An Advocate’s Hustle: Pulling Out the Stops

by Nancy Ruffner*

This was written as a response to a blog post for APHA Advocates by Trisha Torrey entitled Advocates Are Afraid to Do This Until They Love to Do It (June 20, 2017). The author wrote about Professional Advocates who have Hustle. Hustle is about getting your client from Situation A to the Solution B that he or she needs or chooses, often in a different direction from what the healthcare system would ordinarily offer, by finding a creative solution when no specific process or procedure already exists. Trisha invited us Professional Advocates to share with our contemporaries our own instances of Hustle.

Because it was Christmas Day night, and the visiting family members were departing (leaving mom to care for Dad).

Because the home care agency had said (but the wife did not comprehend) they could no longer staff the case, too difficult, caregivers refusing.

Because a referral to hospice had been made but “no one at the visiting doctor agency knew anything about that”, and then advised that the physician was away until January 10.

Because a 5’2′ wife could not handle her 6’2″ bedridden husband with dementia, and a minimum two-person assist.

Because it occurred to us that perhaps a hospice referral could be done on the spot if in the hospital.

Because we felt sure that one hospice provider would indeed be at one particular hospital, contracted to perform the hospice consultations for all palliative and hospice organizations.

Because the Client was in pain and unable to verbalize it, and was fighting everything and everyone.

Because the Client was not eating, refusing even a tablespoon of his favorite holiday foods, and the former home health agency had documented a recent weight loss of 11 lbs.

Because no one from the rehab, home health agency or the visiting doctor had even begun to set the expectation with the family that this man may be nearing end of life.

Because we knew it was backwards , but it just might work-

I called 911.

The Client was transported to the ER where he presented with uncontrolled pain. Together his wife and I sat in the ER 48 hours, (support, and teaching time) where she learned to seize every opportunity for Q&A with each person attending to the Client. Despite the prolonged observation status the request for hospice consult was made. His pain was managed, he calmed. The children were contacted, and later the hospice meeting held (with two of the six children in attendance). The assessment was performed and a plan developed.

All six children and their families gathered, arriving from in and out of state. With the Client’s pain under control and family in agreement, the Client entered a hospice home. He knew his family was there. Together they had nine days they otherwise may not have had, shared in peace and love.

~ July 8, 2017

*Nancy Ruffner is the owner of Navigate NC

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