Healthcare Advocacy for the Elderly: Community to Policy

Introduction

Ageism, isolation, and misconceptions about gerontology are all issues that the vulnerable elderly population faces (Brojeni, Ilali, Taraghi & Mousavinasab, 2019). As Yamada et al. (2015) point out, however, healthcare disparity and healthcare inequality among the elderly represent one of the biggest issues because they underlie all the others: if the elderly population does not have sufficient access to care, it is unlikely to be able to battle the effects of ageism, isolation, or ignorance about gerontology. Healthcare costs have doubled since the 1990s (Yamada et al., 2015), and this places an added burden on the elderly population, whose resources are finite. Yamada et al. (2015) put it this way: "as healthcare costs rise, more of the increasing costs are transferred to certain disadvantaged populations, and patients would have to spend a considerable share of their healthcare costs out-of-pocket" (p. 1745). In other words, the cost increases of healthcare are shifted onto vulnerable populations — and too few advocates are speaking up in their defense against this injustice.

While access disparity and unmet needs for vulnerable populations are often the result of complex healthcare policy arrangements, the federal government through the legislative branch could create a more equitable path for the elderly. For example, Congress could pass a law that eliminates the out-of-pocket expenses that elderly persons must pay for care. This paper discusses how healthcare advocates can aid the elderly population and the ethical concerns that should be considered as health advocate workers shift from a community setting to that of a business.

How Healthcare Advocates Can Aid the Elderly Population

Three ways in which healthcare advocates can aid in addressing and delivering vital healthcare practices to the elderly population are: 1) to organize, inform, and rally the community; 2) to engage politically so that legislation can be passed supporting greater equity for the elderly in healthcare; and 3) to work with seniors directly so that they know they are being supported.

Organizing the community is one of the most important ways in which healthcare advocates can aid a vulnerable population because, ultimately, it is the community that will need to band together to effect real change (Maryland & Gonzalez, 2012). One aim of organizing the community is to raise awareness about the issue. If no one knows why there is a problem, no one is going to do anything to address it — such as writing to a congressman or volunteering at a nursing home. Information is power, and when one organizes the community with the aim of spreading information, raising awareness, and empowering the public to act, the healthcare advocate can make meaningful strides in helping the elderly population simply by getting others educated and involved.

One way to do this is to host community forums. Community centers are ideal locations for these kinds of forums: the public knows where they are, they are accessible, and they can accommodate a good-sized crowd. The healthcare advocate can invite members of the elderly population to speak directly to the public, or can speak on behalf of the elderly community by sharing their stories and experiences — whether those touch on the inability to pay for care, the isolation that comes from being marginalized, the effects of ageism, or other concerns. Financial issues, transportation barriers, depression, and social withdrawal are all risks that the elderly face, and making those risks known to the public is what can begin to change the situation by inspiring people to act. As Community Health Advocates (2015) demonstrates, the advocate can partner with local organizations to further promote education and assistance to the vulnerable population and ensure that its needs are being met.

Getting information online and out to a broader audience is another effective way to reach the extended community. Because this issue is not limited to any one locality but impacts the elderly population across the country, it is important to reach a wider, nationwide audience. One approach is to use online services such as blogs, social media platforms like Twitter and Facebook, and video streaming services like YouTube to create educational material that can be quickly and conveniently shared by users around the world. Awareness campaigns can gain traction through hashtags on Twitter, drawing in others who want to support the initiative. Even crowdfunding is a viable solution, as many people today use platforms like Kickstarter and GoFundMe to secure financial support from the online community for causes they believe in.

Organizing the community should be carried out at both the local and national levels to ensure that the disparities the elderly population faces can ultimately be addressed at the federal level. Getting the attention of lawmakers requires people to band together and direct their voices to the government. Using the tools of social media alongside the engagement of one's local community can help move the process in the right direction.

Getting Politically Engaged

If the aim is to enact legislation that would close healthcare disparities for the elderly, the healthcare advocate will need to become politically active at some point. Just as other organizations engage lobbyists to advocate on behalf of their interests in Washington, advocates have to become their own lobbyists — meeting with politicians, conveying information, and demonstrating why many people expect Congress to act. The more pressure the advocate can put on politicians, the more likely real legislative change in favor of the vulnerable population becomes.

Advocacy organizations already exist that a healthcare advocate can join in order to achieve these aims, as Stainton (2016) shows: "Horizon Blue Cross Blue Shield, the state's largest health insurer, has agreed to fund a new advocacy organization comprised largely of business and labor groups in an effort to educate consumers on New Jersey's evolving healthcare system and seek public input on how to improve this changing landscape." This illustrates that a number of stakeholders in the healthcare industry have a vested interest in understanding community needs and finding ways to address them. A healthcare advocate does not have to go it alone but can work within existing advocacy organizations already set up to improve the healthcare environment.

Getting in direct contact with legislators remains the central goal, however, for those who wish to effect legislative change. One can write to congressmen, arrange meetings, or call their offices — but without useful information, concrete facts, and a convincing presentation, the chances for change are limited. Advocates have to engage with lawmakers at a high level: they must be informed, influential, and able to demonstrate broad national support for the policies they are promoting. Legislators, like business executives, respond to numbers — the more support an advocate can demonstrate, the more seriously a legislator is likely to consider drafting or co-sponsoring relevant legislation.

Conclusion

Healthcare advocacy for the elderly should focus on organizing the community, engaging with politics, and reaching out to the population itself to make sure its needs are being met. The advocate must focus on each of these three areas regardless of whether situated in a community setting or a business setting. Advocacy is not a one-dimensional affair. Health advocates must be engaged on multiple levels and truly committed to fighting for the rights and needs of the population they represent. They must always be looking out for and protecting the people — whether that means meeting with the community, giving presentations to raise awareness about the needs of the elderly, using social media to spread information at a national level, interacting with politicians to help promote or craft legislation that would close the gap in healthcare disparities, or interacting directly with the elderly population and organizing volunteers who will come to their residences to spend time with them.