Assisting patients and carers to manage subcutaneous administration in the community
Family members and carers may wish to assist with drug administration in the last days of life; this may enable the patient to be cared for and to die at home, particularly if access to after-hours nursing or medical support is limited. In some community-based healthcare services, patients and carers may be taught to administer intermittent subcutaneous injections via a cannula. The caring@home project has developed evidence-based, best-practice resources to support healthcare professionals in teaching carers to manage breakthrough symptoms safely using subcutaneous drugs at home.
The drugs are often drawn up into syringes by nursing staff and left in the home for administration by the patient or carer. This process may affect the stability of these drugs; check with the local Medicines Information Service to ensure the drug is suitable for use after storage.
Community palliative care or nursing services usually manage continuous subcutaneous infusions (CSCIs) in the community. Patients and carers need to monitor for the following issues and report to the palliative care or nursing service if they occur:
- technical problems such as a flat battery or kinked infusion line
- site reactions such as swelling, redness or pain
- dislodging of the cannula
- leakage from the site
- adverse effects of the drugs.
Depending on the policies of the healthcare service, patients and carers living in remote areas may be trained to manage the CSCI.