn’t until my second day at the hospital that a nurse suggested I add it as an “allergy” to prevent me from getting it again. I was so thankful to have that option explained to me.

I was also furious that it took me very clearly expressing my desire to not have that medication offered to me multiple times before someone actually offered a solution. If I hadn’t been as aware of the medication options, they would have given it to me again.
What did I learn from this experience?
  1. Ask questions. If you don’t fully understand the explanation, ask for more clarification. So often people do not ask for more information even if they don’t understand because they are worried about coming off as “stupid”. If you don’t fully understand the options being offered to you, it is the fault of the healthcare provider for not doing their job of explaining your options well, not your fault for not understanding.
  2. Ask for other options. I should have asked if there was another option to the Dilaudid when I was concerned it may be too strong for me. Then I would have been able to learn about both options and could have made an informed decision. I still may have chosen the Dilaudid based on the information presented, but I would have been better prepared for the reaction I experienced.
  3. Don’t be afraid to get a “second opinion”. I had to speak with 3 nurses before someone offered me a solution which I found acceptable. Everyone told me they couldn’t take the medication off my chart, which I know is not true. Orders are changed all the time, including discontinuing medications. But no one wanted to call the doctor to get the order. It was much easier to put down that the patient refused.
We assume healthcare providers have our best interests at heart. Everyone I know goes into healthcare for all the right reasons, they want to help people. Unfortunately, due to time constraints and poor staffing your interests many not always be the priority. In a 2018 study, it was discovered that physicians only let people talk to them for 11 seconds before interrupting them. How can they truly understand your concerns when they don’t have the time to listen to them?

​I also believe the influences of ageism in healthcare further complicate the issue of aging adults getting the level of care they need and deserve. Next time you have a medical appointment or need to seek out emergent care, make sure you ask questions about the treatments being offered and ask about other options. If you’re unsure they are offering you the best options, ask for that second opinion.

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    Dr. Beth helps adults 55+ understand the changes of aging and how to live a healthy active lifestyle, so they don’t start to miss out on the good things in life.

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