Caregivers, supporting

For patients receiving oral antibiotics either prophylacti-cally or as treatment of febrile neutropenia, counsel them that initial or persistent fever should be reported promptly and that compliance with the regimen is critical. Patients also should have easy access to medical care and adequate caregiver support. Provide information on drug interactions and adverse effects. 

Not all patients are appropriate candidates for outpatient VTE treatment. At a minimum, patients must be reliable or have adequate caregiver support. Patients and their caregivers must be willing and... 

These facilities usually consist of private residences or apartments housing six to 10 patients, with therapeutic services contracted by the facility and caregiver support. Not much available in the United States, these facilities are frequently used in many other countries (34). 

Educate patients and/or caregivers about the expected outcomes for patients with Alzheimer s disease, and provide contact information for support/advocacy agencies. 

Educate both the patient and caregivers about lifestyle modification and refer them to support when needed. 

Be a resource and give continuous support to the patient and caregivers throughout the long course of the disease. 

Complementary and alternative medicine therapies, such as acupuncture, biofeedback, chiropractic manipulation, dietary supplements, herbal therapy, and homeopathic preparations, are used by individuals with allergic rhinitis.29,30 Use of bromelain, gingko, ginseng, licorice, quercetin, and Urtica dioica has been reported, but large-scale studies documenting efficacy are lacking.31,32 Caregivers should inquire routinely about patients use of alternative therapies and counsel patients about the lack of validated data to support such practices.12... 

Several studies support this theory. One of them, published in 1995, observed 191 children at 6-month intervals during early and middle childhood. The study found that variables operating at the level of the family (mainly, quality of care giving, parents marital status at the time of the child s birth, emotional support given to the caregivers, and the caregiving style) were good indicators of which children would or would not show ADHD-related problems. The results indicated that the child s early experiences do have an effect on the development of ADHD.16... 

There is no cure for Alzheimer s disease. Historically, management has been aimed at enabling the patient to have the best life function for as long as possible, minimizing the distressing symptoms for the patient and family, and supporting family members and other caregivers... 

People with disabilities should also make prior arrangements with their caregivers or community support persons or agencies. Will caregivers be able to accompany them to an evacuation site What will happen if the caregiver can t reach the client Table 16.2 lists examples of body systems often affected by disability and potential needs for equipment, supplies, and personal assistance. 

The Council recommends that healthcare organizations develop and implement (or provide access to) education and training programs for healthcare professionals, technical support personnel, patients, and caregivers that address methods for reducing and preventing medication errors. 

As with other chronic diseases, education of caregivers and family members is crucial. In one study, 70% of patients wanted their family members to know more about hypertension. The patients reported that negative attitudes, insufficient family support, and lack of confidence in the management of their blood pressure were contributing factors to their long-term adherence problems. Whenever possible, a family member or caregiver should be included in educational sessions to help the patient follow instructions and stay on track over time. 

Provide patient and health care professional education and medication information Evaluate and document patients and caregivers ability to understand medication instructions and provide oral and written counseling on their medications Refer patients by consult to specialty clinics, order appropriate laboratory tests and other diagnostic studies necessary to monitor and support the patient s drug therapy Perform venipuncture or finger sticks for the purpose of withdrawing blood for clinical laboratory test... 

There are two ways to classify the types of data collected—subjective and objective. Subjective data refer to all information provided by the patient that cannot be confirmed independently. The weakness of subjective data is that it cannot be confirmed, observed, or measured by the interviewer. However, it can be validated by other means. For example, patient compliance with a medication regimen can be supported by talking with a family caregiver however, this is also subjective. 

The practice of clinical pharmacy in the home care/home infusion setting is a challenging, but rewarding practice site. The pharmacist is a vital member of the home care team, which includes the patient and/or their caregiver, the physician, the home care nurse, and various other support personnel (e.g., pharmacy technicians, customer service personnel, billing personnel). The practice sites vary greatly, and many clinical, operational, and marketing opportunities exist. 

Fig. 1 The hospice interdisciplinary team. The patient, primary caregiver, and family are the focus of the hospice team s efforts in collaboration with the patient s primary physician. The core team is represented by the next circle away from the center. The support team is indicated by the outer circle. Community resources that support hospice care are listed outside that circle. Pharmacists serve on both the core team (second circle from the center) by providing direct pharmaceutical care to patients and families, and on the support level (next circle out from the center) by providing professional and public education about drug therapy in the care of terminally ill patients. (From Lipman AG, Berry JI. Pharmaceutical care of terminally ill patients. Journal of Pharmaceutical Care Pain and Symptom Control 1996 3(2) 31-56.)...

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