Kathleen Gillett from Dorset Macmillan Advocacy looks at what an advocate can and will do to support an older person affected by cancer:
When I explained to someone recently that peer volunteer advocates could accompany the person they are supporting to medical appointments they remarked ‘Like a befriender then?’ ‘Yes and no’, I replied.
The advocate, in addition to walking in the door with the patient (and carer) can do any or all of the following:
- Ensure the person has remembered the appointment, has satisfactory transport arrangements and knows exactly where to go
- Ensure the person knows what the appointment is for and who they are going to see
- Ensure the person has thought about the previous appointment and prepared for this one by thinking about what they would like to get out of it and writing down any questions they would like to ask
- Prompt the person to ask questions they have prepared and, if needed, ask the questions on the patient’s behalf
- Monitor the person’s understanding of any terminology used and ask them if they would like fuller explanations
- If the person is asked to make a decision about treatment options check whether they feel ready to do so and if not how much time is available
- Take notes during the appointment to make a written record for the person to refer back to later
- Make sure the person is clear at the end of the appointment what the next step will be
- Have a cup of tea while waiting for transport home
- Later on run through what happened at the appointment to see how the person feels it went, whether they felt comfortable and were treated with dignity and respect
- Discuss any treatment and care options and their implications and whether more clinical information is needed
- Agree with the person if any new and immediate needs have arisen and what they would like to do next.
I was reminded of reading Ken Worpole’s obituary of the hospice architect, Ian Clarke. Clarke ‘believed passionately that hospitals for the dying should be welcoming, reassuring places and he spent his career designing uplifting spaces for palliative care’. Clarke wrote of healthcare environments; ‘Why can we not get away from the ubiquitous ‘no-place’ hospital corridors that we are so used to?’
I agree that environment is important and have visited well designed hospices and cancer centres that clearly enhance wellbeing. However, for me when I go for the first time to a new place or have an appointment of significance in a familiar place, feeling well prepared and having a trusted person to go with me is equally important. This, coupled with the friendliness and manner of the staff that I meet there, will make a bigger impact on me than the surroundings in isolation.
Kathleen Gillett, Dorset Macmillan Advocacy
Older People Living with Cancer 