When a Health Crisis Happens: Why Having a Patient Advocate Can Make All the Difference

Most families don't expect a health crisis to happen. We go about our daily lives, taking care of work, children, parents, and everything in between. Then suddenly, a loved one falls, receives a serious diagnosis, or ends up in the hospital—and everything changes.

In this episode of HELP! Nobody Told Me, Jasmine Shapiro and Jordan Kagan sit down with Mary Federowski, CEO of Avoa Health, to talk about what happens when families suddenly find themselves navigating the healthcare system and don't know where to begin.

Mary brings more than two decades of experience in healthcare, beginning her career as an EMT before working on the corporate side of healthcare with organizations including Blue Cross Blue Shield, Delta Dental Plans Association, Advocate, and Ascension Healthcare Systems. Her own family's experience with the healthcare system eventually led her to ask an important question: What happens to families who don't have someone they can call for help?

That question ultimately led to the creation of Avoa Health.

The "Sandwich Generation" Is Carrying a Lot

One of the challenges discussed in the episode is the growing number of people who are simultaneously caring for children and aging parents.

Mary explains the term "sandwich generation" as people who may find themselves caring for younger family members while also helping their parents or grandparents. In some families, multiple generations may need support at the same time, leaving one person trying to manage the needs of several loved ones while still working and taking care of themselves.

The responsibility can quickly become overwhelming.

A family member may suddenly find themselves coordinating appointments, communicating with doctors, understanding insurance, handling finances, managing medications, arranging transportation, and making important decisions—all while trying to remain a son, daughter, spouse, parent, or grandchild.

As Mary points out, an unpaid caregiver can end up becoming the medical expert, financial expert, insurance expert, project manager, chef, and much more for their family member.

And when all those responsibilities pile up, the family relationship itself can suffer.

Why Do Families Wait Until There Is a Crisis?

One of the most important conversations in this episode is about why people often wait until something goes seriously wrong before asking for help.

Mary says many of the people who reach out to her are highly capable, accomplished individuals. Their instinct is often to think, "I just need to work harder. I can figure this out myself."

The problem is that by the time they realize they are overwhelmed or burned out, the situation may have been going on for months or even years. Other families don't seek help until a major "trigger event," such as a fall or health crisis, forces them to recognize that they need support.

But planning doesn't have to begin with a crisis.

In fact, one of Mary's biggest messages throughout the episode is simple:

Get ahead of it.

What Does an Independent Patient Advocate Do?

A patient advocate can help families navigate the many logistical and administrative challenges that come with healthcare.

Mary explains that Avoa Health does not provide medical advice. Instead, the team helps families understand their options, coordinate resources, navigate healthcare systems, and reduce the administrative burden that can fall on family members during an already stressful time.

An important distinction Mary makes is between a hospital-based navigator and an independent patient advocate.

Hospital-based navigators can provide valuable support within their healthcare system. An independent advocate, however, isn't tied to a particular healthcare system or provider. That allows them to look at the individual's needs and help identify options across different systems and providers.

That independence can be especially useful when a person's care involves multiple doctors, hospitals, insurance companies, or geographic locations.

Sometimes, Having Someone There Changes Everything

Mary shared one story that illustrates why advocacy can matter so much.

A client who lived in Southern California suffered a serious fall while visiting Chicago. He broke both arms and his kneecap and had no family nearby. His family eventually had to return home to their own jobs, children, and responsibilities. Avoa Health stepped in to help coordinate his care.

There were several complications. The patient needed to be transferred between hospitals, the hospitals were struggling to communicate with one another, and there were insurance complications because his coverage was from outside Illinois.

Mary and her team helped communicate with hospital staff, assist with paperwork, coordinate with the receiving hospital, and work through the insurance issue. The transfer that could have taken weeks was ultimately completed in two days.

The family could support their loved one from a distance, but having someone physically present to advocate and coordinate made a significant difference.

As Mary put it, being able to step in and say, "I need your help with this" can sometimes help move things forward.

Healthcare Advocacy Isn't Just About Medical Decisions

Another important takeaway from the conversation is that healthcare decisions often have financial and administrative consequences, too.

Mary encourages people to pay attention to their medical bills and insurance statements. Her team can provide a general review and identify things that may warrant further investigation, although she notes that she is not a medical biller.

One practical tip she shares is to ask for an itemized hospital bill.

If you receive a large medical bill, understanding exactly what you're being charged for can help you determine whether there are charges that need clarification. Mary also encourages people not to be afraid to ask the billing department whether there are options for reducing a bill or negotiating the amount owed.

Her message is straightforward: advocate for yourself financially, too.

Have the Important Conversations Before You Need Them

Perhaps the biggest lesson from this episode is that planning ahead can make an enormous difference.

During the lightning round, Mary was asked what the biggest mistake families make is.

Her answer?

Not talking sooner about what that person wants for their healthcare.

That conversation can start with a simple question:

"What does a successful day look like to you, and what resources do we need to have in place to make that happen?"

That question can open the door to conversations about where someone wants to live, what kind of care they would want, who should make decisions for them, and what support they may eventually need.

It may not be an easy conversation, but having it while everyone is healthy and able to participate can make future decisions clearer.

Make Sure Your Important Documents Are in Place

Mary also recommends making sure you have the appropriate powers of attorney for healthcare and finances, as well as an advance directive when appropriate.

Just having these documents isn't enough. Families should also know where the documents are and make sure the people who may need them can access copies.

Mary explains that Avoa Health keeps virtual copies of these documents for clients because situations can arise where the documents are needed unexpectedly.

The goal is to avoid discovering during an emergency that an important document is sitting somewhere inaccessible.

Plan Earlier So You Can Stay at Home Longer

When asked whether people should focus on staying at home longer or planning earlier, Mary's answer was:

"Plan earlier so you can stay at home longer."

Planning doesn't necessarily mean making every decision about the future today. It means having conversations, understanding options, organizing important documents, and knowing who can help if circumstances change.

And perhaps most importantly, planning can give families more choices when those choices are still available.

As Mary says near the end of the episode, much of this begins with a conversation—and conversations are free.

Don't Wait for the Crisis to Start Planning

A healthcare crisis can be overwhelming enough without trying to figure out the system at the same time.

Whether you're caring for an aging parent, helping a spouse, raising children, or simply thinking about your own future, this episode is a reminder that asking for help isn't a sign that you can't handle things. Sometimes, having the right person beside you can allow you to spend less time managing logistics and more time simply being there for the person you love.

The best time to start planning may have been years ago. The next best time is today.

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Listen to the Full Conversation

Want to hear more from Mary Fedorowski for more insights on patient advocacy, caregiving, healthcare navigation, and preparing for the unexpected?

Listen to the full episode of HELP! Nobody Told Me and join Jasmine Shapiro, Shannon Johnson, Mindy Leonard, Jordan Kagan as they continue the conversation about the life transitions nobody gives us a manual for.

This blog is based on the conversation featured on the podcast and is intended for general informational purposes. Senior care, medical, legal, and financial decisions depend on individual circumstances and should be discussed with appropriate qualified professionals.