Home nursing care
November 16, 2015 at 6:44 pm #91685
So, I’ll be updating this from first-hand experience over some time. My hubs is seriously ill, Stage IV COPD and Stage II lung cancer. He’s lost 40 lbs in 3 months and is so weak, that he can’t swallow completely – making aspirated pneumonia a real risk. He got a feeding tube, a couple of weeks ago because a) he wasn’t eating and b) he wasn’t hungry. We’re also fighting a stubborn case of thrush in his mouth and throat.
In retrospect, we both should’ve known what was going on a long time ago. But of course, he denied it (“it’s just a flesh wound!”) and refused to go to the doctor while all this was still treatable. So my living room is now a hospital treatment area. This is for longer term convalescence nursing; not so much the first aid/trauma style. You guys probably have that covered pretty well already.
But there are lots of other things required for other circumstances. Feel free to post your tips and experience too.
November 16, 2015 at 9:28 pm #91686RobertParticipant
Prayers your way. It’s hard to see people go down hill quickly. My pops went from over 2 bills down to 142 when he died. Being the closest son and the only one in the family with an inkling of medical knowledge, I did a lot of home nursing stuff with him over the last couple years.
It is definitely different from trauma care type medicine, but it’s something we need to plan on/for also.
Their will be a lot of long term care involved with many of the injuries we consider as survivalists. Regular chores like properly cleaning wounds, bandaging, etc. also really eat up supplies. Most of us look at a box of 100 4x4s and think that’s plenty. You’ll go through that in no time.
In general the one big thing people need to do is be observant. Being around the person regularly gives you a heads up on this that a doc or caregiver who doesn’t seem them regularly doesn’t have. What is their baseline? Not just vitals but overall condition. I was telling extended family members that mental clarity was going in my Dad years before others started saying “I think he’s losing it.” Yeah no duh right, I told you that 5 years ago, no one listened
One of the acronyms I remember from back in the day was SOAP-
Subjective, Objective, Assessment and Plan.
How long did he smoke?
November 17, 2015 at 11:16 am #91687Joe (G.W.N.S.)Moderator
In retrospect, we both should’ve known what was going on a long time ago. But of course, he denied it (“it’s just a flesh wound!”) and refused to go to the doctor while all this was still treatable.
Unfortunately this is very common.
Best limited advice:
Be willing to accept help. Try to take some time for yourself on occasion. Find the right person to talk to about things, this stress can cause you physical problems too. Keep yourself healthy and exercise can help relieve stress.
Will be praying for you both.
November 17, 2015 at 11:47 am #91688MaxKeymaster
Prayers are inbound. Make sure you take care of you. You aren’t a help if you get worn down and sick. Follow G.W.N.S.’s advice. Went through a long term illness with mom, had equipment everywhere. Take advantage of the technological aids, a lift chair was a great help, less struggle to get in and out. Next up is dad who has ALS.
November 17, 2015 at 1:57 pm #91689xsquidgatorParticipant
Prayers for you and your family. I lost my mom to cancer earlier this year, different kind, but similar in that we were all in denial about how far along it had gotten. I’m sure you know this, but keep doing what you can the best you can, and the rest is up to God. As hard as it is, I believe He doesn’t give us more than we can handle. May God bless you.
November 17, 2015 at 4:35 pm #91690janeParticipant
Gramma, prayers to you…. your husband’s situation and rapid deterioration sounds a lot like what happened to my mom who passed away a few months ago. She would not eat, which led to her becoming very weak, weight loss, swallowing issues, and ultimately pneumonia. She lived at home, but had homecare – but she would still not eat properly, and when she did it was only energy- and nutrient-lacking processed junk.
She spent the last week in the hospital on a feeding tube, then her last couple of days on a ventilator. In the end, she was simply too weak to breathe on her own.
I am absolutely convinced that she would still be alive, and could have lived years more, if she had eaten well.
Xsquidgator — my condolences to you and your family about your mom. It sure is tough to lose your mom…
November 18, 2015 at 6:57 pm #91691
The equipment side changed rapidly for us. I ordered a recliner, because he refused to sleep flat in bed; preferring the couch and a pile of pillows. We used a cane for a week; then he became incontinent that week and bedridden using a wheelchair. He had a lot of trouble getting into the chair today – despite the fact that I am strong; outweigh him; and know the ergonomics.
We’re set up in the great room. That’s to keep him engaged in what life is going on around him when he is awake. We’ve tried to minimize the steps to a cart full of the basics for bed care and use the wet bar as the meds/food center. He is sleeping more, and only gets a 1/4 dose of painkiller at night. On his good days, he is helpful to those of us caring for him. On his bad days, it’s best to just leave him be as much as possible.
I have nurses come stay at night, to train myself to “stand down” a little. Going to add some day time hours, too. Stuff still needs to get done, especially in light of current events. I’m making last minute shopping runs NOW, to avoid the rush later. That has to happen right along with everything else.
There are a lot of little things, I found out, that are needed. Dosage cups and syringes for liquid meds; pill splitters and crushers; graduated cyliners/cups… lots of ways to wash up the patient without literally getting them in the shower or tub. LOTS of laundry detergent. Urinals. Small cups and a way to crush ice – which he isn’t even allowed with a crazy, virulent case of thrush (and he isn’t tolerating nystatin well) and silent aspiration. That means he doesn’t cough if something goes down the wrong way. Aspirated pneumonia is something we watch for daily.
Associated with both COPD and Cancer, is a wasting syndrome (cahexia) where it’s not a matter of they WON’T eat — they completely lose their appetite and aren’t hungry. It destroys or catabolizes muscle mass – which is one reason he may not be swallowing well. We try speech therapy to strengthen his muscles in his throat tomorrow. I’m afraid he’s still losing weight. He can’t go to radiation or chemo, if that’s the case two weeks from now.
Thanks for your prayers, y’all. During those times I’m just here keeping him company while he sleeps, I’m planning out how quickly I can implement a plan to get squared away in the Eastern Redoubt.
November 18, 2015 at 9:20 pm #91692xsquidgatorParticipant
Hope all’s as well as it can be.
Thanks for the kind words, Jane, and I’m sorry for your loss, too.
November 28, 2015 at 5:23 pm #91693
Well, it’s all over. He died suddenly at “quittin time” on Tuesday.
I’m still adjusting. Fortunately many of his medications will be useful to keep; the ones that weren’t are already gone. There are some things I would differently, in this situation again.
I’ll post more on that later. Meanwhile, since he wasn’t always in agreement with me on how quickly things are getting dangerous in this country – and from how many directions – I’m not letting the grass grow under my feet.
November 28, 2015 at 7:55 pm #91694
November 28, 2015 at 7:58 pm #91695AndrewParticipant
I’m sorry for your loss. I pray you find comfort and strength during this time of trial to continue with what you need to do.
November 29, 2015 at 8:48 am #91696
Simple things to collect or save for home nursing:
Twin size sheets & blankets; at least 3 sets per bed. You’ll need someone doing laundry all day. (double duty: when the sheets get threadbare, turn them into bandages; old blankets can be covered as the inner sandwich of a quilt.)
Dishpans or basins, old towels & washcloths
Don’t count on having paper or disposable anything – so bedpans, urinals and be able to wash up. Bleach water like in old fashioned diaper pails will help sanitize and you must use the hottest water to wash; sunshine (UV) will also help sanitize.)
Gloves are ubiquitous in healthcare; stock what you can, add heavier rubber gloves, and reserve for contagious diseases. Soap & water and proper handwashing will serve for all else. A soft nailbrush, too.
Understand the physical signs of imminent death; all the numbers collection devices in the world will mislead you from some of those symptoms. Hospice information provides an easy to digest source of this information – and also information on making the transition as natural and comfortable as possible for everyone. (My hubby had a death rattle for a day or so before he passed. Ironically, I was reading about it at that time, when it all became immediate.)
Lack of appetite leads to loss of essential muscle mass. This leads to weakening the ability to swallow, drink or speak; the loss of calories for the lungs and heart to work – and in the end, cell die off. Yet this is the normal progression for terminal phases of disease and “old age”. Modern medicine has many gadgets and drugs to attempt to slow the progression, and can only reverse it if started early enough. The question for the caregiver is, is there a valuable reason for patient and family, to attempt prolong the process when there is little or no chance of recovery?
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