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Ensuring your loved one’s safety while in hospice care

By Terre Mirsch

Last week I attended a national Safety Summit, where thousands of healthcare workers gathered to share stories and ideas of how to improve patient safety–whether  care is delivered in a hospital, outpatient setting, long-term care, home care, or in hospice. Significant measures have been taken in healthcare settings across the country to reduce the incidence of errors and patient harm. Healthcare workers must be diligent all day, every day in practicing safety behaviors that prevent human error. Some of the practices that you may have observed include proper patient identification as well as frequent hand hygiene.

As caregivers, there are measures that you can take that will assist healthcare providers in safely caring for your loved one, and that will reduce the chance that you will make a mistake when caring for your loved one.

  • Keep a personal health record (PHR) that shares all medical diagnosis, tests, and treatments that have been performed. A PHR collects, tracks, and shares past and current information about your or your loved ones health.  If your loved one is receiving hospice or home care services, be sure to include this information in the PHR.
  • Have an up to date list of medications available. Bring this list with you any time your loved one needs medical care and have it available when the hospice or home care team visits. The list should include all prescription medications as well as any over the counter medications, vitamins, and herbs that your loved one takes. The list should also include the dose of the medication as well as how often they are taking the medication and what they are taking it for. This will enable your healthcare and hospice team to check for medication interactions while ensuring that your loved one is on the best medications for comfort and symptom control.
  • Check with your healthcare team prior to starting any new medications or stopping any medications, including herbal products. Many herbal products interfere with the effects of prescription medications and can cause serious adverse reactions and side effects. If the person under your care is no longer able to swallow or take certain medications, be sure to let the team know.
  • Practice frequent hand hygiene.Hand hygiene is the single most important step in controlling the spread of infection. Wash your hand before and after giving care.
  • Always stop and think before you administer a medication or treatment for your loved one.During our busy daily lives, it is easy to get distracted or confused and accidently pick up the wrong bottle, give the wrong dose, or do the wrong thing. Prior to acting, pause for just a second or two and ask yourself–is this the medication that I intended to give? Do I have the right dose? Is this the right time? Once you have administered the medication, check again to make sure you got it right.
  • Don’t guess if you are unsure about what to do. It is best to ask questions and find someone who knows the answer rather than trying to figure it out on your own. If your loved one is receiving hospice care, remember that the team is available to you 24/7. Research has shown that when we take a guess, we are likely to choose the wrong answer 30-60 percent of the time!
  • Communicate information and concerns to the healthcare team in a clear and concise manner.Before you visit with the healthcare team or pick up the phone, take a few moments to write down your concerns and any information you want to share. Stick to the relevant points so that you can be sure your point is both heard and understood.
  • If other family members or friends are involved in your loved ones care, take the time to help each other out by checking each other and making sure that everyone understands what is entailed. Coach each other by providing positive feedback for a job well done or by gently correcting each other when needed.

Caregiving is hard work- we all need a pat on the back or a thumbs up from time to time. Practicing these behaviors will help to ensure that you, and your healthcare team, are providing the safest and most effective care possible for your loved one.

6 Comments Post a comment
  1. Thanks for putting this list together Terre. I can especially relate to the “don’t guess” bullet. Having cared for someone at home with a terminal illness I found myself bewildered quite a number of times. I was grateful and fotunate to have fine hospice care. When I didn’t know what was going on or how to best do something they were always responsive. It would usually take about 2-5 minutes, at most, for a professional to call me back and help. And if it sounded serious to them they were at my home within 10-30 minutes.

    As a non-paid and untrained caregiver I learned that being conscious of our limitations is a must. For instance, when my loved one got to the point where she was impossibly thin and frail, without even the strength to lift her head, I was terrified to consider moving her out of concern I would hurt her in some way. Each day was a confrontation with the unknown and the only sane choice was to ask for help.

    October 22, 2012
    • Thank you, Ira, for your response and for sharing your positive experiences with hospice. One of the many benefits of hospice care is the availability of help and support 24 hours a day. It is not uncommon that questions or concerns arise during the night hours. This is also a time when fear and anxiety can be overwhelming. I am grateful for our wonderful triage nurses who are always just a phone call away and for our evening/night nurses that visit our patients and families whenever there is a need.
      Indeed, it is important that we don’t guess or try to figure things out on our own- whether we are non-paid and untrained caregivers or paid professional caregivers. The safety of our loved ones is too important to take a risk with a guess. Asking questions is a good safety habit.
      Thank you, again, for sharing your thoughts with us and thank you, as always, for following Caring with Confidence.
      Terre

      October 22, 2012
  2. these are very good ideas and also smart ones. anything to produce less errors!

    October 22, 2012
    • Thank you, Terry. I am glad that you found these ideas helpful. Much of what family caregivers encounter are new experiences and it is not uncommon to be overwhelmed with the unfamiliar tasks and demands that arise. As caregivers, we face many distractions and interruptions as we attempt to multitask throughout the day. This coupled with physical and emotional exhaustion increases the risk of making errors. Taking a few seconds to stop and think before we act or to ask some clarifying questions will prevent these unintended errors from occurring. Thank you for sharing your thoughts and thank you, as always, for following Caring with Confidence.
      Terre

      October 22, 2012
  3. Thank you for this thorough checklist of how to make the hospice experience a successful one for patient and caregivers/loved ones.

    October 23, 2012

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