What Is The Role of A Patient Advocate?

Today SevenPonds speaks with Linda Garvin, R.N., M.S.N., a patient advocate with 35 years experience working in healthcare. Linda is the principal of Patient Advocate Bay Area, Inc, located in the San Francisco Bay Area. Through her private health advocacy practice, she assists individuals in managing their illness and navigating the complexities of the healthcare system.   

Editor’s Note: This interview has been edited for length and clarity.

Linda Garvin

Ellary Allis: Will you explain what a patient advocate is?

Linda Garvin: A patient advocate is a specialist in an area of health care concerned with advocacy for patients, family members and caregivers. As a patient advocate, I accompany patients to physician’s appointments, create an agenda, and formulate questions for the patient or their family to ask their physicians or other members of the healthcare team. I can follow-up with health recommendations, coordinate procedures, and serve as a decision-making guide when someone is faced with a serious or complex diagnosis.  

In my practice, I make home and hospital visits, which is important if someone has a hospitalization for an acute medical situation. I assist with finding second and third opinions to read medical records or give treatment options. I also assist with discharge planning and assessment of home needs, which can be very complex. Many patients return to the hospital within three weeks of discharge to the home, but I try to prevent this from happening by coordinating their care.

Also, when a person transitions from the hospital to a skilled nursing facility or back home, I help ease that transition for the patient and their family  by making numerous proactive suggestions to avoid potential problems.

Ellary: What led you to become a patient advocate?

Linda Garvin: I had always enjoyed combining problem solving and medical collaboration. I enjoy the challenge of working with many different healthcare professionals in complex situations as well as guiding individuals through our complex health care system.

During my 35 years in healthcare, I’ve covered a lot of ground. I started out as a registered nurse providing direct patient care, and that included work at Stanford hospital. I did some teaching at Massachusetts General, in their masters program. I worked as an administrative nurse at the University of California, and did some legal nurse consulting.

I owned and managed a workers’ compensation case management business for several years. Eventually, all of my experience dovetailed nicely into developing my private practice as a nurse health advocate.

I enjoy working with middle-aged and older adults.  I also enjoy helping individuals with chronic health challenges, as well as different types of cancer diagnoses.

Ellary: What do you find rewarding about working with people with chronic pain?

Linda Garvin: People with chronic pain don’t always get the care they need or know about the variety of resources that are available to them. They often don’t know that there are pain specialists they can work with and/or guided imagery techniques and relaxation techniques that might be useful. I think it’s important to be a resource for people, by informing them of all their treatment options  

Ellary: What’s been the most surprising thing about being a patient advocate? What have you learned through this career that has surprised you?

Linda Garvin: The most surprising thing is how unprepared peoples’ families and children are when it comes to understanding either their medical condition or their parents’ medical condition. People don’t seem to have an organized way of keeping information handy, and they rely too heavily on electronic records. They assume that if they go to the emergency room all of their records will be online. The problem is that computers break down frequently, and not all the information online is accurate. It’s a good idea to carry written copy of your medical record with you when you seek medical care.

Also, many folks are not in the habit of keeping a list of their  over-the-counter and prescription medications on them. What’s more, a good number of these people are living alone and don’t have close relatives or children who are available to help. People have an estate attorney for their estate, but they don’t think to have an individual nurse advocate selected in case they run into a problem. Having a nurse advocate is one way of being proactive about your health care challenges.

Credit: listland.com

Ellary: Have you worked with any particular patients that stood out in terms of how you were able to assist them in their end-of-life journey?

Linda Garvin:  I had a unique situation over the past year when I was contacted to assist an older parent from the Bay Area who had a child with chronic alcoholism. The person had cirrhosis of the liver and lived 2,300 miles away. The family wanted him to be flown from an ICU in the middle of the country to the Bay Area.

I spoke to his nurses, the ICU doctors and the hospice and palliative care physicians. I also had to find an available bed in a skilled facility close to his parents’ home. The patient ended up taking a private medical plane because he was too sick to take a commercial flight.

Once the arrangements were made to transfer the patient, I had to coordinate getting hospice there to see him when he arrived.  When the patient arrived in California, he was quickly taken and admitted to an assisted living facility, where hospice was provided and he was surrounded by family. It was extremely rewarding to help the family make these arrangements so they could all be together in the same town during his final days.

Ellary: Do you have any advice for the family and friends of a hospice patient who want better advocates for their loved one?

Linda Garvin: Well SevenPonds is a fantastic resource! And the National Institute on Aging lists the documents that should be prepared and reviewed by an attorney: the durable power of an attorney for healthcare, durable power of attorney for finances, a will, a living trust and a living will. There is also something called a POLST form. That stands for Physicians Order for Life Sustaining Treatments. It is a legal doctor’s order that says what a person wants and doesn’t want done should they be seriously ill and unable to speak for themselves.

One of the most important things that I’ve learned from my practice is the importance of talking about things early on when it seems like things are taking a turn for the worse.  This often allows the individual who is ill to participate in those conversations and let their loved ones know what they want done.

This concludes the first part of our interview with patient advocate Linda Garvin. Please come back next week when we continue our conversation in part two.