Including Families and Caregivers

"What would you like your family to know?"

Family and informal caregivers play an important role in the lives of their loved ones. They also play an increasingly important role in how the health care system functions. By communicating effectively with all the individuals involved in your patient's care, you can help him or her while making efficient use of time and resources. Informal caregivers may be important "informants." They can also help to reinforce the importance of information you give or the treatment you prescribe. When a companion is present, be aware of communication issues that arise in three-party interactions. Too often, the conversation may be directed at the companion and not at the patient; in some cases, the encounter can become a "two against one" match, which no one really wins. Whenever possible, try to sit so that you form a triangle and can address both the patient and companion face-to-face.

To protect and honor patient privacy, be sure to check with the patient on how he or she sees the companion's role. In many cases, the caregiver or companion can be a facilitator, helping the patient express concerns and reinforcing what you say. But it is best not to assume that a companion should be included in the medical encounter. First, check with the patient. Conducting the physical exam alone protects the patient's privacy and allows you to raise sensitive issues. The best time to conduct a "mini-mental" exam is during a private exam, so that a family member cannot answer questions or cover for the patient's cognitive lapses.

Families may want to make decisions for a loved one. Adult children especially may want to step in for a parent who has cognitive impairments. If a family member has been named the health care agent or proxy, under some circumstances, he or she has the legal authority to make care decisions. However, without this authority, the patient must make his or her own choices. Try to set clear boundaries with family members, and encourage others to respect them.
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Preventing Carbon Monoxide Poisoning After an Emergency

Generators, grills, camp stoves, or other gasoline, propane, natural gas, or charcoal-burning devices should never be used inside a home, basement, garage, or camper - or even outside near an open window.
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Continuing Care Retirement Communities (CCRC)

Continuing Care Retirement Communities (CCRCs) are also referred to as life care communities. Entering one is usually a once-in-a-lifetime choice and that's the appeal. Many have large campuses that include separate housing for those who live very independently, assisted living facilities that offer more support, and nursing homes for those needing skilled nursing care. With all on the same grounds, people who are relatively active, as well as those who have serious physical and mental disabilities, all live nearby. Residents then move from one housing choice to another as their needs change.
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Warning Signs That 401(k) Contributions Are Being Misused

Increasingly employees are asked to make voluntary or mandatory contributions to pension and other benefit plans. This is particularly true for 401(k) savings plans. These plans allow you to deduct from your paycheck a portion of pretax income every year, invest it and pay no taxes on those contributions until the money is withdrawn at retirement. Is your plan being misused?
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Dangers of Genetically Modified Food Confirmed

Several recent studies confirm fears that genetically modified (GM) foods damage human health. These studies were released as the World Trade Organization (WTO) moved toward upholding the ruling that the European Union has violated international trade rules by stopping importation of GM foods. Why has this information been held from consumers?
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