When Planning Meets the Unexpected:

Why Patient Advocacy Matters Most in a Crisis

Even with careful planning and strong support systems, healthcare emergencies can happen without warning. For older adults, a single fall can quickly turn into a serious healthcare crisis. At Stepping Stone Advocacy Services, this is a reality we help families navigate every day.

Recently, this truth became personal for Lori Schellenberg, RN, CCM, founder of Stepping Stone Advocacy Services, when her mother experienced an unexpected fall at home.

A Fall Can Happen in an Instant—Even With Precautions

Lori’s mother lives independently in a Continuing Care Retirement Community (CCRC) and generally manages her daily activities well. She uses a brace for foot drop, and a walker for ambulation and is typically cautious about mobility.

One evening, after dinner, she removed her ankle brace to relax and decided to take a short walk in the hallway for a bit of exercise. Because the walk was brief, she believed she did not need the brace and planned to be careful.

Despite these precautions, she fell.

She does not know exactly how or why it happened.

Fortunately, she was close to her apartment door and was able to scoot along the floor to get herself back inside. Although her ankle was painful, she later managed to pull herself up holding on to furniture, and could stand. She hobbled to her chair and finished her evening watching television, and went to bed.

Several hours later, she woke during the night and attempted to get out of bed. This time, the pain was severe, and she could not stand. She contacted the concierge desk and called 911.

Emergency Care Is Only the First Step

Emergency medical services transported her to a new, state-of-the-art satellite emergency department affiliated with a nearby hospital system. She was evaluated promptly, and Lori was able to speak directly with the emergency department physician.

The diagnosis was a significant ankle sprain. The discharge plan included limited ambulation, leg elevation, ice, Tylenol, and Tramadol for severe pain.

While the immediate medical issue was addressed, patient advocates understand that discharge instructions alone do not ensure safety—especially for older adults after a fall.

Why Falls in Older Adults Require Advocacy

A fall, even one that appears minor, carries the potential for serious complications, including repeat falls, loss of independence, or hospitalization. Preventing further injury requires proactive planning, clear communication, and practical support at home.

Lori’s sister, who lives nearby, brought their mother home and helped ensure a safe environment. Ice was readily available, and a bedside commode, which was stored in her closet, (just in case she ever needed it) was placed in the bedroom, where her mother already had a lift chair, an adjustable bed, and easy access to essentials.

Before leaving, Lori’s sister confirmed that her mother could safely perform pivot transfers—from bed to chair, chair to commode, and back again.

Meals were arranged for delivery, and her primary care provider was notified of the fall, emergency department visit, diagnosis, and her temporary homebound status. A referral was requested for home health physical therapy, and the home health agency was contacted directly to facilitate timely follow-up.

This is what patient advocacy looks like after an emergency visit—intentional, coordinated, and focused on preventing the next crisis.

Education and Fall Prevention: Small Changes That Matter

Once the immediate situation stabilized, Lori reinforced critical safety education—an essential component of effective patient advocacy.

Her mother was reminded of the importance of wearing her ankle brace during all ambulation, even for short distances and even when she feels confident. Many falls occur during routine activities when individuals believe they can “be careful.”

In addition, the family made a preventive decision to leave the bedside commode in place for nighttime use on an ongoing basis. Because her mother does not wear her brace at night, eliminating unnecessary walking to the bathroom significantly reduces fall risk during vulnerable overnight hours.

These are small, intentional changes—but they are often the difference between recovery and repeated injury.

Why Patient Advocacy Makes a Difference

Today, Lori’s mother is recovering well. What could have escalated into a life-altering event was stabilized through timely medical care, proactive follow-up, and thoughtful planning.

At Stepping Stone Advocacy Services, we see firsthand how quickly a “small” emergency can become overwhelming for families—especially when navigating hospitals, discharge planning, home safety, and follow-up care.

This experience reinforces what we share with patients and caregivers every day:

Planning is essential. Education prevents complications. Advocacy matters. And no one should have to navigate a healthcare crisis alone.

Need help navigating a healthcare crisis or caring for an aging loved one?
Stepping Stone Advocacy Services provides expert medical, insurance, and care coordination advocacy to help families make informed decisions and reduce risk.

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