Being an advocate for a senior requires more than making doctor appointments and helping to ensure the senior makes it to the appointment. That is the simple part. Some seniors may not want to press doctors regarding their care because they are afraid they will be punished by not getting the care they need.  Doctors may be so busy that they will sometimes miss crucial issues on the charts in front of them or may accept non-committal answers from a senior scared to death of hospitals and ending up in a nursing home and not look deeper for the underlying cause of health issues.

This is written not to disparage the health care professionals who care for seniors. However it helps the doctor to know someone is with the senior who cares enough to know their medical history and to ask questions about problems they are experiencing. Of course, the trick is to leave the dignity of the senior intact by first letting them provide as much information to the doctor as they are willing or able to supply and to ask as many questions as occur to them.

Important Point #1: If you, as an advocate, have POA over health care, you should keep copies handy, even scanned into your computer (both at home and at work), so that if you end up in an emergency room situation, you can print a copy before leaving home or work to provide the hospital. Health care professionals are bound by privacy laws that restrict their ability to discuss a patient’s health with anyone but the patient, spouse, or the person the patient has designated by power of attorney over health care matters. Having a copy of a POA over Health Care in your possession to place in the medical records which designates you as having POA ensures that all health care professionals who work with your parent/in-law/friend will answer your questions about the patient’s care even if they have to tell you that they do not yet know the answer to your questions.

Important Point #2: If you end up taking a senior to the emergency room as I did my father-in-law, be prepared for a long stay. As the advocate for the patient, you will need to be on hand for the history taking process to point out previous hospitalizations, recent illnesses and to do so for each nurse/doctor/lab tech who comes to the patient’s bed. All the bottles of medications that the patient takes should be gathered and kept with you in a plastic bag for entering into hospital records. So have someone find you a comfortable chair near the patient’s bed and do not switch off with family members until all the tests are done and the doctor finally arrives with a diagnosis. After the attending physician tells you what the diagnosis is, if all the symptoms are not addressed, ask him/her questions. You may need those answers to make informed decisions. You could be there for a long time.

Important Point #3: If the patient is admitted to the hospital from the emergency room, make sure that the hospital staff knows you are to be informed of any change in the status or care of the senior and be sure to put a telephone number in the records where you can be reached 24/7. If there are to be any changes in rooms or any invasive procedures done, especially at bedside, you want to be informed.

(I was horrified to arrive at the hospital one morning to find that my mother was placed in a room with two other patients overnight while preparing for a colonoscopy, meaning she had to walk past the other patients all night to go to and from the bathroom as the detergent she was given to drink cleaned out her system. In addition, the staff planned on having the colonoscopy performed bedside with only a curtain between them and the other patients’ beds. I made sure my mother was moved to a room that had no other patients in it while the procedure was performed. But she needed me as an advocate to take care of her dignity.)

Not all the duties should fall on the family member who has POA. At this point, our family emails back and forth about post hospital care, how Dad is responding to physical therapy, who will take Dad for routine labs (not quite as crucial as the results, unless the technician finds something immediately that becomes an emergency situation) and what to do about Dad’s 91st birthday. We, as a family, are quick to update one another on health issues related to the senior members of the family.

Important Point #4: For serious and critical illnesses or for long distance caregivers, there are professional advocates who can be consulted. Many can be found simply by doing an internet search using the words senior advocacy.

If you are a member of the sandwich generation, looking for further advice, I suggest doing an internet search for articles by Gail Sheehy on caregiving.  The most important point she makes in her articles is that caregivers need to take care of themselves. It will not help either you or your loved ones if you are constantly drained emotionally and physically. Learn to pace yourself and to enjoy life’s milestones for yourself and for the seniors you love. Right now, I am looking forward to my mother’s 80th birthday and hoping to have her to cherish for many years to come. Live long, Mom, and prosper.

I got to thinking about this recently.

Who am I an advocate for?

Earlier that same day, I ran into one of my students in the ocean while I was on vacation. This 17-year-old teenager was so glad to see me that he leaped over and hugged me. After introducing me to his family he told them that I was the most caring, influential and helpful person in the whole school. As a School Nurse, this meant a lot to me.

I was the only one he perceived to care about him and what happens to him. He was on the verge of dropping out of high school. After astutely picking up a potential health related problem that significantly impacted his education, I referred him and his mother to a Neurologist. He and his mother were relieved to know that there was “a reason” why his grades were falling and he was having difficulty in school.

He was advised to get his GED.

Standing in the water at the beach I had a conversation with him that I hope will change his life forever. He made a decision to come back to high school and finish his education. Although he is a smart student, his challenges drew him away from being the model high school student and completing the curriculum. Cynical staff members wrote him off as being “lazy” and a problem student.

I believed in him.

Standing on the beach with my cell phone in hand, I placed a phone call to the principal of the high school on his behalf. There was only three weeks left in the summer before school starts. The time to act and put the wheels in motion was NOW.

He hugged me so many times to thank me for helping him and believing in him.

I was glowing. I was his champion and advocate.

Advocacy for our youth and challenged individuals comes in all shapes, sizes and packages. We don’t have to be in the Kennedy family to make and create change. Creating an opening for people and going the extra mile is a ripple in the steam of life that will continue on into infinity. Lives will be changed FOREVER. So let me as you, “Who are you being an advocate for?

ADHD advocacy is a nascent trend in the mental health industry. For years, children struggled without advocacy support while trying to cope in social environments and in the classroom. ADHD clinicians began to heed the call for advocacy, but their role was limited to medical education for parents and education personnel. National ADHD advocacy organizations have been effective in lobbying politicians for ADHD laws, especially in the areas of education and the workplace. National organizations have a macro sphere of influence, not the micro attention to detail that is parental ADHD advocacy.

Parents are the only true advocate for ADHD children. Their sphere of influence ranges from medications to ensuring education equity. While researching ADHD is a positive first step in becoming an advocate, knowledge of the condition is not enough to make an impact on an ADHD child’s life. Parents must become involved and make the commitment to advocate for their child. Here are some important areas that demand parental ADHD advocacy:

Recognizing the signs

ADHD education begins with recognizing the complicated signs of the condition. By complicated, I mean that some symptoms of ADHD mirror other disorders like anxiety and depression.

The best place to research ADHD symptoms is the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The manual provides a general list of 18 symptoms and the requisite criteria for making an ADHD diagnosis. Dr. Daniel Amen breaks down the 18 symptoms further by providing a detailed list of symptoms in checklist form.

Parental ADHD advocacy is ineffective if parents do not understand the basic symptoms of the condition.

ADHD clinician testing and evaluation

An ADHD diagnosis is a two-step process. Parents must make it a three-step process by carefully scrutinizing a list of clinician candidates. I recommend choosing a clinician based on your friends or family practitioner referral.

Parental ADHD advocacy involves creating a list of questions for each clinician candidate. Questions should include:

* How do you make a diagnosis?
* Do you have references?
* What is your position on ADHD medications?

Parents are usually involved in the second step of the diagnosis process, which entails the attendance of a significant other. Parents should also participate in the first step of the process. The first step is a series of psychological tests that determine if a second consultation is warranted. Parental ADHD advocacy during this step is observing how the clinician conducts the tests. Moreover, parents must eliminate any clinician who aggressively pushes ADHD medications during the first step.

ADHD Medications

The purest form of parental ADHD advocacy is understanding one fact: ADHD medications do not cure ADHD. The medications are prescribed to mitigate the symptoms. They are not a panacea, and there are other options that help children manage ADHD. The same concern for illicit drug use should be applied to the prescription of a stimulant narcotic for an underdeveloped human being.

If parents decide that ADHD medications are the best course of action, they must be vigilant when it comes to monitoring their child’s prescription. Side effects occur when a child takes the wrong dosage during the wrong time of day. This usually happens at school, so parents must clearly communicate their child’s ADHD medication regimen with a school nurse and administrators. They must also ensure that the medication does not fall into the hands of other children who are looking for a stimulant “high.”

Above all, parental ADHD advocacy means promoting the alternative treatments for the symptoms. This may entail banging heads with the clinician. Banging heads is a good thing when your child’ health is involved.

Exercise

The physical and mental benefits of a regular exercise routine far outweigh ADHD medications. Exercise is a long-term solution for rampant hyperactivity. ADHD medications are a quick fix that introduces potent chemicals into a child’s system.

Parental ADHD advocacy for exercise is more about changing a child’s sedentary lifestyle. Parents should encourage their children to refrain from playing video and computer games. The encouragement needs to start at a young age, when unhealthy habits are easier to change.

The ADHD establishment continually dispels the theory that too much television causes ADHD. While television does not directly cause ADHD, lying around without significant periods of exercise exacerbates the condition’s symptoms. Parents are the first line of defense to prevent a sedentary lifestyle from firmly taking root in a child’s lifestyle.

Diet and Nutrition

Sugar was once considered a contributor to ADHD symptoms. Once again, ADHD science seems to dispel the sugar attribution as myth. Nonetheless, a healthy diet based on nutritional components is, like exercise, an integral part of maintaining a healthy body and mind.

Parents may not have a stronger advocacy role for their ADHD children than the decisions they make about sustenance. Fast food is out. Fruits, vegetables, and fish rich in Omega fatty acids are in.

Competitive Sports

Many parents operate under the false assumption that sports participation curtails impulsiveness and hyperactivity. The energy released during a sport competition will calm an ADHD child. The problem, however, is distraction is a characteristic that ruins athletic performance.

Enrolling an ADHD child in sporting leagues is an excellent strategy to circumvent the mind numbing games played in front of television and computer screens. True parental ADHD advocacy means thoroughly explaining to the child’s coach what exactly constitutes the condition known as ADHD. Most coaches are amenable to adapting their coaching style in order to promote an ADHD child’s strengths.

Advocacy also means not pushing your child into a sport that he or she does not enjoy. Find the right sport and encourage the child to participate in it until they reach a level of superior performance or lose interest all together.

Education

A child’s ADHD diagnosis is often the result of school performance. Teacher and administrators notice the child’s distraction and hyperactivity, and bring the behavior to the attention of the parents. Parental ADHD advocacy for a child’s education achievement is irrefutably mandatory.

Pay attention to how the school system makes changes to enhance your child’s learning capability. Knowing ADHD laws is a start, but constant monitoring of your child’s performance and persistent insistence that the school adheres to ADHD laws strengthens parental ADHD advocacy. Part of Mark Norris`s work consists of developing a strong partnership between parents and academic professionals. With the parents consent, he organizes school meetings and follow ups with them, their child and the academic team involved in the child’s success. An objective and detailed portrait of the child’s strengths and challenges is presented and when necessary, classroom accommodations are established.

Parents can also provide a nurturing environment at home, where one-on-one tutoring complements the instruction given in school. The ultimate strategy in parental ADHD advocacy is to instruct your child in a home school environment.

Political System

Political advocacy means becoming involved in ADHD organizations that push legislators to write ADHD friendly legislation. At the very least, involvement in ADHD organizations will allow you to stay abreast of legal status changes that affect your child.

Parent Coaching

ADHD coaching is a growing industry. Most of the attention given to this alternative method for managing ADHD is how a coach benefits adults. Parent coaching is not about mentoring your child. It is about taking courses and assimilating information from a certified ADHD coach.

Parent coaching places you in the student’s role. You learn many strategies on developing your child’s strengths and mitigating the more onerous ADHD symptoms. Mark Norris is at the forefront of this invaluable movement. He has developed a comprehensive site dedicated to the issue and a detailed coaching program that he implements for adults.

Four to six percent of the United States population is estimated to have ADHD. Recent trends indicate the percentages will sharply increase. Most of the increase is due to the burgeoning diagnosis rate among children. As the rate continues to rise, parents must be aware of the advocacy responsibilities they inherit as their child navigates the turbulent waters of ADHD.

Advocacy means involvement. Involvement does not happen unless you have a deep commitment for your ADHD child’s progress.