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Elder Advocacy: A Growing Field for a Growing Need

I was walking past the Veteran’s Building in my town when I noticed an elderly woman with a walker creeping towards me. She asked, “Are people there yet?” I said, “What do you mean? The building’s closed.” She was heading to an annual conference on the future (which sounded fascinating) but had jotted the wrong date on her calendar, and was a day late. “Oh well, I live just a few blocks from here. Guess I’ll walk home,” she told me.

I continued on to the library, and when I came out fifteen minutes later she had advanced perhaps 50 feet from where we spoke, and was trying to negotiate her way uphill. With the walker. And she was crying. There were other people around, but no one was paying the slightest attention to her.

I crossed the street and offered to assist until we reached the main road. By then I wondered how she was going to get home. It was high noon, scorching, and she was wearing a lot of layers she refused to remove, citing flabby arms. (Caring about our appearance doesn’t decline with age!)

So I walked alongside her. After another twenty paces, I said, “Dori,” (for by now we were friends), “It’s awfully far to walk, and so hot. Why don’t you let me drive you home?” She demurred, then accepted gratefully. I found her a bench in the shade, went back for my car, and drove the few long blocks to the senior housing community where she lives.

That day, I was acting as a de facto elder advocate.

As the population grays at a record rate, elder advocacy is mushrooming as well. Advocacy can take many forms, from tracking and reporting elder abuse (which often goes unreported because the elder is dependent on someone else for care — or due to diminished mental or physical capacities) to working with legislators, elder care facilities and social workers to ensure their needs are being adequately addressed.

One key issue involves medication. Seniors can easily become overmedicated from seeing multiple specialists, each of whom may write a prescription. While it’s difficult to assess precisely how many prescription medications someone 65+ takes daily, five appears to be average. Yet some seniors take between 10 and 20 pills per day — a staggering number. Just keeping track of what medication to take when, and in what dosage, can be daunting — and then there is the possibility of adverse drug interactions.

Medications can and do affect temperament and mental functioning. Without someone acting on a senior’s behalf, real problems can arise. One reverse mortgage professional reports, “I am hearing more and more about change(s) in mood and ability in elderly patients when changes are made to their prescribed medications. For example, a woman I have known for many years, who is now 97 and receiving full nursing care, went from responsive during conversations to almost a zombie state and unable to hold her head up and stay awake — slumping in a wheelchair. Her sister has been her advocate and overseer with the nursing home and raised questions regarding her sister’s treatment. Guess what?  A few days later, the doctor adjusted her medications and she returned to normal.”

This is also where power of attorney (POA) is critical, as discussed in HECM and the Differently Abled. If a senior decides to create a durable POA, which allows the POA to make decisions in the event of mental incompetence, they would be wise to also obtain a letter verifying proof of mental competence at the time the POA is signed. An Advance Directive can serve the same purpose as a healthcare POA, and would also protect the elder’s wishes by acting as a blueprint for their preferred health decisions in the event they are unable to voice their opinion. Ideally, a durable POA and Advance Directive work in conjunction to ensure a senior receives the care they desire.

But first an elder must know about these options, and choose to exercise them while of sound mind. Reverse mortgage professionals can serve as de facto elder advocates by suggesting seniors consult an Elder Law Attorney or a financial professional to put these important documents in place, long before they might ever be needed.