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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Fight The Bite! Avoid Mosquito Bites to Avoid Infection

When dealing with West Nile virus, prevention is your best bet. Avoid bites and illness; although the chance that any one person is going to become ill from a single mosquito bite remains low, the risk of severe illness and death is highest for people over 50 years old.
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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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Fiber

An apple a day--that is, a whole apple with the skin--will give you approximately 3.6 grams of fiber. That's a good start, but you still need a lot more fruits, vegetables, and whole grains to meet the daily level of 20 to 30 grams of fiber recommended by the National Cancer Institute. Eating foods with plenty of complex carbohydrates and fiber (vegetables, fruits, and grain products) is part of a healthy diet for several reasons.
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Reloading Scams

If you've been a victim of telemarketing fraud once, chances are you're on a list to be called-and scammed-again. Telephone hucksters call these 'sucker' lists. They include names, addresses, phone numbers, and other information, and they are created, bought, and sold by crooks. They're considered invaluable, because dishonest promoters think that consumers who have been tricked once are likely to be tricked again. Find out how reloading scams work.
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