Repatriation – coping at home after hospital

At home I found I could do a quite lot myself, but was glad of someone being there for tasks which required two hands or anything more than the lightest lifting, and in case I slipped or tottered. The nursing philosophy seems to be to allow/encourage patients to do as much for themselves as they can. That’s good. It promotes self-reliance but may also be a symptom of over-work. My daughter showered me in the hospital the morning I came out.

People who are treated in public hospitals are automatically assessed for after-care. I was concerned, from personal as well as professional interest, to find out what would apply after a private hospital stay, especially as I was not covered by ACC or medical insurance. Before I went in I contacted the Care Coordinators and they assured me that I was entitled to the same services as public hospital patients. So I mentioned on my pre-admittance forms that I would like some assistance at home as I live alone. It appears that nothing can be arranged in advance, so it is a good idea to mention your needs to nursing staff at every possible occasion (without being too much of a pest). My nurse, who looked after me throughout my three nights stay, did pass on my request and an occupational therapist had a discussion with me about my home situation – layout of the place and access, bathroom arrangements, how I could get meals, etc (this visit also appeared as a separate item on my bill – nothing was ignored). As a result, on the first weekday after my discharge from hospital a district nurse came to see me and arranged for assistance with showering three times a week. I am grateful for this, as I know the home care services are overstretched. I found that I will not need ongoing nursing attention – the wound is healing well and I don’t even have a dressing on it now – a week after the operation. The moral of the story is to make your needs heard and keep on asking, but don’t be too demanding, especially if you have friends and family who will come and help you.

I don’t get any house cleaning help, but then I never was very house proud. I cleaned all my windows before I went into hospital – over a week or two. My strategy was to buy a small hand-held vacuum cleaner. This picks up bits on the kitchen floor, hair in the bathroom and even liquid spills.

When it comes to showering, I don’t have friends I would feel comfortable to ask for help. Family is a different matter. How many times did we wash our children through the years? But my advice is to co-opt an adult child who has children herself, if possible. She will be delighted to wash someone who does not wriggle all the time, who responds to commands and does not winge about water getting into their eyes (my grandsons would wear their swimming goggles in the shower if their mother would let them). She will find it a pleasant change that the showeree does not dissolve into uncontrollable giggles when the soles of their feet are touched (or perhaps you are still especially susceptible). I was so glad that I had had a grab rail put in beside my bath/shower – a good piece of forward thinking, which I would strongly recommend. If you are remodelling your bathroom, put in hand rails, or at least have the linings strengthened so they can be put in later without tearing the walls down. The towel rail beside the bath is also very helpful for support.

Sleep is a big issue when only one sleeping position is possible. In hospital the bed was motorised and went up and down, as a whole and at each end (quite an exciting ride). But at home, even two weeks after the operation I have not found the optimum arrangement of pillows to help me sleep. And I have up to seven of different shapes and degrees of squidgyness with me in bed. A bed mate is not recommended in these circumstances unless he/she can cope with flying pillows and groans of frustration at all hours.

Getting out of bed is difficult with one arm out of action, in the absence of automation. I cannot put any weight on one elbow or shoulder. And getting out is important when you have to “go” several times a night. (I found it especially embarrassing to have to ask the hospital night staff to help every time in the early days.) It helps to think about which side of the bed would be easier for disembarking and to have something solid there to push on to help yourself up. My left arm is affected (and I am left handed), so I sleep (off and on) on the right hand side of the bed and have a chair next to it to push myself upright on.

I was asked how I got on cooking. I thought for a while and then realised that I hadn’t actually done any. I ensured in advance that I had a well-stocked freezer. Defrosted stuff does not taste quite the same, but it only needs heating up in the microwave. A small bench-top oven is excellent for meals for one, and very accessible –whether or not you have had surgery. I must also pay tribute to friends and family who have invited me for meals or brought food in. I will let you into a cunning plan. Staff at Age Concern National Office offered to bring me food, so I invited them to a pot luck dinner. This way, they bring me food, we have a pleasant social evening and I only have to put out crockery and cutlery and carry a bottle of wine or two.

Depending on your shape, size and fashion sense, clothing and dressing may be more or less of a problem. I sorted out my baggy clothing beforehand; some which I could get on over an arm sling and everything which was easy to manage. Trousers with elasticised waistbands make things easier, front-opening shirts, and tops with collars. The shoulder strap the sling, with a Velcro fastening, can be chafing on the neck and is best tucked away under a collar.

It is hard to manage if your usual writing hand is immobilised. I have some very spidery crosswords and Sudoku solutions to attest to this. Notes which I took for this blog are in some cases undecipherable now. Reading in bed had always been one of my most treasured luxuries, but it is hard to hold up a book in bed with one hand, at least I find it so. Instead I listen to the National Radio programme, some of it recorded on my daughter’s Ipod (kindly loaned) and read sitting up at the table. Looking at TV programmes and DVDs does not present problems and is about all I am capable of by the end of the day.

I can only repeat my previous exhortation to recognise that everything has to be done more slowly. What about your experiences? It would be good to share.

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About Age Concern New Zealand 'on research'

At the heart of everything Age Concern does is a passion to see older people experience well-being, respect, dignity, and to be included and valued. We support, inform and advise older people on issues such as access to health care, transport, housing, financial entitlements, and social opportunities. We also work to combat real problems in our society, like elder abuse and neglect, chronic loneliness and social isolation. We provide specialist services with trained and qualified professionals able to give expert advice and assistance. Age Concern is a charity and relies on the support of volunteers and public donations to do much of the work we do. To help us help older people, please consider making a donation of your time or money. To see how, visit www.ageconcern.org.nz
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2 Responses to Repatriation – coping at home after hospital

  1. Both your blog about the surgery and the one about recovery at home were so comprehensive; full of constructive commentary and advice. Thank you for sharing your experiences. The pot luck dinner with ACNZ staff was a great idea.

    Hope the outcome of that shoulder surgery is turning out to be worth the discomforts and expense.
    All the best Judith
    Margaret Guthrie

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  2. Adrienne von Tunzelmann says:

    What wise advice Judith! You should write the post-op manual. I was astonished to find there wasn’t such a thing when I left hospital (private) after a hip replacement. When I asked ACC if they had a ‘managing at home’ guide they sent me a pamphlet on Tai Chi for Over 70s!

    My top tips relate to being on crutches but perhaps handy also for other incapacities.

    First, buy (or make – easily done) an apron with pockets to hold all your regularly used bits and pieces: phone, pen, glasses, pad, book etc. Mine even held a travel mug upright for carrying hot drinks from kitchen to chair. NZ Nature (mail order) has a really good one and some garden centres sell them. It saves the frustration of no sooner sitting down than realising something you need is in the next room.

    Second, I had an old fashioned tea trolley which was perfect for transporting meals, and also for unloading the dishwasher – I put everything from the machine on to the trolley and pushed it to the cupboards. You can steer it with one hand, or if on crutches give it a series of nudges. Saves traipsing backwards and forwards. It worked so well in the kitchen, I still use it!

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