You guys are gonna get sick of me asking these questions pretty soon...if you haven't already :-)!! This is for Polly or anyone else who's dealt with this situation. Since I'll be going to help out my mom for a week or so when she gets home from the hospital, is there anything in particular I should expect to be doing or how will she need my help?? She was in a wheelchair for a couple of months before the surgery, so I'm assuming that she has very little...if...any muscle tone. I'm hoping that someone else will be coming in to change bandages, etc. but I don't know. I'm getting nervous now. I never wanted to be a nurse, but I want to help my mother any way I can.

Help....!?

-- Anonymous, September 05, 2003

Answers

Marcia, the bandage part is the easy part!! At least 75% of nursing is being able to think on your feet - the other 25% is pretty evenly divided between knowledge and practice! You'll do fine! How long will Mom be in the hospital after her surgery? Will she go to a regular medical floor for the first few days; and then to a skilled nursing/rehab floor for a week or so? That's how it usually happens here. Or do they plan to send her straight home? Is she planning to start walking again?

Here's a list of ideas in any case. A mattress protector on the bed and pads for her underpants. Cheap sanitary napkins will do fine. Getting up to go to the bathroom takes a lot longer than you'd think; and sometimes (especially in the elderly) it can take a while for the bladder sphincter control to come back to normal. Pain meds can delay wakening or the sensation of needing to go to the bathroom also.

Raise the bed. Ditto her favorite sitting chair. Put 4x4's under the box spring or make open end boxes out of 2x4's to put the legs in. Make sure it's sturdy! A satin bottom sheet, or satin draw sheet (piece of satin fabric across the bed) and a satin or nylon nightie will make it easier for her to get in and out of bed. A piece of satin tucked over the cushion of the chair will also help her slide forward and back. Forget pj's with bottoms - too darn much trouble to get down when you gotta go! Forget waistbands with buttons and zippers for the same reason. Sweatpants, elastic waist pants or skirts are best for daywear.

Raise the toilet seat. A bedside commode with the bottom cut out of the bucket to form a chute to the toidy works well, as it has arms to help push up from the toilet with. A lot of times you can find these a resale shops, or can borrow them from others. Don't try to lift her up out of chairs or off the toilet; just provide her with an arm to pull up against. Make sure you have a good solid stance, with your feet at least shoulder length apart and don't bend forward when you are helping her stand or walk. A belt that you can fasten loosely around her waist is good to hand onto when she walks, if she's a bit unsteady. Don't let her stay in bed all day, or stay in one position for too long at a time - she needs to keep moving to keep her bowels working and to strenghen her muscles.

If she has a walker; a little bag that attached to the front with velcro is handy to keep glasses, kleenex, etc... at hand. Do not let her use the walker to pull her self up - that's asking for a fall. Before she comes home, take up any throw rugs. Put up any treasured knick-nacks that are elbow height or below. Make sure pathways are open and as straight as possible; and at least 12" wider than the walker for manueverability. Move out furniture or tables to make room if needs be. She probably won't like her environment being changed, but just remind her that it isn't permanent; and that she has changed her environment in the past to suit life changes - like making room for a crib, etc...

Bandages - she shouldn't have one by the time she leaves the hospital, or at most it will be a clear covering over her sutures or staples. The incision will be kinda ugly, and may weep a little drainage. A lot of drainage, foul smelling drainage or pus like drainage are signs of infection; as are an increase of redness, swelling and tenderness at the site, and an increase in her temperature. Elderly folks often have a "normal" temp that is lower than 98.6 - ask the nurses what her temp has been running before you leave, so that you will be able to compare oranges to oranges - or temp to temp. She will need to return to the doc or a home health nurse will visit to take out the staples. She may also have a physical therapist visit or appointments; and will undoubtably be given exercises to do at home. She needs to do them. And she won't like them and will argue about it.

Pain meds can cause dizzyness, orthostatic hypotension ( blood pressure drops suddenly when rising) and constipation. If she c/o pain, try repositioning first, hot or cold packs, then mild analgesics (tylenol) and then the pain pills. Remember that the hydrocodones (Vicoden, lortab ect) have acetaminophen (tylenol) in them, so don't od her on tylenol. Bad for the liver.

Make sure she takes in plenty of fluid. Hip surgery causes a lot of blood loss; and it also disrupts production of new blood cells as most of them are manufactured in the long bones of the leg. Prepare iron rich foods - serve prunes at breakfast, spinach at lunch, liver, etc...to help with the anemia that almost always is a factor until her blood cell production is back in swing. Iron pills are horribly constipating, so if she's on them, increase her fluids by 1/2. Clear any medications with her doctor, especially herbal teas or supplements - some of them can have an effect on blood pressure and coagulation.

That's all I can think of for right now, but if you have any specific questions, please ask. Hugs to you for helping Mom and hugs to Mom too, for raising up such a good kid!

-- Anonymous, September 05, 2003

Marcia, I just want to give you some moral support here. Big hug...you'll be fine.

-- Anonymous, September 05, 2003

Thanks, Dee. I'm gonna need a TON of moral support and yours definitely helps!!!

Polly...thanks for all the info. It sure looks overwhelming, but we're gonna do the best we can! I'm going to print out your response and take it with me for MORE moral support :-)!!!

-- Anonymous, September 06, 2003