Surviving Hospitalization of an Aging Parent or Spouse–2: 7 Tips for Coming Home

The first thing Deb, the RN-Geriatric Care Manager, said to me during her “courtesy call” at the hospital was something like:

“Get everything in order at home: fresh sheets and towels on bed and in bathroom; wash laundry, your hair; bring in a supply of groceries; do everything you need to do because you won’t have time to do it initially.” Excellent advice.

The following suggestions came from healthcare workers in the hospital
or from what worked well for me

1,  Bring all hospital records and discharge information home. Keep in a separate folder. (Mt. Sinai gives a folder containing this,) Add all future hospital/medical material and business cards from the doctors (easily accessible FAX + other contact info important) if you’re continuing with them after hospitalization. I also added them to my iPhone contacts. Depending on where I was, the information was at hand.

2.  Have a pill organizer at the ready at home if medications are part of the regimen.

3.  If there are prescriptions to be filled, ask if the hospital will phone them in to your pharmacy for you. In our case we only asked for a week’s supply from the pharmacy and they delivered. (We don’t drive in NYC and I didn’t have time for the walk back and forth–20 mins. total).
     Our physician immediately phoned our prescription-by-mail service (which he did in the past when refills were needed) for the 90-day supply. I phoned the service to double-check that they would arrive before our week’s supply ran out.  All came in a timely manner.

4.  Have a calendar or appointment book/engagement calendar that enables seeing–at the least–one week at a glance. It’s the roadmap of life following hospitalization for a serious problem, when additional services will be needed.
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A calendar with boxes for each day is perfect for keeping track of and making doctors’ appointments, and all related services (eg. physical therapy). It also allows room for jotting down our personal appointments/meetings, plus  room for schedule changes.
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Since I’m more comfortable looking at a big screen (rather than a small one) when making appointments, I add to my computer’s calendar from my old fashion appointment calendar’s boxes. Yes, the cloud can efficiently make connections between my computer and iPhone and that’s good in a “pinch;” but I prefer the computer’s screen size and the engagement calendar’s boxes. This may be age-related?

5.  Put an armchair with firm seat in a convenient place for socialization. Makes it easier for people with weakened muscles from a hospital stay to sit and get up– and enjoy the stimulation of those in the room.

6.  Make certain the bathroom is safe: a shower bench, grab bars, a raised toilet seat with arms.
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Most NYC apartments have small bathrooms. Showers aren’t wide, toilets are often inches from the vanity and sink. My independent husband was positive he needed none of the above–all of which were recommended by the hospital social workers and Deb.
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Because our bathroom was remodeled with a “comfort height” toilet right next to the vanity and sink, we didn’t need the additional raised toilet seat with arms. While the shower floor wasn’t slippery, I had concern too much shower steam could make the showerer woozy. But my husband declined the shower bench, saying the shower was so small he couldn’t have a problem.
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The shower bench, from what I understand, isn’t covered by Medicare. Don’t know about grab bars or raised toilet seat because we never ordered them and, as it turns out, they weren’t needed.

IMG_0971That said, Sr. Advisor R had her shower refitted after breaking her hip when she was 97. She staunchly rejected help and knew this was the best tactic to justify her refusal. (Click photo at left to enlarge)

I plan to have grab bars installed in the near future. If we plan to live to be 80+, why not!? And, while more costly, they needn’t look institutional.

American Standard bath safety

Click to view American Standard’s Avisia ADA-compliant offerings.

Related: 13 Tips for Surviving Hospitalization of an Aging Parent or Spouse
               Old Bathrooms, Old Parents–97-year-old’s ADA-compliant shower updates
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13 Tips for Surviving Hospitalization of an Aging Parent or Spouse

How many times have people said “You must take care of yourself?” when caring for an elderly loved one who’s hospitalized.

There’s stress….too many things to take care of; possibly many people giving advice; definitely emotionally draining. And then when we feel balance–if not control–we’re knocked down by a big wave of new problems: unexpected health changes or minor setbacks, hospital staff who are too busy to answer call buttons in a timely manner or worse.

In truth, the ongoing hospital experience with my husband gives me little to complain about. That said, after 2 weeks I’m convinced these suggestions ease the experience:

First and Foremost Remember the Goal–in this case 2 goals:

  1. To get him or her well and out of there asap
  2. To keep ourselves from getting dragged down by all the stuff–from people’s attitudes (including the patient’s and family members’) to pushing ourselves to meet every expectation. In short fend off–protect against–frustration and exhaustion.

Organize, organize, organize.

  1. Decide what’s controllable. Make the most of and gain strength from that. And act on it. We can wear ourselves out worrying about things that aren’t controllable in a hospital. (Confession: I like to think everything is within my control. My counseling kicks in–thank goodness–and I identify whether or not I can control. If I’ve tried everything (talking to anyone who can help, getting all information I can,) and it hasn’t worked, I’ve disciplined myself to “let go.”)
  2.  If not staying at the hospital, each night put everything in logical order and use a tote bag or equivalent for items that need to go–the next day–to the hospital for parents/spouse/ourselves. That way nothing is forgotten the next morning.

Example: It was bitterly cold in NYC and I tried to take the bus, rather than taxis (expensive) to the hospital. So I put my down parka on a chair near the door with bus pass in one pocket, lined gloves in the other, and placed the things that needed to go to the hospital next to them. That way if the phone rang while getting ready, I wouldn’t lose my train of thought and could sprint to the bus stop if necessary without leaving anything behind.

3. Take medications and vitamins on time. Place them where we can’t forget them. It’s easy to put this off when we’re rushing–or completely forget. We need all our strength.

4. Sleep/Rest: Get enough of it. We think more clearly and make better decisions when we’re rested.

5. Ask questions to learn the hospital routine in order to make the most of the visiting hour schedule and schedule our own “must-do’s” around it. I also asked where the hospital’s food offerings were located. (Fortunately there was a Starbucks close by.)

AT THE HOSPITAL

1. If surgery is scheduled, ask how long it should take. That enables us to control what we do during that time. There’s probably a waiting area for families. Some may find the large commonality of shared concern supportive. I don’t. We’ve always lived far from family. Although friends volunteered to wait with me, I decided being surrounded by anxious people in the waiting area for many hours would be overly stressful.

So I met a friend (who’s sensitive and fun to be with) at the hospital and we left, but didn’t go so far that I couldn’t get back quickly. My husband’s doctor said he’d call my phone upon completing the surgery, which he did, saying surgery had gone well and I had about 4 hours before my husband would be awake enough to know I was there. That worked well. His call was like a 4-hour time-out from stress.

2. Get the phone number of the floor/unit/ward before leaving the hospital on Day One. It comes in handy, It helps avoid visits to an empty bed when tests, scans etc are being done. Before my husband was able to talk on the phone–in the beginning days after surgery–it allowed me to get information and leave a message in the early morning, before I went to the hospital. I was careful not to overuse the latter.

3. Remember or write down the names of every healthcare person who attends your loved one and call them by name when you say “hello” or “thank you.”  It seems to create a small personal bond, which gets faster results when we have questions or need help (in the latter case remember the “I need your help” phrase).

4. “Thank You Kevin/Samantha/Whoever” can’t be said too many times.

5. Show interest–however brief, if you can do it–in every hospital person who comes into the room. Because I counseled high school kids, I often asked where the nurses, CNAs etc. got their training and explained reason for my interest. If they were from another country I asked where they were from and if family was there and if they went back to see them; and if I’d travelled to the country or wanted to, I told them. I know my interest  meant something to them and when we needed something, they never failed to come through quickly.

6. Fight infection. Mt. Sinai had hand sanitizer dispensers and signs about sanitizing hands everywhere–at the entrance, exit, by the elevators, at the entrance to each unit, and in each room. The rooms also had boxes of gloves. I was prepared to be a watchdog about this, but everyone was trained well and automatically put hands to dispenser upon entering and exiting the room.

Every hospital may not train as well–and monitoring everything is no easy responsibility. Yet we become the eyes and ears for hospitalized aging parents and our spouses. And doesn’t that buttress the case for why we need our rest!

                           to be continued…..

Related: Hospitalization Tips that Make a Difference for Grandparents. Parents, Children and Us
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Aging Parents: Sooo Much to Do–Too Little Time-Holiday Organization

Wrapping Christmas Gifts

Juggling everything on a normal day, with over-busy, over-programmed schedules, is hard enough at this time of year–whether we’re children of aging parents, caregivers or Sandwich Generation. Do we feel like we have ADD?

DISORGANIZATION, FRAZZLED NERVES–worsened by the unexpected glitch. And can’t we count on that! There’s an old saying “I’m dancing as fast as I can.” Taking that a step further: when we try to dance faster than we can, don’t we wear out or lose our balance? So how do we stay balanced?

9 Strategies that work 

Re: Making lists–works for some (once on paper, anxiety ends); not for me if the list is long.  A long list of to-do’s overwhelms: a stomach can go into knots just looking at it. I do have a mental list, but don’t write it down at the beginning. I know if I look at it I’ll become immobilized for a time…probably want to cry…which may help some, but again not me. (My eyes get red and puffy and I’m out of action until I look normal again.) 
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1. Get rid of visible messes at home. Their sight compounds the stress and confusion. Thoughts get scattered, surrounded by and knowing there are: unmade beds, messy kitchen, stuff strewn around. (Forget children’s rooms). And with too much to do, it’s easy to leave beds unmade, add to an already-begun pile of stuff to put away later etc., etc.

2. Get help doing the above. Don’t waste your time.  “I need your help” is the important phrase that psychologically pulls people into your web and gets results. Enlist children, any able-bodied person (husband/wife/other) in the house to help.  A noted researcher in the 1970’s when divorce was escalating, advised single-parent-frazzled mothers: “Even an 8-year-old can vacuum.”

3. Think about the time of day you are more efficient and energetic. I know the middle of the day isn’t best for me. I have tremendous energy in the morning and then a short burst later at night. At night, however, I don’t have patience for detail things, so at this time of year the “no-brainer” kinds of things–like wrapping presents–are perfect.

4. Everything needn’t be done this minute. Accomplish a few of the easy-to-do things that are mixed with all the other must-do’s that cause anxiety. Find the easiest time-sensitive one, and accomplish it. Reward: a psychological pick-up.

5. Try to identify a few more easy ones; get at least one of those out-of-the-way, you’ll feel better. Then attack and accomplish one of the more difficult or time-consuming anxiety-producers. Reward yourself. Take a break. Eat chocolate, take a short nap, watch TV, go for a walk–you get the idea.

6. NOW MAKE THE LIST, prioritizing what remains. Fit “remains” into time available in the days that are left, using the above model.

7. Next think about what can reasonably be done, how others can help, thus saving  you time and/or stress. We can get help with almost anything these days if we ask or can pay for it. Yet many of us don’t ask when we’re overwhelmed. We often think it takes too much time to have to explain. But if we’re asking a capable friend or family member, why do we hesitate? (Controllers: take note. This is hard.)

8. If necessary, delete the least important from the list…the one(s) where the world won’t come to an end if not taken care of now. Put it/them off or cancel.

9. Knowing the duration of the stress helps. Seeing the light at the end of the tunnel provides relief.

When we’re less stressed those around us no doubt notice; indeed it’s probably a gift–as we do our best to help parents, grandparents and older friends age well.
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Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.