I have a friend, 54 years old, who was completely healthy in every way, until last weekend when he had a stroke out of the blue. So far they don't know what caused it, because he's fit, perfect weight, normal cholesterol and BP, etc.

He's in the hospital, and I'm not convinced he's being moved along fast enough, though I could be wrong. He had a Modified Barium Swallow test, the result is severe risk for aspiration, and cannot swallow at all, he's on a do not feed or drink order for obvious reasons. He's using a feeding tube into his stomach through his nose.

During my visit today I found the head nurse and asked her to help me figure out what is going on with his treatment plan, and discovered that it's a pretty loose affair, and that their job is simply to diagnose and stabilize him before he can enter an IPR (In-Patient Rehabilitation hospital).

I've never been a patient advocate before, so I want to do the best I can to get him moving along.

My feeling, though I may be wrong, is to get him out of there as soon as possible and into the care of specialists who can get his swallowing organs working again, and of course, the rest of him better after his stroke, since he can't really walk on his own, though he is chugging along on a walker with a PT and OT helping him.

He doesn't have any family to help him, he's on his own with no advocates to speak of.

Can you guys give me any advice to help him along ? I feel very strongly that time is the main enemy here, though again, not being a medical person, for all I know I could be wrong.

Any advice very much appreciated.

I'm sorry to hear about your friend, hope he recovers from the stroke.

As for patient advocate, the best you can do is stay on top of things, be there to ask questions and let them know he's not on his own.

Problems might be you not having a relative link, and no written permission to receive any information on his healthcare, ie HIPAA rules.

Sounds to me like he's going through the typical post-stroke care. It's been a week. Initial treatment, whatever his case was, then aspiration precaution, then rehab. You can't rush his swallowing. The fact that he can ambulate with assistance is encouraging. A lot of stroke patients can't even do that a week later. Did he lose his ability to speak? How does he communicate his wishes? Since he has no family, to bypass HIPAA, see if he's ok with you being his advocate and being able to receive all his medical info.

Yes, he can speak, but it's more like a whisper, since his voicebox isn't working, though he cracks into semi-normal voice, going in and out from whisper to broken voice.

Yes he can communicate fine, you just have to listen closely. His mind is 100%, he's just plumb worn out.

He already gave verbal permission to the nurse in charge to let me know his medical information, and he told her to let me help him as his advocate.

So the nurse put me into the computer as being allowed to know his medical information, but did not mark me as family in the computer, since I'm not. She sent a note to his Hospitalist MD, an Internal Medicine physician, with my name and phone number.

IF the doctor can't talk to me because I'm not related by blood, is there any paperwork he can sign to allow me to act on his behalf as his advocate ? I'm pretty good at getting things moving along, I just have to avoid being an asshole. He's an engineer by trade, and fully capable of handling his case, but he is very weak and sick, and I'm not confident he can do it without help. I'm working with his neighbors to help out with his house and pets, and will be expanding that by going there myself to take care of stuff, and perhaps helping with his bill paying and other stuff like that you can't deal with when you're down and out like that.

He doesn't need a power of attorney thing or anything like that, he's 100% mentally fit and can communicate effectively. I just want to get things moving, scheduled, and keep all those records and follow up to get him better before a serious complication pops up for lack of attentiveness or the hospital care community dragging their feet for lack of a better term.

So, is there paperwork like that that will allow the doctor to let me help him execute on his wishes with specialist care, getting things filled out and signed to switch on specialist care, transfers to specialized rehab, etc., as soon as is possible ?

Hat Tip wrightd for stepping up. Prayers sent.

Healthcare Power of Attorney is what it’s called where I am and that’s what you need to get ASAP.
If the hospital has a patient advocate, see if they can help you get that document and any others done.
Sounds like that facility is being very cooperative but down the road another place may require that.
Also try to find out what his insurance covers.

quote:

Originally posted by 220-9er:
Healthcare Power of Attorney is what it’s called where I am and that’s what you need to get ASAP.
If the hospital has a patient advocate, see if they can help you get that document and any others done.
Sounds like that facility is being very cooperative but down the road another place may require that.
Also try to find out what his insurance covers.

Yes he as very good employer based insurance with a solid carrier. But, he can make all his decisions himself, so I don't know what this "Healthcare Power of Attorney" means. If it means HE is in charge I can jump on that fast, if all it is is carrying out his personal decisions for all that stuff.

quote:

Originally posted by wrightd:

IF the doctor can't talk to me because I'm not related by blood, is there any paperwork he can sign to allow me to act on his behalf as his advocate ?

Yes, it’s called a Medical Power of Attorney. Should be pretty easy to get one and get it signed by him. This would allow you the same information he is allowed and would allow you to make all medical decisions for him.

Yea, that's a little confusing for me, since he is 100% metally fit, but probably not clear like he is running an engineering project like he does all day long before he got sick. Just someone to keep all the medical conversations and decisions he approves on his own, and helping him stay up to date etc. I don't think he can do all that at this time by keeping evertying in order and making things happen, he's just too weak, but if I say, I talked to these doctors and facilities and they are recommending xyz, and if you approve, I'll help you with the paperwork and followup etc. That sort of thing really and nothing more.

I guess I just made that unnecessarily complicated.

^^^ In that case, he can sign the hospital's own paperwork that he will explicitly allow you to receive all medical information related to his treatment. Every hospital and clinic has that sort of paperwork. Once you have access to all that, you can always discuss with him about what's going on, and he determines what he wants done or not done. Yeah, you're not making medical decisions for him.

I'd recommend what's been advised above and try to get a Healthcare (Medical) POA ASAP. He's a young guy who's had a stroke and currently coming back from it. Later, away from this medical facility, if he had another event you'd have the Healthcare POA to help with his care in the even he is unable to communicate.