People are discharged home from the hospital sicker and quicker than they used to be. Recently I worked with a client who suffered from complications after a simple hernia operation. During the operation her bladder had been nicked and there was some internal bleeding. While her body healed she was sent home with an abdominal drain and urinary catheter.
I was called by her daughter after she had been home for a day, and they were struggling to manage these foreign devices. Families are so often expected to be able to manage fairly complex medical issues in the home setting. Patients who don’t need the constant medical attention of a hospital, but who are not well enough to manage their care independently are discharged home into the care of their families, friends, and community services. The calls I receive from people coming home from the hospital are often because of a complexity that seems beyond the realm of knowledge or comfort of their family caregiver. This could be something as small as giving a daily injection for six weeks after surgery, or something more involved like changing a wound dressing, irrigating a drain, or administering a long list of daily medications. I know that the nurses and discharge planners at the hospital do their best to teach patients and their families what they need to know prior to discharging them, but this is something that often gets done quickly and without ongoing support.
For this client, I started our home care services with an initial consultation where I spent over an hour with her and her daughter reviewing how the drain and catheter works, how to troubleshoot common problems, what they need to watch for, how the devices aid in healing, how to empty the collection bags, how to help prevent infection, how to move around without irritating the devices, and when to call for help. Just being able to spend this time helped the daughter to feel more confident in managing her mother’s care, and also offered her the reassurance that she can always call me with questions. Since her mother is quite weak and needs help up to the washroom quite frequently, her daughter decided to hire our staff to provide overnight care so she could rest without interruption, knowing that her Mother was being cared for. Families can provide excellent care for their loved ones when they have the appropriate support to be able to do so safely. This support and education is part of what makes CalaCare a unique home care agency with a mission to empower individuals to be informed and involved in their health.
-Jennifer Kazmaier RN