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CHF-COPD  Five Basic Steps of Disease Management At Home |
Five Basic Steps of Disease Management At Home
Home caregivers can support their loved ones by following a few basic steps. Many of these require you to talk to your loved one and to work out a plan. Whenever possible, write down your plan and keep it where both of you - and any back-up caregivers - can locate it. Key steps are to:
Step 1: Keep a daily log
By keeping track of basic information, you will be able to provide the doctor with accurate and up-to-date reports, either over the phone or during visits. This record does not need to be complicated. In fact, the simpler, the better. A spiral-bound notebook or composition book will do just fine. Have your loved one get in the habit of recording the following information each day:
- Breathing - easy, difficult, coughing, and so on
- Medications taken - names, doses, and times, as well as any side effects
- Diet and activities
- Other symptoms to discuss with your doctor, such as swelling
Step 2: Know When to Call the Doctor
The following symptoms merit a call to your loved one's doctor or nurse. Review these lists with your loved one. Both of you should know when a call to the doctor is necessary.
- A gain of 3 pounds or more within a few days or a week
- Increased swelling in hands, ankles or feet
- Difficulty breathing at any time or coughing at night
- Decreased urination
- Confusion, dizziness, or faintness
- Nausea or vomiting
- Increased fatigue
- Muscle cramps or weakness
- Any distressing symptom
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- Increasingly difficult breathing, or wheezing during usual activities
- Increased coughing, an increase in mucus, or chest pain with coughing
- Mucus that is bloody, has an odor, or is green or yellow
- Swollen hands, ankles, or feet
- Increased fatigue
- Muscle cramps or weakness
- Shortness of breath that interrupts sleep
- Any distressing symptom
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Step 3: Know Who to Call
Keep the following information handy, and be sure that everyone knows where it is:
| Medical Contact
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Alternate Contact
if first contact is unavailable
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- Name
- Telephone Number
- Pager/After hours number
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- Name
- Telephone Number
- Pager/After hours number
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Step 4: Be Prepared with Information the Doctor Will Want
Your conversation with the doctor will be more effective if you can give the following information. These are just some of the questions you may be asked. Knowing this information before calling the doctor or nurse will make your exchange more effective.
Any symptom that distresses you or the patient is worth a call to the doctor. Be prepared to tell the doctor or nurse if you are concerned about any of the following:
- Location
- Character (sharp, aching, shooting, etc.)
- When did it begin? Is it constant or intermittent?
- What is the patient's normal weight?
- About how many pounds has she gained?
- Over how many days?
- Where is the location of the swelling? (Hands, feet, ankles?)
- How long has the swelling been present?
- Difficulty breathing or coughing at night
- When did the breathing trouble begin?
- What makes breathing more difficult? What makes it better?
- When did the night coughing begin?
- How many times has the patient urinated in the last 24 hours?
- What is the urine's color and odor?
- Feeling dizzy, faint, or confused
- How long has the patient felt this way?
- How long has the patient felt this way?
- How long has the patient felt so tired?
- Muscle cramps or weakness:
- Which part of the body is cramping?
- How long have the muscle cramps or weakness been going on?
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- Increased coughing during usual activities.
- When change began
- Change in color: bloody, green, or yellow
- Odor
- When did the breathing trouble begin?
- What makes breathing more difficult? What makes it better?
- How long has the patient felt so tired?
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Step 5: Have an Action Plan
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1. Don't Panic
Shortness of breath or other symptoms can be frightening. Keep calm, and try to calm your loved one. Remember, help is just a phone call away.
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2. Call
- Call the doctor or nurse. Have the number handy.
- Keep paper and a pen by the phone to write down medical instructions.
- Be prepared to answer questions about the symptoms your loved one is experiencing.
- Tell the doctor or nurse about any medications your loved one is taking.
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3. Follow Instructions
Often the doctor or nurse will give you instructions over the phone on things you can do to relieve symptoms. This might be taking additional medications or making a trip to the hospital. Be prepared to follow the instructions. Ask questions. If you don't understand what you are told, ask the nurse or doctor to explain again.
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