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Patient Guide Resource

Patient Guide for Proper Medication Use

Store medications in their original container at room temperature (unless otherwise directed), in places that are not accessible to children or exposed to sunlight. Avoid storage in the bathroom, glove compartment or automobile where extremes of temperature and humidity will cause medications to deteriorate.

Learn the trade and generic names of any medication you are taking. Tell doctors, dentists or other health care professionals you see regularly that you are taking these medications. Before taking any drug, be sure you have informed your doctor, nurse or pharmacist about any unusual reactions you have had to medications in the past, any special medical problems, any medications you have taken over the last few weeks including any OTC (over the counter) medications.

Always read the label before taking any medication. Take the medication exactly as prescribed at the recommended dosage for the duration of treatment. Never share prescription medication.

When using a medication prescribed for occasional or prolonged use, check the container for an expiration date.

To avoid potentially harmful changes in effectiveness, do not change brands of medication without medical approval.

Never mix different medications in a single container, and don’t remove any medications from its original container or remove the label except when filling a ‘medication minder’.

Discard any medications that are outdated or discontinued by the physician. Follow any specific disposal instruction on the medication label or patient information you receive. Call the Hospice Nurse if you have questions regarding the disposal of medications.

Tell your hospice nurse and pharmacist about side effects that you have been experiencing while taking a medication.

If you or someone else has taken a medication incorrectly, call your doctor/hospice nurse.

POISON CONTROL CENTER
(516) 542-2323

To refill prescriptions provided by hospice, call the hospice nurse who will arrange for home delivery. Please call for refills when supplies are low and before you run out. In the event that a dosage is missed, consult with the hospice nurse. Do not double the next dose unless advised to do so by the nurse.

Instructions for Patients/Families about Constipation

Some degree of constipation is a side effect of pain medications; therefore, good bowel management and regular bowel habits are essential if one is to maintain a certain degree of comfort. A bowel movement is not necessary every day. However, constipation, hard or infrequent stool movements, is one of the biggest problems facing patients.

Causes of Constipation

  • Low fiber diet
  • Decrease/fluid intake
  • Medications for pain
  • Depression and anxiety
  • High Calcium levels
  • Decreased activity from fatigue and weakness
  • Tumors in the intestinal tract
  • Incorrect use of laxatives

Signs/Symptoms of Constipation

  • Abdominal distention (swelling)
  • Pain or tenderness
  • Flatus (“gas”)
  • Cramping or discomfort
  • No bowel movement in 3 days-if constipation is present after 5 days suspect stool impaction
  • Small amounts of liquid stool which is confused as diarrhea
  • Stool leakage or incontinence and pain
  • Recurrent feelings of wanting to move bowels

What You Should Do

  • Establish a routine. Try to use the bathroom at the same time every day.
  • Keep a daily record of movements.
  • Try increasing the amount of fluids you drink and the amount of fiber in your diet.
  • Do not ignore the feeling to move your bowels.
  • Take all prescribed medicines as directed by your doctor, especially the laxatives. If you have any questions, talk to the hospice nurse.
  • If the doctor increases the amount of pain medicine ask him to increase the amount of laxative.
  • If it can be tolerated, try to increase your activity level somewhat. Activity helps to move stool along the intestinal tract.
  • Let your nurse know if 3 days have passed since the last bowel movement.

Things to Remember

  • Medications for pain can constipate right after they are started; therefore, it is important to take stool softeners and/or laxatives simultaneously with them.
  • Constipation can occur if the dosage of the laxatives is inadequate.
  • Patients who are not eating continue to produce waste in the bowel so the need to have bowel movements continues and may still become more impacted.
  • It’s important to remember that you should have a bowel movement at least every 3 days.
  • Constipation can cause loss of appetite, nausea, vomiting, abdominal pain, rectal pain, confusion, abnormal distention and sometimes obstruction. Pain tends to move in waves and can radiate to the chest, back and upper legs.

Instructions for Patients/Families about Oxygen Therapy at Home

If your doctor wants you to receive extra oxygen:

Things to Remember

  • Maintain the oxygen flow at the prescribed rate. If you are not sure if oxygen is flowing through the tube, check all connections and check the tubing for kinks or other obstructions. If you are still not sure, place the nasal cannula in a glass of water. If you see bubbles, oxygen is flowing. Shake off water before inserting the cannula.
  • Keep oxygen equipment away from any direct source of heat or open flame. Do not use candles for religious ceremonies or ambiance. Do not allow oxygen tubing to be near the stove or space heater. Oxygen under pressure can explode if it gets too hot.
  • Don’t smoke or allow others to smoke in vicinity of oxygen. A “No Smoking” signs should be posted in the room and outside the doors leading to the room as a reminder.
  • Flammable materials should not be used near oxygen. Avoid the use of skin care products that contain alcohol or oil (alcohol and oil are flammable). Do not use nail polish remover.
  • If nostrils become dry or cracked apply a water-soluble lubricant such as K-Y Jelly; do not use Vaseline.
  • Don’t use electrical appliances within 5 feet of oxygen. Avoid the use of electrical blankets or heating pads.
  • Avoid the use of polyester/nylon linens or clothing. They can create static electricity that could possibly ignite the oxygen.
  • If you have increased trouble breathing, notify the hospice nurse. Do not assume that more oxygen will make you feel better or breathe easier. Never change the oxygen flow rate unless your nurse or doctor instructs you to do so.
  • If you experience an electrical outage, notify hospice and utilize the back-up oxygen tank.

Instructions for Patients/Families about Fire Prevention at Home

Fire safety begins by eliminating as many potential causes of fire as possible. The following is a guide to assist you in eliminating fire hazards in your home.

Check All Cords

  • Lamp, extension and telephone cords should be placed out of the flow of traffic.
  • Cords should be out from beneath furniture rugs and carpeting.
  • Cords should be in good condition, not frayed or cracked.
  • Extension cords and electrical outlets should not be used to carry more than the proper load.

Smoke Detectors

  • Utilize smoke detectors.
  • Be sure batteries in the smoke detectors are charged.

Emergency Exit Plan

Have an emergency exit plan and an alternate plan that is known by all members of the household.

Space Heaters

  • Heaters should be placed where they cannot be knocked down.
  • Heaters should be placed away from furnishings and flammable materials, such as curtains and rugs.

Kitchen Safety

  • Ventilation system/range hood exhaust is properly functioning.
  • Towels, curtains, grease and other flammable materials are located away from the range.

Bed Areas

Locate ash trays, smoking materials, and other fire sources (heaters, hot plates, teapots, etc.) away from beds and bedding.

Storage Areas

Storage areas should be free from flammable liquids.

Instructions for Patients/Families about Fall Prevention at Home

Objective: To make patients, caregivers and employees aware of safety risks

Wheels on beds, stretchers, wheelchairs, commode chairs etc. should be locked when stationary. Electric beds should be kept in low position except during direct patient care. If feasible, the control should be within patient’s reach.

If a patient is bedbound, a bell, buzzer or appropriate noisemaker should be kept in easy reach of the patient at all times. The bedbound patient should be instructed to call for assistance when getting out of bed. A similar alert device should be placed in the bathroom.

If side rails are appropriate to the individual needs, the caregiver should be instructed to keep these up at all times.

The patient should arise slowly from a sitting or lying position to minimize faintness, dizziness or orthostatic hypotension. The patient will walk carefully looking straight ahead & turn carefully & slowly.

There should be adequate illumination in the home. Suggestion for night lights in areas when patient transfers to the commode or ambulates at night.

Assistance devices used for ambulation should be kept at the bedside. The commode should be kept at the bedside for easier transfer and to prevent falls at night.

All stairways should have handrails and be illuminated with light switches at the top and bottom of the stairway.

Uneven floors, clutter or poorly placed furniture, loose carpeting or throw rugs and other risks which could lead to falls would be pointed out to family and suggestions made for correction or removal. Special attention made to electric cords & oxygen tubing.

Special care should be taken in the bathroom where most falls occur. Placement of a shower chair in the tub is necessary to assure safety when showering. Non-skid surfaces in the tub are crucial. Avoid small throw rugs in the bathroom, which often contributes to falls.

If walking is difficult, encourage patients to use a bedside commode instead of walking to the bathroom.

Choose proper attire. Wear appropriate footwear (non-skid soles). Avoid excessively long clothes. Wear eyeglasses or lens when indicated.

Avoid leaning or supporting yourself on unstable objects, i.e. rolling objects, towel racks, soap dish on shower wall etc.

Patient/Caregiver Safety Education

Objective: Hospice is here to help you remain safe & prevent any unnecessary injury.

Patient/Caregiver should be aware of the Hospice Emergency number, to access a hospice nurse, 7days a week, 24 hours a day.

Suggestions to think of escape routes in an emergency and ramps for wheelchairs should be considered.

Family members should be instructed never to leave the patient alone in a locked house unless a neighbor or friend has access and is available if intervention is needed. Consider placement of a personal emergency response system i.e. Lifeline.

Any suspicion of patient abuse or neglect should be brought to the Team Manager so a course of action can be planned.

Home Medical Equipment

  • Do not try to repair any medical equipment delivered to your home.
  • If equipment appears to be broken or not functioning properly, contact hospice.
  • Check regularly that equipment is in good repair.
  • Check that bedrails stay in place and are in working order.
  • Refer to written instruction material provided by equipment vendor for care & maintenance.

Safe Disposal of Sharps

Millions of people use needles, syringes and lancets at home for their health. These needles, syringes and lancets are called sharps. Used household sharps must be stored safely and disposed of properly to protect people from disease.

Use Sharps container to store used sharps. When your container is ¾ full of sharps, bring it to a safe disposal site such as any hospital or nursing home. Call first to find out hours, days and location. You may call the New York State Dept of Health at 1-800-522-5006 to find a disposal site in your area.

If you do not have a sharps container, you may use a plastic bottle that cannot be broken or punctured such as a bleach or detergent bottle. When this container is ¾ full of sharps, fill container with 1:10 bleach solution. Tightly screw the cap closed. Put tape over the cap and write “Contains Sharps” on the bottle. Discard container with the household garbage.

Stay Healthy

Simple Steps You Can Take to Keep From Getting Colds, Flu and Other Respiratory Infections

Clean Your Hands

Washing your hands often will help protect you from germs. Use soap and clean running water to wash hands whenever possible.

  • Use warm water if it is available.
  • Avoid using bar soaps-use liquid soap and water whenever possible.
  • Wet your hands with clean running water and apply soap.
  • Rub hands together to make later and scrub all surfaces.
  • Continue rubbing hands well under running water.
  • Dry off your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.

Use waterless hand rubs: Waterless hand rubs work to decrease the number of germs on your hands. Use them when in public places or when you’re not near running water. These hand rubs are available in most supermarkets and pharmacies.

    • Be sure the one you choose has an anti-germicidal, such as alcohol.
    • Apply product to the palm of one hand.
    • Rub hands together.
    • Rub the product over all surfaces of hands and fingers until hands are dry.

When should you wash your hands?

      • Before preparing or eating food
      • After going to the bathroom
      • After handling the garbage
      • Before and after tending to someone who is sick
      • After touching handrails or other things touched by many people
      • After blowing your nose, coughing or sneezing
      • After handling an animal or animal waster
      • Before and after treating a cut or wound

Cover Your Mouth and Nose

Cover your mouth and nose with a tissue (not your hands) when coughing or sneezing. It may prevent those around you from getting sick. Dispose of used tissues immediately.

Avoid Touching Eyes, Nose, or Mouth

Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose or mouth.

Avoid Close Contact

Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.

Get Vaccinated

Contact your healthcare provider regarding your eligibility to receive the flu and pneumonia vaccine.