Family Health Team that includes a Patient Navigator = hub of the wheel
2001 Nova Scotia. Joanne Cumminger
-160,000 Canadian will be told they have cancer this year.
-CCAC Case Managers have only the bottom line in mind and do not act as advocate. They arrange for caregivers, Red Cross, and VON, but do not advise and counsel the patient or their family.
1. A Counsellor who can listen
a. - don’t try to see the big picture: one day at a time,
b. -for someone with 15 weeks of UIC, they don’t have time to fiddle around.
c. - help to cope with the fear and shock.
2. Ensure that support systems are in place with referrals to agencies such as Canadian Cancer Society, the Altzheimer’s Society, hospice care, respite care, adult day away programs, palliative care human and agency resources
3. Advocate for Case Management - assist with the determination of treatment goals and the generation of questions for the oncologist. advocate with doctors and nurses
4. Administrative Interpretation: -understand forms, terminology & pathology reports.
5. Ethical concerns are met: is the treatment working? Is the treatment worthwhile and an effective use of time, patient energy and resources? Demand a geriatric assessment to determine their quality of life. Radiation on a 75 year old is different that the same effect on a 45 year old. There may be other comorbidity factors such as infections, that contraindicate treatments. M mother had been weak and in pain for a couple of years. Her colitis, and the swelling in her leg where the lymph node had been removed, and general weakness prevented her from adequately coping with radiation. The chemotherapy, after the radiation did not ‘take’, simply resulted in her not being able to eat and gave her a great deal of pain. Her leg was so swollen that she could barely move.
6. Facilitate the paperwork for drug plans, unemployment insurance
7. Education - maze of tests, app’ts., treatments,
8. Symptom management – dad radiation gave him a urinary tract infection, which was undiagnosed by the technicians, and the emergency staff. A list of signs and possible side effects could have helped us understand what to look for.
9. Pain management - Fight for adequate pain relief. There is no reason for someone to be in pain. There seems to be a fear of providing too much pain relief amongst RPNs, but once the pain is out of control it is much worse and more difficult to reign it in.
10. Make arrangements for you or your loved one beforehand. Let family members know what you would like to do. Dementia sets in fairly quickly and without a reality check you or your children can be in a panic. A Living Will helps everyone concerned.