Advocating for a loved one

Advocating for a loved one is always scary, however, it’s necessary.

A dear friend of mine took her husband to the ER three years ago and it had a nightmarish quality and it became a complete and utter circus I’m afraid.

In the ER my friend’s husband was diagnosed with kidney stones. It was ONLY AFTER he was admitted did they find out that there were no resources in order to treat him. And they were informed that the only way her husband could be taken to a different hospital was if it was life threatening. I was floored when I heard that update. Their nightmare had begun. The hospital kept promising my friend that things would work out, and then nothing would happen, and her husband was getting sicker and weaker by the day.

I told my friend through DM (we’re Instagram buddies and we live in the same city right now) that she needed to call the number on the back of her insurance card and ask for some help from the insurance. Since she hadn’t had good insurance previously, this was something she hadn’t known about until I mentioned it. For a person who normally avoids talking on the phone, this friend of mine became an absolute warrior. She was telling the insurance what was going on and one of the customer service agents went above and beyond to get my friend some answers and see what to do. My friend called her an angel. She had a caseworker for her husband by the end of Monday. When my friend started making some noise to get attention to her husband’s dilemma, other people started doing stuff too. She recruited her father-in-law, a retired doctor to help her advocate for her husband since she was running on empty. She hadn’t slept much and it was showing. I’m so glad she recruited her father-in-law to help because things started to push forward. I smile every time I think of her father in law doing the best freaking ballsy move I have ever seen before or since by a retired physician. Her father-in-law called the hospital every single time he had a new question and got updates when his daughter in law was stonewalled, told the wrong thing and basically lied to. Not the best way to treat the wife, ya know?

Once a case manager from the insurance was on board, they were working on trying to move her husband to a new facility. Well, the CEO and the head nurse came to visit her husband to see what the heck was going on. He personally called a doctor and surgery was scheduled for Tuesday morning. While they had a brand-new urology department, it hadn’t been used because there were no staff to man it.

Tuesday morning everybody was eagerly awaiting news that they had gotten the kidney stones out. NOPE! One of the kidney stones was deeply embedded and there was now an infection. The urologist that had been brought in to do the procedure was at his wits end and frustrated with the administration. My friend learned he’d been in the ER department all day the day before, and not once was my friend’s husband’s case brought up to the urologist. Not once! In fact, by the time the call came for him to come do the procedure, the doctor was home for the night and in bed already! To say that physician was beyond livid when he learned of this case is putting it rather mildly.. My friend’s husband had another procedure done and he was able to go home and be with his family as he recovers from this nightmare of a hospital stay.

If you think that was the complete end of the story, you’d be wrong. When all the bills came due, it totaled a whopping amount. You ready for this? The hospital charges totaled $84,000.00 and no, they never sent anything into the the insurance. I told my friend to call the case manager immediately. Like now. I’d told my friend the news would not be taken very well. I was right. The news went over like a lead balloon and it got the hospital investigated by not only my friend’s insurance, the hospital is being investigated by 4 of the biggest insurance companies in the country right now. Insurance takes stuff like this quite seriously. The insurance really saw red when the hospital sent the bill to collections. There is a law (The Medical Debt Collections Act) that collectors must wait 180 days after the initial billing before they can contact the debtor

So if you want to advocate for a loved one here’s some tips:

1. Call the customer service number on the back of your insurance card. insurance is there to help. Besides, the insurance keeps track of what’s going on and if there’s a huge problem brewing, they can get some headway and get a case manager for you
2. Recruit family to help make phone calls and make some noise if nothing is being done
3. Keep at it. You may be tired, however, you may be the only one advocating for your loved one.
4. If necessary, bring in the newspaper and the nightly news. Sometimes shedding light on the bad stuff gets stuff changed so it won’t happen to another person like it did to your family.

So here’s 8 tips on how you can get started to advocate for yourself and a loved one.

Believe in Yourself!!!! I can’t stress this one enough. If you don’t believe in yourself, nobody else will believe in you either. Take this chance to shine and get our voice out there for what you want(within reason of course)

Know Your Rights-You are entitled to equality under the law. Some who have had mental health challenges erroneously believe that they do not have the same rights as others.

Decide What You Want Clarify for yourself exactly what you need, be it a procedure or surgery. This will help you set your own goals and help you be clear to others about what it is that you want and need for yourself.

Get the Facts When you advocate for yourself, you need to know what you are talking about or asking for. The internet is an excellent source of information. However, you will need to check its accuracy by looking at several different references to see if they agree. I myself, use at least 5 different vantage points when doing research of what I need to ask for to advocate for myself. Check with people who have expertise in what you are considering. Ask others who have issues similar to yours. Check references in the library. Contact mental health agencies and organizations for information and support.

Planning Strategy Using the information you have gathered, plan a strategy that you feel will work to get what you need and want for yourself. Think of several ways to address the problem. Ask supporters for suggestions. Get feedback on your ideas. Then choose to take action using the one that you feel has the most chance of being successful. Gather Support In advocating for what you need and want for yourself, it is helpful to have support from family members, friends and other people who have similar issues. This one is HUGE. The more support you have, the better things can get worked out to getting what you need or have changed. Target Efforts Who is the person, persons, or organization you need to deal with to get action on this matter? Talk directly with the person who can best assist you. It may take a few phone calls to discover which organization or person can help, or who is in charge, but it is worth the effort. Keep trying until you find the right person. Sometimes this will take longer than you think it will, plan your time with a buffer around it to make sure you don’t run out of time trying to find the right person to talk with.

Express Yourself Clearly When you are asking for what you need and want for yourself, be brief. Stick to the point. Don’t allow yourself to be diverted or to ramble on with unimportant details. State your concern and how you want things changed. If the other person tries to tell you reasons why you cannot achieve what it is you want for yourself, repeat again what it is you want and expect until they either give it to you, help you get it, or refer you to someone else who may be able to give you what you need. If you feel this may be difficult for you, you may want to role-play different scenarios with a supporter or a counselor. Assert Yourself Clearly Don’t lose your temper and lash out at the other person, their character or the organization. Losing your temper over something is never a good thing. Speak out, asking for what you need and want and then listen. Respect the rights of others, but don’t let them “put you down” or “walk all over you.”

Be Firm and Persistent Don’t give up! Keep after what you want. Always follow through on what you say. Dedicate yourself to getting whatever it is you need for yourself. Also keep a running written log for proof of your tries and the results or non-results of those tries to get something moved forward.