... to help one another
Dear Members and Friends of UUFCC.
The Patient Advocate Committee has been formed so that you will not have to confront medical situations alone. Even if a family member or friend is present, a Patient Advocate can often be of assistance in listening to your concerns and working to communicate them through appropriate channels. On a doctor visit, in a hospital, or during home health care, an extra set of eyes and ears can provide you support. Patient Advocate volunteers will make every effort to maximize your comfort level, enhance communication, and ensure appropriateness of care, all the while maintaining confidentiality.
If you cannot imagine a time when you might need help, please look at the attached scenario sheet. These situations are examples of when a Patient Advocate might be appropriate for you. If after reading it you think it's a good idea, please fill out the survey, also attached, so that your emergency contact information can be entered and held secure, to be utilized only when you request it. Hand it to Herb Levin or Diane Allen-Harkins, co-Chairs of the Committee. A poster is on display in the Social Hall, with pamphlets explaining further the function of Patient Advocates. Please look for it, and don't hesitate to speak with an Advocate, identified by his/her badge.
Herb Levin and Diane Allen-Harkins
Co-Chairs of the Patient Advocate Committee
Scenarios where a patient advocate might be useful……
1. You live alone. You have no family nearby. You have been taken to the emergency room. Your best friend is out of town.
2. You live with your spouse/best friend. You are both in an accident, and hospitalized.
3. You are a patient in the hospital, alone, and were okay until the drugs kicked in, and you ceased to understand the doctor’s information/instructions.
4. You are with your hospitalized spouse/significant other, but must leave to run an errand. You don’t want to leave him/her unaccompanied.
5. You are feeling nervous about an upcoming medical visit, and would like someone to accompany you and take notes.
6. You have gone to a medical visit, and have forms to fill out, but you do not fully understand the content. You want someone to help get a fuller explanation.
7. You need someone to call family members for you to explain your medical status.
8. You live alone, and a home health care representative will be coming. You want a third party present in case you don’t understand everything.
9. You are going to be admitted/transferred to rehab, or hospice, and have no support system in place.
10. You need someone to write down your thoughts during a time of medical service.
For a printable copy Click Here Patient Advocate Interest Survey see example below
Patient Advocacy Interest Survey 3/14/14
The Patient Advocates committee is aware that many ot the oongregants of UUFCC live in or visit our area at
some distance from family members and/or the person who is their personal medical proxy.
Patient Advocates offer a number of services tor people who are alone, without support or who may need extra
support even if their family lives nearby. lt you are interested in learning more about or obtaining assistance from
a patient advocate, please till in the following infomation and return this form to Patient Advocacy oo-ohairs: Herb
Levin or Diane Allen-Harkins
Would you be interested in any of the following services? Please Mark YES (X) or NO (X)
I would like to hear more about the services offered by Patient Advocates YES ____ NO ____
I need the service of an advocate at this time . . . . . . . . . . . . . . . . . . . . . . . YES ____ NO ____
I might want a patient advocate sometime in the future . . . . . . . . . . . . . . . YES ____ NO ____
| consent and give below my emergency contact infomation to be utilized in the event of a medicalemergency.
(Note: all infomation you give will be kept in the strictest confidence to be shared only by The Minister,
the Patient Advocate Chairperson and an Advocate of your choosing)
YOUR NAME: ___________________________________________
YOUR PHONE #: __________________________
YOUR EMAIL if applicable: __________________________
Primary Emerqencv Contact:
THEIR NAME: ________________________________ Relationship to you: __________________
PHONE NUMBER: ____________________________
CELL PHONE: _______________________________
Secondary Emeroency Contact:
THEIR NAME: _______________________________ Relationship to you: ___________________
PHONE NUMBER: ___________________________
CELL PHONE: ______________________________
Patient Advocates are prepared to assist in the following ways:
1. Being with you during important appointments with your doctors.
2. Meeting you at an ER and staying with you through the process of hospital admission and discharge.
3. Seeing that you are well cared for when hospitalized, in rehab, or in a long term care facility.
4. Helping you to better understand the treatment options doctors have offered.
5. Helping you to understand and remember the instructions you receive about pre-op preparation and post-op care.
6. Helping you to arrange for home health care.
7. Helping you to prepare an advanced directive for end-of-life care and to see that it is respected.
8. Helping you to deal with health-related financial issues.
Registry of Patient Advocates, March 2014
RESIDENT ADVOCATES SEASONAL ADVOCATES
Herb Levin 286-7939 (Cell) Co-Chair Gustavo Reynoso (917) 626-6192
Diane Harkins 570-867-1110 Co-Chair
Tom Deuley (915) 276-1314
Rosemary Hagen 475-4432
Dennis Shaw 830-0848
Ted Zawistowski 625-3186 (home)
Jack Harkins 570-423-1294
If you would like the help of a Patient Advocate, please call someone on this Registry. He or she will discuss your needs with you.
If for whatever reason, one is not in a position to help, another Advocate will be suggested.
You've got a friend