Sometimes, psychological support at the moment of trauma can help people move on. Knowing that someone is on your side, and being confident that what needs to be done on your behalf will be done, can be very soothing.
Patient advocates work as sounding boards. They may open up an important conversation by saying, “Let’s talk about how you feel about this change and how it’s going to affect all aspects of your life.”
Kilim offered an example of a case where careful listening made all the difference. “I had a patient with a serious lung disease who needed a machine to breathe,” she recounted. “He refused to engage with others, so I sat and talked with him about how using the machine will affect his life.” Once he felt heard, he came to his own conclusion and told his doctors, “I’m willing to use the machine.”
Kilim believes her services are most effective right after diagnosis or if a patient is facing a long road of rehabilitation after trauma. As a Patient Advocate, she accompanies the individual through a journey. “A storm is ahead and you want someone alongside you when you have to weather it,” Kilim explained. “Knowing that you have backup is helpful and reassuring.”
Patient advocacy is not about telling patients what to do. It’s about giving them information they need to make the best possible decisions and helping them get their voice heard. In this role, Kilim explains medical terminology and helps her clients manage all their paperwork and understand what it all means. She presents data-driven information about what the future is likely to hold and prepares them for anything that’s upcoming, such as an appointment with a specialist, a test or treatment.
“When you support someone through this sort of transition, you assist them going through the different stages of grief and building a new life. Being alongside someone when going through these stages of grief, you help them make a positive transition to a new identify without trauma.”
This requires allowing people the space to voice their concerns. Early on, Kilim talks with clients about the different aspects of their lives – eating, walking, relationships with family, traveling, their religious life. “The minute you talk about that, it gives people a safe space to consider how they will be affected. To give enough kavod (honor) to their issues. They might be angry with God. What does this mean for me? Why did it happen to me? I permit them to feel, and express, those things.”
Early in her medical training in the UK, Kilim knew she wanted to go into family medicine where the emphasis is on understanding the person in his or her world. “I was trained to see that patients are not an illness in isolation. This perspective translates well into patient advocacy and jells with supporting a person through the process.”
“I love being a family doctor, but I only get 10 minutes with each patient. I was disillusioned in [hospital] jobs. I could see that patients didn’t understand what was being thrown at them. I remember being at the bedside of an elderly woman. Her family was discussing whether or not she should have an operation. There are so many variables and the family is not equipped to help her. Should a 93-year-old make the decision? Should the family decide? Based on their values? Based on her values?”
As a young country built with ingenuity, Israel welcomes innovation. For Kilim and thousands of immigrants like her, making aliyah provides the chance to weave their skills and experiences in new ways, to improve Israeli society. “I know Patient Advocacy exists in the US,” she said, “but it’s a relatively new concept in Israel. I want to use my skills to help others.”