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PATIENCE, PLANNING AND SUPPORT: REFLECTIONS ON DEALING WITH AGING FAMILY MEMBERS
If there are problems or concerns at home, what is the plan for getting to the ER, calling 911, or seeking advice or help for a medical issue? All of these things require preplanning. It is challenging to manage this last minute or alone if you are not prepared.
6. Once the discharge is imminent, what services will you need and or have available for the patient at home? Once the patient is discharged,
the discharge is what triggers the need for home health or physical therapy. We learned very quickly that communication between the hospital and home health could be lacking. What care is needed at what intervals, and what needs to be done to arrange or schedule these services? Will the social worker arrange these services? When can you expect them to start? When do they need to start? Ensure you have the list of all of the services that will be needed, the telephone number for that service, and confirmation from a physician that the service is being ordered and is necessary.
Lesson 2: What About the Unexpected
Despite my Dad being a fairly healthy 75-year-old, staying in the hospital has risks like having surgery. First, he developed bladder retention and needed a catheter, which we had to learn how to empty/clean when he was discharged home. Then, he had a surgical infection and became so ill at
home that we had to have him transferred to the hospital via 911. It happened quickly. At about 9:00 am, he was speaking and joking. By 11:00 am, he had mounted a fever, was barely able to move, and was incoherent. He went back to the hospital and spent the next month in the ICU. During his time in the ICU, he almost died. It was scary, but we discussed his wishes for medical care and funeral arrangements beforehand. It was not a discussion you necessarily wanted to have, but it was necessary. When your loved one passes, it will be sad and stressful. The more you can plan and know ahead of time, the more manageable it will be.
When the unexpected happens, try to keep a routine for your loved one. If they usually have oatmeal on Monday and Wednesday morning for breakfast, try to do the same. If they read a book each night, have someone read to them
from that book each night. A routine means normalcy, and sometimes, that is precisely what is needed to help get them through the day. A wipe-off board with daily goals is a great idea, too.
Lesson 3: Start Now by Defining the Goal of Aging
Is the goal to bring your loved one home from the hospital versus a nursing home or rehabilitation facility? Is the goal to keep them in their home (for as long as possible)? These topics need to be shared in a discussion and preferably agreed upon so that your loved one can provide input and “own” the things they will need to do to reach the goal. Depending on the goal, you will need to define what physical and mental characteristics they will need to meet it. Do they need to walk on their own without assistance? Do they need to be able to feed themselves and make their needs known verbally to a caregiver or someone they might not know?
Do they need any assistance (walker, cane, or wheelchair)? Is the environment they are going from the hospital to set up sufficiently enough to help assure them of success (grab bars, single-story access in/out of the house of bathroom (tub/ shower)?
When my family went through the list for my Dad (and it was long), we decided to think about the positive. We wrote down the things my Dad could do (breathe on his own, see us and respond, say his name, say our names, swallow water by mouth, etc.). The sooner you determine what they can do on their own, the easier it will be to determine where the “gap” is (what they need help doing, what they can improve, and what they can do already). NOTE: If you have different goals from those of your loved one (for example, they want to come home, but you don’t believe that will ever happen), it is up to you to try to determine an attainable shared goal. Maybe it is over a period of time, or perhaps it has multiple steps. The important thing is that everyone agrees and that the discussion comes from a place of mutual respect.
Lesson 4: Don’t Forget to Take Care of Yourself
While you’re taking care of your loved one, your life still must continue, and you need to leave room for others. The “others” may be your spouse, children, work colleagues,
or close friends/extended family members. Those other
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