Susan Sabo-Wagner Cites Challenges With Home Care for Patients With Cancer

Susan Sabo-Wagner, MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas, discussed how housing conditions can impede positive outcomes for patients with cancer who are receiving cancer care support at home.

Susan Sabo-Wagner, MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas, discussed how limited understanding on how to care for one’s health and extenuating circumstances can contribute to a higher likelihood of infection, ineffective health habits, and increased need of resources.


What are some of the biggest challenges that your patients may face, if they are receiving cancer care support at home, in their housing conditions?

That's mostly the unsafe areas. Definitely depending on where you live, where you're from, where you reside, you have unsafe neighborhoods. You have home health that may not want to go into those neighborhoods. You might have a great home health network, which might be in that area, but maybe not in that particular area. You have increased risk of infection, because you have people, you think that, “hey, you're gonna be doing fine,” and even maybe in a better area, but they just don't take care of themselves, or they can't take care of themselves, or somebody is supposed to be taking care of them but neglecting them. Then you have increased risk for infection. That's one of the number one things that happens to patients on chemotherapy is they get some sort of infection due to when their immune system is down.

You want to be able to have that fishbowl effect of being able to see inside their home, like, “what are you actually dealing with?” Education is really a key element. If you've grown up in this kind of environment, and you've lived in this kind of environment your whole life, you don't know what you don't know. You know enough to get by. Not saying people are dumb at all, it's just the education in terms of how you need to live in order to be healthy and be safe and eat well.

I may have said this at the presentation, but you have people who say “yes, I'm having diarrhea, I think it's from the treatment.” Well, are you eating 3 meals a day? “Yes, I'm eating 3 meals a day.” There's a story of a patient who, yes, they were eating 3 meals a day, they believed their diarrhea was from the treatment. Turns out that 3 meals a day that they were eating was 3 cans of tomato soup, Campbell's tomato soup. That's going to give everybody diarrhea over time. It's not a healthy thing to eat. But, you've got just enough money where you're getting a Happy Meal. That's it.

Education is certainly something that we do our best to try to manage from a distance. Prior to implementing our program where we were doing this survey from the beginning and understanding where people are, meeting them where they are, we were being much more reactive in terms of, all of a sudden patient is having diarrhea or can't make it to the treatments or whatever the case may be, and then we're providing resources once we find out. In this way, we're trying to be more proactive about it and try to prevent some of these things and understand what the patients are dealing with ahead of time.

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