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Patient-centered care across disciplines, Assess the caregiver–care…
Patient-centered care across disciplines
Dental Assessment
Mucositis treatment strategies
Foam brushes or very soft bristled brushes. Brush twice a day, and floss daily.
Mild fluorinated toothpaste may be used
Non-medicated oral rinses
Mucositis can be painful, could be why patient is so opposed to brushing his teeth, analgesia should be considered
Patients should be seen for routine dental visits for exams and cleanings, every 6 months
Lip care with lanolin-based oinment
Patient readiness for learning/responsibility
Implement a reward system for consistent oral hygiene
What is patient's reason for poor oral health habits
Age appropriate communication and education
Education assessment of importance of dental hygiene
Preventative strategies
Non-cariogenic diet
Oral hygiene
Fluoride use routinely
Adequate hydration
Consequences of poor dental hygiene. Ensure both patient and parent understand importance of oral hygiene. Educate patient and parent understand the relationship between poor dental health and risk of CLABSI.
Include parent in education. Discuss with the mother if she is interested in reviewing parenting methods that could help her with the patient when he is neglecting oral health.
Infection risk
High risk chemotherapy protocol
Frequent hopsital admissions
CLABSI
Education - CLABSI can be caused from injured mucous membranes, which lowers defense against an infection. Pathogens can enter through injured mucous membranes
Supportive care prevention
Daily bath or shower
Daily linen change
Encourage out of bed activity, ambulation, bowel movement regimen
Regular dental exams and cleanings
Social Work Consult
for
Caregiver burnout.
Social Worker assessment of caregiver situation. Social assessment of family, living situation, financial concerns
Social assessment with child
Addressing concerns of child. Children ~12 avoid discomfort, want to see their friends, and want to be normal
Offer support and counseling as needed
Cognitive and social assessment
Assess the mother's knowledge and ability to implement patient care.
Evaluate the caregiver’s appraisal of the caregiving situation, the level of understanding, and willingness to assume caregiver role.
Ask mother to demonstrate care of care recipient.
Involve other family members or friends to teach patient care.
Assess the family resources and support systems.
Recommend available community resources such as respite, home health care, adult day care, geriatric care, housekeeping services, home health aides, Meals On Wheels, companion services, transportation services and parent caregiver support groups.
Connect mother with health insurance options.
Evaluate the caregiver’s physical and mental health status that can affect caregiving.
Acknowledge to the caregiver his or her role and its value.
Allot time for the caregiver to discuss problems, concerns, and feelings. Ask the caregiver how he or she is managing.
Introduce stress-reducing methods to the caregiver.
Concern of oncology health care team
Nutritionist to help advice on foods easy to eat with the mucositis.
Pediatric Oncology Social Worker
Occupational therapy to make sure that he is reaching his developmental milestone as well as school activities
Assess and ability to afford healthy food options
Social determinants of health
Health care
While patient has medicare, determine healthcare options for mother
Neighborhood and environment
assess barriers to transportation and housing that the family might have
Education
assessment of the family education for successful outcomes
Social and community context
what kind of support system does the family have in place at home to assist with daily challenges
Economic Stability
social work to determine that the family financial needs/concerns are met
collaboration of all teams
family meeting with all team members present
allow all concerns to be brought up by family and collaborative teams
ensure that the family needs are met
ensure that the patients needs are met
oncology team and social work can collaborate with concerns and additional resources they might need
Assess the caregiver–care recipient relationship.
Encourage son to show gratitude for care given by mother.
Assess for neglect and abuse of care recipient.
Redefined family relationships. There is a loss of control and loss of safety. There may have to be redistribution of family roles
