May 13, 2014

Patient Advocacy Workshops: 

This Sunday, May 18th at 11:00 a.m., I am giving a free workshop on PATIENT ADVOCACY at the Paint Creek Unitarian Universalist Congregation that meets at the First Congregational Church, 1315 N. Pine St, Rochester MI 48307.  This will be a 15-20 minute short version of information.  See post for May 4th, below, for more 

information on a free, full presentation.


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

May 5, 2014

Patient Advocacy book: 

One of my elder law colleagues took two years off from her practice and wrote about patient advocacy issues after her mother died from medical mistakes.  Jeanne Hannah has graciously donated dozens of books to me to give to clients.  If you would like a free copy, call!


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

May 4, 2014

Patient Advocacy Workshop: 

On Thursday, May 22, 2014 at 6:30p, I am giving a FREE workshop on how to be a Patient Advocate.  We are often thrust into this role with no training, and must often act at lightening-fast speed, making perhaps life and death decisions when our emotions are on overload...not to speak of not understanding much about the medical system, culture or language!  Talk about impossible!  I will be educating the layperson on how best to advocate for good care for their loved one.  Hope to see you there!  


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology



January 29, 2014

How Do I Appeal A Hospital Discharge?


If you receive Medicare, you can appeal your discharge from a hospital if you believe you are being discharged too soon.  You must contact the Quality Improvement Organization (QIO) for your geographic area.  In S.E. Michigan, the QIO is the Michigan Peer Review Organization at 22670 Haggerty Rd, Farmington Hills MI, (248) 465-7300.


You must have received notice from the hospital of an impending discharge at least 2 days before the scheduled discharge date.  Once received, you have until noon of the following day to contact your QIO.  The hospital's decision will be reviewed by physicians at the QIO and their determination will take up to 72 hours.  During the pendency of the appeal, you cannot be charged for your hospital stay.


If the QIO's decision supports the hospital's, then you will be discharged on the date indicated on the QIO'S determination notice.  If the QIO agrees with you, your hospital stay continues until the hospital again determines when your discharge is proper.


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology


May 19, 2014

Patient Advocacy Workshop SUCCESS 

Yesterday, I presented a free workshop at the Unitarian Universalist Church in Rochester MI.  Several audience members commented on the high value of information presented.  Many people went away much better informed to more effectively advocate on behalf of their loved ones.  The next FREE PATIENT ADVOCACY WORKSHOP occurs this Thursday, May 22nd, at Gilda's Club of Metropolitan Detroit, on Rochester Rd, 3 blocks north of 13 Mile Rd in Royal Oak MI.  Come and learn think you'd never think to ask about in 

advocating for better health care.

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

May 28, 2014

You Don't Have To Be A Doctor To Save Your Loved One's Life! 

I have no medical training.  Yet, three times I saved my mother's life over the 22 years I cared for her.  Let me tell you about one of those times...


Mom had always fought off colds and flu, even well into her elder years.  But something changed upon another round with the common cold.  Her body changed.  As one ages, the body's ability to metabolize prescription medications, and fight infection both change.  When she didn't feel well, she understandably didn't eat much.  When she didn't eat much, her blood sugar began to drop.  Yet, the assisted living facility's medical care team did not take note of this and continued to administer her diabetic medication, further driving down her sugar.  


When I visited her that night--I hadn't intended on returning a 3rd time that day, but my instincts told me to check in, she was semi-comatose.  After considerable internal debate, I decided to call the ambulance (she had been through the medical maze for 18 years by then and clearly wanted not to go to the hospital).  I talked with her and told her I was not a medical expert, and that I could not leave her for the night with her being scared about what might happen.  So she agreed to go to the emergency room.


Her blood sugar had plummeted to 36!  Normal is 120.  Her reading was next to fatal.  She was immediately put on IV and within minutes, she became herself again.


Had I not returned that night, she would not have been checked on for another 12 hours, until morning breakfast.  She would not have survived the night when 12 hours earlier, she was a hair's breath from death.


NEVER UNDERESTIMATE your instincts.  Always trust yourself in making the right calls, or call for help.  Finally, know that the personal care staff in the assisted living facility may be unable to connect the dots between someone's changing condition, and necessary tweaking of regularly scheduled medications!

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

May 23, 2014

Free Patient Advocacy Workshop @ Gilda's Club A Great Success! 

We had a great, interactive discussion on dilemmas faced by patient advocates.  We shared about the problems we have faced while interacting with the health care profession on behalf of ourselves or our loved ones.  We talked about how some doctors began their visits by saying, "I hope you don't have a lot of questions," how busy medical staff dodge questions and what we can do to get critical and specific answers, how to request a medical chart review (our own or our loved one's) when staff treat them like Fort Knox yet we have clear legal authority, and much more.  Gilda's Club graciously added soup and sandwiches.  We all had a great and informative time!  


Stay tuned for the next free patient advocacy workshop!

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

June 3, 2014

You Don't Have To Be A Doctor To Save Your Loved One's Life! 

I have no medical training.  Yet, three times I saved my mother's life over the 22 years I cared for her.  Let me tell you about another one of those times...


​After she had her massive stroke in 1990, she remained in rehab for several months.  In visiting with her one day, she pointed to her stomach.  Since her speech was permanently knocked out by the stroke, she could not explain to me what the problem was.  So I went to the nursing station.  A nurse explained to me that a intramuscular shot of Heparin had just been administered.  Knowing that was a fast-acting blood-thinner, I asked why, especially since she was already on a blood thinner, Coumadin.  She said the doctor ordered it.  I asked to talk with the doctor.


I was put in touch with him by phone and asked him the same question.  I learned two lessons, to my horror.

First, I learned that the nurse had not told him my mom was already on a blood thinner.  He admitted the Heparin injection should never have been administered.  So, it became clear to me that simple and perhaps deadly mistakes can be made in patient care over simple communication errors.  Second, I asked him when he last saw my mom.  I was stunned to learn that he only was required to physically see each patient once every 30 days while in the nursing home!  This meant that virtually all doctors orders are done over the phone.


Never assume once your loved one is in long term care that your patient advocacy duties are lessened.  Constant vigilance is required on our part as patient advocates to help insure our loved ones get the best care possible.


SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology

June 27, 2014

Getting Patient Information On A Hospitalized Patient

This past week I asked to see a patient chart at a hospital, and had the proper legal authorities lined up to do so.  As is always the case, I was told that the hospital would be happy to supply anything needed at discharge.  I explained that in my Geriatric Care Manger capacity (not my elder law attorney capacity), I was there to help all parties insure the best care for my 96 y.o. client.  Still, releasing chart information was not something they or any hospital wants to do while the patient is there.  I added that I was familiar with HIPAA, and that the patient advocate has a right to request such information while the patient is hospitalized.  I had a release from the patient advocate to obtain this information.  The nurse conferred with her powers to be, and finally returned with the requested information.  

In another similar encounter, after being put off by the RN, Resident, Unit Nurse Mgr, and Director of Nursing, I finally walked into the Chief Legal Counsel's office and explained that a Patient Advocate has the right to see a medical chart during the patient's hospitalization.  He said, "You're absolutely right.  Ask the nurse to review the chart with you."  That's where I'd begun 3 days ago!  You'd think the problem was solved....

However, shifts change.  A new cast has to be persuaded.  I finally pulled out the Chief Legal Counsel's card and said, "He said it was OK, call him."  

It's never easy to get patient chart information during one's hospitalization, but it can be done with a heavy 

dose of knowledge and perseverance!

SUE E. FABIAN, J.D., M.Ed.

ElderWISE Advisor/Advocate

Elder Law Attorney

​Certified in Gerontology