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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Hurricanes

Hurricanes are severe tropical storms that form in the southern Atlantic Ocean, Caribbean Sea, Gulf of Mexico and in the eastern Pacific Ocean. Scientists can now predict hurricanes, but people who live in coastal communities should plan what they will do if they are told to evacuate.
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Upper Endoscopy

Upper endoscopy enables the physician to look inside the esophagus, stomach, and duodenum (first part of the small intestine). The procedure might be used to discover the reason for swallowing difficulties, nausea, vomiting, reflux, bleeding, indigestion, abdominal pain, or chest pain. Upper endoscopy is also called EGD, which stands for esophagogastroduodenoscopy (eh-SAH-fuh-goh-GAS-troh-doo-AH-duh-NAH-skuh-pee).
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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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Register for the National Do Not Call Registry

The National Do Not Call Registry gives you an opportunity to limit the telemarketing calls you receive. Once you register your phone number, telemarketers subject to the FTC's Telemarketing Sales Rule, must stop calling you. Most legitimate telemarketers respect the Registry and won't call a number on it. But scammers are willing to violate the Registry restrictions. If your number is on the Registry, be suspicious of any telemarketing calls, unless they are from companies with which you already do business or that are allowed to call under an exception to the rule.
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