Why a Health Advocate Is Your Most Important Health Care Plan!

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This is the final article in my series on health care.  This article has been preceded by nine other articles.  There is no need to read them in order but if you have not read the other nine, you will be missing a good deal of information that just might help you live longer, healthier and happier.  As I finish this series on health care, I am gratified that over the ten weeks I have been writing about the subject, I have found only more evidence that confirms the advice and opinions I have given in this series.  In this final article, I want to talk about how important it is to have someone as an advocate when you enter the health care system in this country.  Let me tell you a personal story that illustrates this point very well.

Several years ago, my sister lay dying in hospice care.  Hospice care is a gentle humane way of helping ease out a person who is at deaths door.  By gradually increasing their doses of morphine, the patients’ bodily functions will eventually slow down and finally cease.  If a patient is accepted into hospice care, it is assumed that they are terminally ill.  What might be a slow lingering painful death without hospice, becomes a respectful and hopefully painless termination of vital processes and death.

My mother went into hospice care in 1994 and died in three days.  She had a terminal infection which was beyond treatment.  We (sisters and brother) sat with her until she expired.  My sister Sheri was also accepted into hospice care in 1999.  She was only fifty-one years old.  She was considered terminal due to her advanced cancer.  As a family, we began another vigil waiting for my sister to succumb to the cancer and morphine.  However, things did not go the same path with my sister.

We noticed that she would seem to come in and out of consciousness.  Often, when she came out she would seem quite rationale and even energetic.  The nurses did not seem to pay much attention to these episodes.  One day, the morphine drip somehow came unplugged.  My sister became quite lucid and wanted to know if it was time for her to do taxes.  She did not seem like a patient near death.  We demanded that they take her off the morphine.  This met with much resistance as I assume they thought my sister would be in great pain and that we would be the instigators of a now painful as well as inevitable death.  Such was not the case.  My sister revived and seemed very healthy.  In a day or so she was out of the hospital.  She moved in with my sister and lived another three years before she passed away in 2002.  The next three years were not always good ones for my sister but we never regretted the decision to take her out of hospice.

Advocacy-bannerThe point of this story is that if we had not been siting vigil at my sister’s deathbed, we would not have been able to prevent a premature death.  This is merely one example of the value of an “advocate” when you must go to a hospital.  I am sure everyone reading this blog has at least one example that highlights how important it is to have someone as an advocate when you are in the hospital.

A health advocate is a family member, friend, trusted coworker, or a hired professional who can ask questions, write down information, and speak up for you so you can better understand your illness and get the care and resources you need – giving you a peace of mind so you can focus on your recovery.

Nurses, doctors and staff all want to do a good job and provide wonderful healthcare.  However, our health care system is under tremendous pressure to cut costs and reduce expenses.  This translates to less time available to care for each patient.  Less time that a nurse or doctor can spend with each patient.

advocateAn alarm might go off in an intensive care room but not be noticed for quite some time.  I have personally observed many times when a patient needed to call someone for assistance but no one came.  Unable to get out of bed, a patient may have to wait a long time before someone is finally able to help them.  In many cases, an advocate in the room can help a patient with minor personal needs.  If more severe needs exist, the advocate can be of assistance if finding someone to help and making sure that the patient needs are not overlooked or even forgotten.

Advocates assist people with making sure their rights are respected. They help consumers to resolve complaints about health or disability services. They operate independently of government agencies, the Health and Disability Commissioner, and the funders of health and disability services.

70b2adaac53bf082bb116c279362275c_advocacy-clip-art-clipart-download-advocacy-clipart_1822-1415Another function an advocate can provide is to stand up for the patient when needed.  Most of the time when we are feeling sick or hurting, we are in no position to stand up for what we need or want.  In such instances, a patient only wants the pain to go away.  Hospitals and health care providers often have needs that transcend the needs of the patient.  The patient that must play second fiddle to a variety of administrative and financial procedures.  Another example might clarify this.

Three years ago, I went to the Mayo Clinic for prostate surgery.  The surgery went fine and I was sent to a room for recovery.  The night passed as most do in a hospital.  Interminable interruptions for pills, blood tests and getting up to walk the surgery unit for exercise.  The night nurse was polite and helpful.  She left sometime after 7 AM and a new nurse came on shift.  She immediately informed me that I had to be out of the room by 12 PM and I should try to do more walking.

I had thought that I was doing a great job of getting mobile but I had not met my new nurse’s standard.  I started to try to walk more and meantime I became fixated on the clock in my room.  I still felt like shit as I watched the hands on the clock move inexorably towards 12 PM.  I am sure that Cinderella did not feel as bad as I felt since she would only be outed as a pauper while I be would be viewed as weak, wimpy and unable to meet standards that every other male prostate victim in America had met.

Fortunately, when the witching hour arrived, I had my advocate intercede on my behalf.  My wife Karen who had kept vigil with me this whole time told them in no uncertain terms that I was not going anywhere until I felt better.  It was now 12 PM but with her assurance, I fell into a deep sleep.  I awoke two hours later and immediately saw that the clock hands were on 2 PM.  Somehow, this extra sleep time was all I needed.  I practically jumped out of bed and started grabbing my clothes.  Karen who had been napping in a chair beside my bed woke up.  I said, “Lets go, we are getting out of here.” She replied, “but we are not packed.”  I replied, “I don’t care, I want to get out of here now.”  Karen grabbled whatever we could and we made the 2-hour drive back to Arizona City from Scottsdale.  I was not sure how I was going to handle two hours in the car post-surgery but I did not care.  I wanted out of the Mayo Clinic and back in my own bed.  To this day, I wonder how much stock my second nurse had in the Mayo Clinic.

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My rule now is this.  I will never let a friend or relative go to a hospital for treatment (regardless of how minor) by themselves.  If I have a friend who has no one to go with them, I will be their advocate.  If Karen needs to go to a doctor, clinic or hospital for any reason, even a hangnail, I will go with her.  Hospitals can be places of healing but they can also unexpectedly be places of death.  No one should assume or take for granted what might or might not happen at a hospital.  I could provide many more examples of unintended consequences that happened to friends and people we knew when they went into a hospital.  Better to be safe than sorry.

Patient advocates can work to help patients and their families by providing a variety of services, depending on the patient’s needs and the advocate’s area of expertise. They may help them to secure health care, manage insurance, or make treatment plan decisions.

Your advocate is your best health care plan.  Your advocate can have your back when you are under the weather or unable to defend yourself.  Your advocate can help make sure that the hospital and its providers live up to their own expectations.  Your advocate can help watch over you when everyone else is busy with other patients or administrative tasks.

Pity the poor person who goes into a hospital without a personal advocate.

This now concludes my series on health care.  I hope my blogs on health care have been useful and that you have found some ideas that will help you to lead a healthier, happier and more robust life.

Time for Questions:

Can you think of a time when you wished you had an advocate?  Were you ever an advocate for someone else?  What role do you think an advocate should play in healthcare?  Do you agree that everyone needs an advocate?  Why or why not?

Life is just beginning.

“For he who has health has hope; and he who has hope, has everything.”  — Owen Arthur

 

What the Hell Do We Need Morality For?

morals and ethicsThis blog is about the subject of morality.  Once upon a time, they taught morality in school and in church.   The first system of morality that many older Americans were exposed to was probably the “Ten Commandments.”   This was a code of rules given to the Israelites by Moses on Mount Sinai.  I have always thought it ironic that a set of morals from the “Old Testament” were supposed to be the foundation for a Christian America.  Even today, advocates of this code of morality want to hang it in town halls, schools, courts and government centers.  This is a part of the Bible that also promoted an “eye for an eye” and stoning adulterers.  Of course, Jesus did say “Think not that I am come to destroy the law, or the prophets: I am not come to destroy, but to fulfill” (Matthew 5:17).  Jesus added at least one commandment to all others that was even more valuable than the ten TenCommandmentsMoses gave.   Jesus said, “A new commandment I give to you, that you love one another; as I have loved you, that you also love one another” (John: 13:34).  I would be much more in favor of seeing this posted in my neighborhood than the Ten Commandments.

Perhaps even more importantly in terms of a system of morality, Jesus gave a sermon where he proposed what has been called:  The Eight Beatitudes:   (Click here to hear the The Beatitudes Song

Blessed are the poor in spirit, for theirs is the kingdom of heaven.

Blessed are they who mourn, for they shall be comforted.

Blessed are the meek, for they shall inherit the earth.

Blessed are they who hunger and thirst for righteousness, for they shall be satisfied.

Blessed are the merciful, for they shall obtain mercy.

Blessed are the pure of heart, for they shall see God.

Blessed are the peacemakers, for they shall be called children of God.

Blessed are they who are persecuted for the sake of righteousness, for theirs is the kingdom of heaven.  —- Gospel of St. Matthew 5:3-10

It is my opinion that the Eight Beatitudes constitute one of the greatest systems of morality to come out of the Bible.  Indeed, I would rather see these taught (if we are going to teach a system of morality) than the Ten Commandments.  I would also not mind these being posted in schools and other public places.

I said that once upon a time, we taught morality in schools and churches.   Actually, we not only taught morality but morality was imbued in our social fabric by many traditional stories and the media.  Children from an early age were exposed to Fairy tales, Uncle Remus stories, Aesop Fables, and Tales of the Arabian Nights.  These stories were full of morals on how to live and behave properly.  Early TV was also full of morality tales.  Shows like Father Knows Best, Leave It to Beaver and Andy Griffith each week clearly conveyed stories of morality and what was right and what was not right in terms of behavior.

sin-guilt-causes-body-pain-sicknessSomeplace along the way, we started losing our sense of morality.  Some have blamed it on becoming a multi-cultural environment.  Some have blamed it on the decline of religion and church going.  Some have blamed education while still others have blamed progress and a business culture that has no room for strict morality.  I am not sure what the actual cause was.  I am more concerned that it did happen.  Studies have shown that our culture has become more amoral than moral and that narcissism now plays an increasing role in our society.  People are less moral and more self-centered than ever before in the history of this country.  A book by Joel Marks (Ethics without Morals: In Defense of Amorality -Routledge Studies in Ethics and Moral Theory, 2012) is one of several that makes an argument for amorality:

“In clear, plainspoken, engaging prose, Joel Marks presents the case for abandoning belief in morality. Anyone who wants to defend the practice of making moral judgments will have to confront the issues Marks raises, and the alternative to morality he proposes.” – Mitchell Silver, University of Massachusetts, Boston, USA 

In the book “The Moral Fool: A Case for Amorality (2009)” the author Hans-Georg Moeller advances the following case for amorality:

“Justice, equality, and righteousness—these are some of our greatest moral convictions. Yet in times of social conflict, morals can become rigid, making religious war, ethnic cleansing, and political purges possible.  Morality, therefore, can be viewed as a pathology—a rhetorical, psychological, and social tool that is used and abused like a weapon.”

In an article “Why Is Narcissism Increasing Among Young Americans?”  by Peter Gray in Freedom to Learn (2014), Gray notes the following:

“For the past three decades or a little more, researchers have been assessing both narcissism and empathy using questionnaires developed in the late 1970s.  Many research studies have shown that scores on these questionnaires correlate reliably with real-world behavior and with other people’s ratings of the individuals.  For example, those who score high in narcissism have been found to overrate their own abilities, to lash out angrily in response to criticism, and to commit white-collar crimes at higher rates than the general population.[1]  Those who score low in empathy are more likely than the average person to engage in bullying and less likely to volunteer to help people in need.[2.]

Over the years, these questionnaires have been administered to many samples of college students, and analyses that bring all of the data together reveal that the average narcissism score has been steadily increasing and the average empathy score has been steadily decreasing ever since the questionnaires were developed [3.]  The changes are highly significant statistically and sufficiently large that approximately 70 percent of students today score higher on narcissism and lower on empathy than did the average student thirty years ago.

What accounts for this historical rise in narcissism and decline in empathy?  There is no way to know for sure, based on the data, but there are lots of grounds for speculation.”

I think we have thrown the proverbial baby out with the bath water.  I agree we need to keep the State separate from the Church.  I also agree that we don’t need the Ten Commandments as the foundation for moral thought in America.  Nevertheless, I do believe that we all need a code of morality to live by.  Whether it be Christian, Buddhist, Confucian, Agnostic, Atheist, Islamic, Jewish, Hindu, Baha’i, or other, we need a set of morals and a template and foundation for our behavior.  We need a baseline that each of us can start from as we assess what is good and what is right.  We need to have some system of ideas about what is correct behavior and how we should live in a social world.

When I was a kid, (somewhere along the way) I was taught the Seven Deadly Sins.  Sometimes they were called the Seven Deadly Vices or the Seven Cardinal Sins.  I assume that since I attended a Catholic school, it went along with the teaching.  The Seven Deadly Sins included the following:

  • Lust7 deadly sins
  • Gluttony
  • Greed
  • Sloth
  • Wrath
  • Envy
  • Pride

Some of you might think that this list is old fashioned or out of date.  How could this set of implicit moral values make a difference in our society?  These are so old; do they really have any relevance anymore?  You have only to look at the world today, to persuade yourself that these “sins” are at the top of the list of major problems.  Greed, envy, gluttony and lust appear pervasive in our culture.  TV shows, movies, magazines, radio, supermarkets, superstars, sports, credit services, escort services, pornography, Las Vegas all portray an American brand of materialism that is nothing short of sick.  Get it now, get it fast, and get more and moreMore is better!  Bigger is better!  Shop till you drop!  He who has the most toys wins!

“If necessity is the mother of invention, then surely greed must be the father. Children of this odd couple are named: Laziness, Envy, Greed, Jr., Gluttony, Lust, Anger and Pride.”  ― John R Dallas  Jr.

Black Friday is only a small manifestation of the greed, lust and sloth that has infected our society.  How many Americans have a regular exercise schedule?  How many obese citizens can you count on the street each day?  How many Americans spend more each week then they earn?  How many Americans will go in debt this Holiday Season to spend money that they don’t have on gifts and toys?  Where is the self-restraint that is necessary to push oneself away from the table or shut the TV off and say “Enough.”  It barely seems to exist.  Is it any wonder that so many countries have a very negative stereotype of the “average” American?  We appear to be a group of people who have lost our moral compass.

ARTICLE 29 —  The Universal Declaration of Human Rights

  • You have a responsibility to the place you live and the people around you-we all do. Only by watching out for each other can we each become our individual best.

At this point, you well may be asking “What right does he have to be so damn moralistic?” Didn’t Jesus say “Let he who is without sin cast the first stone?”  “Are you so perfect that you have a right to look down on other people?”  “Who does he think he is, Jonathan Edwards?”  “I don’t need anyone telling me my faults.”  “I get enough negativity from work without having to get it from you.”

Please allow me to clarify a few misconceptions.   In some religious circles we are all sinners.  Since I am agnostic, I don’t subscribe to a religious view of sin.  My use of the terminology is borrowed from the religious sphere since I think the concept of sin has a very useful connotation if we can free it from some of the pejorative and negative associations with which it is fettered.  First of all, I do not believe that you will go to hell for committing these Seven Sins.  Second, you will not be a bad or evil person because of them.  Third and accentuating the positive, you may be happier and healthier if you are more aware of these “sins” and can do a better job of examining the role that they play in your life.  My bringing these “sins” out is to help us all become more aware of the morality that we have allowed to become obscured in our daily lives.

There are only two mistakes one can make along the road to truth; not going all the way, and not starting.  —-Buddha

We have had a decline in morality that started over one hundred years ago and it still seems to be declining.  More people are worried about their taxes increasing then the poverty facing many people in this country.  More people are worried about their security then the number of people going to jail every day for victimless crimes.  More people are worried about the price of gasoline then the pollution we send into the atmosphere every day.  Self-centeredness has become a dominant fixture of the American landscape.  “Greed is Good” says Ivan Boesky and everyone applauds.

If you look for truth, you may find comfort in the end; if you look for comfort you will not get either comfort or truth only soft soap and wishful thinking to begin, and in the end, despair.   — C. S. Lewis

Why do I think we should care about morality? 

goodevilWithout morality, we are not even as good as animals.  Animals eat, drink, sleep, procreate and fight when they have to.  They do not do it simply to hurt other animals or to wage war against groups or individuals that they cannot tolerate.  Animals care for their young and exhibit many characteristics of moral behavior.  In captivity, animals may display much more aggressive behavior.  For instance, Orcas in the wild have never been observed to kill other Orcas.  This is not the case for Orcas in captivity.  There is no such thing as civilization without a commitment to moral and ethical behavior.  Even animal societies are proof of this.

“I am Envy, begotten of a chimney-sweeper and an oyster-wife. I cannot read, and therefore wish all books were burnt; I am lean with seeing others eat – O that there would come a famine through all the world, that all might die, and I live alone; then thou should’st see how fat I would be! But must thou sit and I stand? Come down, with a vengeance!”  ― Christopher MarloweDoctor Faustus

Without morality, we have no compass to define what is good behavior and what is bad behavior.  We are reduced to the level of opportunists willing to take advantage of anyone and anything that suits our ends.  Listen to the current debate on the use of torture and the recent CIA report and you will find numerous “experts” advocating that the “ends justify the means.”  One man on NPR noted that he thought we should ask the victims of the Twin Trade Towers what they thought about the use of torture to capture Osama Bin Laden.   John McCain said it best when he opined in Congress (12-9-14) that “”Our enemies act without conscience. We must not.”  Nevertheless, he is opposed by his own party in his opposition to torture and in fact to even releasing the CIA Tortmoralityure Report.

Many Republicans have argued against releasing the report, especially as the threat of the Islamic State in Iraq and Syria grows, and U.S. intelligence officials have warned that its release could cause backlash from nations and groups hostile towards the nation. American embassies in the Middle East have been put on heightened security alert for its release.

McCain replied that “This report strengthens self-government and, ultimately, I believe, America’s security and stature in the world.”  (CNN 12-9-14)

Finally, without morality, there is no way to transmit values from one generation to another.  A lack of morality has led to the increase in amorality that is now symptomatic of our society.  Amorality is a set of beliefs which deny the value of morality or at best are indifferent to morality.  A rock is amoral.  It is neither good (moral) or bad (immoral) but may be used for either purpose.  Anything or anyone without a conscience is amoral.  It is a fine line and one that is very easy to trespass between amoral and immoral.  Many people today may think their behaviors are amoral when actually they could better be described as immoral.  Harken back to the Seven Deadly Sins and ask yourself, how many of these vices are amoral?  Are greed, gluttony, lust and wrath amoral?   Can anyone with a good conscience say it is okay to partake in these vices?

“Seven deadly sins,
seven ways to win,
seven holy paths to hell,
and your trip begins

Seven downward slopes
seven bloodied hopes
seven are your burning fires,
seven your desires…”
― Iron Maiden

Time for Questions:

What is your moral code? What are the three most important morals in your life?  Do you think everyone should have an explicit moral code?  Why or why not?  Do you know many amoral people?  What do you think about amorality?  When is it justified?  What do you think the world would be like if everyone was amoral?  Would it be a better world or worse? Why?

Life is just beginning.

“Remember tonight… for it is the beginning of always”  ― Dante Alighieri

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