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1. Chronic care emphasizes the maintenance of function and prevention, while the current healthcare system is focused on curing and restoring
Within the contrast of these conflicting agendas, the term “medical necessity” has become a focus of contention and frustration The Nurse as Advocate
2. Education is an important part of advocacy
It is important to empower patients and families to become self-advocates
Educate on the ramifications of insurance coverage
Instruct how to frame an appeal
Advise on how to engage healthcare team in the process The Nurse as Advocate
3. The Nurse as Advocate Spokesperson and advocate in negotiations with case managers and other decision makers
Investigator and linkage to community programs
Liaison to the pharmaceutical industry
Innovator and developer of programs and services
4. Patient Receipt of Adequate Care Navigating private insurance, Medicare, Medicaid
Prescriptions
Long-term care
Living wills
Clinical trial participation
5. Patient Rights and Protection Americans with Disabilities Act (ADA)
Health Insurance Portability and Accountability Act (HIPAA)
Family and Medical Leave Act
Healthcare proxies
6. Life Planning Advance directives
Living will
Healthcare proxies
Power of attorney
Trusts
7. ADA and Disability Rights Rights of the disabled
Accessibility
Reasonable accommodations
A level playing field for the disabled
Removal of obstacles to independence
Dynamic legislation for the disabled
8. Tools of Advocacy Major issues affecting people with MS
Patient rights legislation
HIPAA—protection and confidentiality
Expansion of health insurance coverage
Broadening of Medicare/Medicaid
Pharmaceutical assistance programs
Long-term care costs
Caregiver tax credits
9. Empowerment and MS Empowerment in MS can be defined as self-direction with an underpinning of hope
Empowerment enables recognition of skills and resources
It involves skill development, coping, mastery over the environment, and flexibility
10. Empowerment and Self-Efficacy Self-efficacy is the belief that one can achieve desired outcomes through behaviors
Personal beliefs will affect effort, the length of perseverance, and the level of anxiety or depression
Adherence and self-efficacy have been strongly linked
11. Promoting Self-Efficacy Mastery over the environment
Vicarious experiences
Persuasive information
Enhancement of physical and psychological states
12. Empowerment by MS Nurses Facilitate goal setting
Provide experiences with peers
Provide ongoing affirmation/“cheerleading”
Maximize wellness
Encourage motivation
Affirm the worth of each person
13. Patient Advocacy and Resources
14. Conclusions Information and knowledge are power
Personal energy is power
Nurses affect a broad spectrum of the healthcare industry
Nurses function in positions that influence societal change and can influence the future of healthcare
Nurses are a powerful voice of advocacy and empowerment