Advocating for our Elders

Advocating for Our Elders

By Jean Kittson

I want to talk about advocacy. In my experience, if we are caring for someone – especially our elders – there is no more important job than being their advocate.

Time and time again in all my interviews for my book, with partners and offspring and professionals, the common cry was: “I pity the older person who doesn’t have an advocate, who doesn’t have kids or a trusted person to look after them”.

To quote a friend’s informed outburst, “…. to try to have a go at the system on your own when you are sick and old. I think about that all the time. If an elderly person tried to manage the systems and bureaucracies and legalities, Centrelink, My Aged Care, the medical systems, applying for Home Care Packages, ACAT, moving into residential aged care, it is a whole other language. If they tried to do any of that themselves, they would have no chance, no chance at all”.

As their advocate, you may very well be their number one essential service, because the world is impatient with old people, and this sometimes includes the departments and institutions, organisations and systems which are FOR old people, and very often you are their only defense. For our elders, one obstacle to maintaining health is trying to do it alone.
As my parents’ advocate it was one of my essential jobs. I always went to their medical appointments with them. This is for many reasons. One was communication. They often couldn’t hear what the doctor was saying. They often didn’t understand what the doctor was saying, neither could I but at least I could hear enough to ask questions and write things down and look them up later. I never spoke for my parents unless they wanted me to, but I could translate what the doctor was saying if the GP was softly spoken, behind a mask or spoke too quickly for their hearing aids. I would remind my parents that they could ask the doctor questions. I would also remind them about worries they may have forgotten (don’t we all) but I had written down. I would always take notes. I would write down everything the doctor said and suggested so that we could follow through with scans and blood tests and changes of medications and drinking more water! GP’s always say that an older person with an advocate is more likely to follow up advice and medication.

A visit to the doctor can be baffling, inconclusive or simply too much information, especially if the patients’ hearing isn’t what it used to be, and the doctor has forgotten this (to be fair, they see a lot of people, some of their patients hear them perfectly well, and some doctors are, frankly, young). It is therefore important for you to help your elders to follow through with scans, blood tests, change of medications, drinking more water, drinking any water.

When elders have a strong advocate, their health outcomes improve dramatically. It is not just getting their treatment right and dealing with issues quickly, it is also because when a GP knows that an elder is well supported and that their instructions will be followed through, they will be more engaged with the patient and confident when they encourage the patient to pursue active treatment. Accompanying your elder is also important because you can see how the GP treats your elder. Are they caring, kind, considerate, respectful? Or are they dismissive, impatient? Is their preferred diagnosis “Well what do you expect at your age?”, or “Your problem is too many birthdays, haha”.

I helped mum and dad leave a few of their GP’s, which is not an idle or easy decision and they would not have had the confidence or the capacity to do it alone. But it meant my parents were healthier in their early nineties and on fewer medications than in their earlier 80’s when I wasn’t so involved.

Having blown that trumpet, it is important to be a subtle and sensitive advocate. You are not the boss. You don’t make the decisions. An advocate supports their elder to make their own decisions. An advocate makes sure the elder is at the centre of all conversations. An advocate also makes sure their elder hears and understands what is going on and that they always have the opportunity to speak for themselves when they are ready.

Of course, you must also speak on their behalf when necessary but it will be always under their instructions. You represent your elder when they cannot represent themselves. At all times, an advocate promotes their elders’ wishes, feelings and preferences. This means that you must know your elder inside out. Literally. You must know them emotionally and physically from top to toe.
You can’t represent their feelings, wishes and preferences if you haven’t discussed it with them. You must talk with them regularly about their aches and pains, their skin, their eyes, their ears, their water works and their moist dark places, every inch.
You must also talk with them about their feelings, their hearts and minds. Sometimes we can get so caught up in worrying about them physically as their bodies age that we forget to give time to what is happening with their emotional and mental and spiritual state.
Sometimes our elders are more reconciled with their own physical decline than we are, and the more important questions are “How are you feeling?” and “What do you think would make you feel better?”.
I know I have mainly talked about the role of an advocate with GP’s but everything I have said about the reasons our elders need an advocate for doctor visits applies equally to all the interactions your elder has with others. Lawyers, for example. Lawyers are a different story altogether. Don’t get me started on banks. Not today, anyway.

Top Tip: As well as empathy, compassion and the time to listen deeply and carefully, your notebook is your most valuable tool. Please take notes.

About Jean Kittson

Jean Kittson AM is an Australian performer, writer and comedian in theatre and print, on radio and television. Read more of Jean Kittson’s articles for Australian Carers Guide here.