Caregiver expertise…What does it require?…

Mom and Babies were hanging out by the recently cleaned cement pond.

“Sighting of the Day in the Bush”

Her attention and love of her offspring have been unrelenting since we first saw them in August.
There’s never been a time in my life that I required a full-time caregiver. Although I had surgery a few times, I recovered quickly and only needed help lifting heavy objects or grocery shopping for a week or so. In all likelihood, this is the case for most of us.
But now, I strive to recover from this dreadful and complex surgery with my sternum cracked, chest cut wide open, and numerous incisions are running the length of my legs, all of which are painful, making moving about the complex.
In addition, I’ve had two painful chest tubes since removed that have stitches to be removed tomorrow when we return to Nelspruit for an appointment with the surgeon.
No doubt, with only 16 days since the surgery, there is still a lot of pain and discomfort. It takes six to eight weeks for the cracked sternum to heal, as would be the case for any broken bone.  
In the case of most broken bones, the patient is wearing a cast during this healing process. It’s impossible to stabilize this type of break with a cast, and thus, I must move gingerly to avoid further injury.
Thus as described above, this is the time I need a full-time caregiver, namely my husband Tom, who’s had no significant experience in this area throughout his life.
I can do several things for myself; bathe, bathroom, getting in and out of bed (where I spend little time during the day as recommended by the doctors). I cannot use my arms for tasks such as folding towels, chopping and dicing vegetables, or performing many household tasks.  
Thank goodness we have Zef and Vusi (included in our rent) who come each day to make the bed, wash floors and clean the house. With all the animals kicking up their heels in the dirt garden, there’s more dust in this house than one can imagine. Here again, one more bit of serendipity that proves that this was the best place in the world for this to happen to me.
As a result, as the caregiver, Tom doesn’t have to spend time cleaning the house; other than doing dishes and picking up after us after they leave, his attention is not divided in my full-time care. This is another huge benefit for which we are both very grateful.
One of his biggest jobs in getting those darned compression stockings on my legs each morning. As tight as they are, it’s an athletic event. It’s not easy putting on these tight knee-high stockings when I have awful incisions in both of my legs, and he’s trying desperately not to cause further pain. But each day, it goes a little more smoothly than the previous day.
Over these past five days, since he took over as my caregiver, after my release from the hospital, there are a few things I’ve observed that truly define the quality of a caregiver beyond the basic tending to bandages, stockings, and mobility.
Let me add here; I requested an early release from the hospital. Once I moved (after eight days) from the ICU unit to the regular hospital, it didn’t take more than a few hours to realize the quality of care went from a 10+ down to a zero. At that point, I knew Tom could and would take better care of me. As a result, I only spent two days in the hospital ward, in a room to myself. 
During this period of high temperatures, some warthogs avoid cooling off in the cement pond when the water has become warm.
Most patients spend from three days to a week in the hospital ward after being released from the ICU unit. In my case, I spent eight days in the ICU and, as mentioned above, only two days in the hospital ward.
Back to the points that I’ve found have been most helpful in addition to basic caregiving tasks have been the following, in order of preference:
  1. Caregiver’s attitude: Nothing could be more distressing than having a caregiver who wasn’t encouraging, upbeat, and optimistic. A negative resentful attitude could, without a doubt, have an impact on the rate of recovery. Regardless of how difficult this may be, never attempt to make the patient feel guilty for putting them in this position.
  2. Willingness to prepare special meals: Many patients have a diminished appetite and desire to eat after bypass surgery. Healthful, familiar meals are a real boon to the patient’s recovery.  
  3. Replenishment of cold fresh beverages can be instrumental in recovery: The medications may cause extreme thirst and a dry mouth. Drinking plenty of fluids is required for recovery. Having stale water or beverages hardly inspires the patient to drink to replenish their needs during the healing process.
  4. Participation in the rehabilitation process: This type of surgery (and most others) require a committed and diligent walking program. By encouraging and gently reminding the patient as to this process is crucial in making a complete recovery. If the caregiver walks with the patient, especially if they’re fearful of falling, the patient grows more confident.
  5. Medication distribution and monitoring: Many times, patients find themselves taking eight to 10 new prescriptions, some of which are taken at varying times of the day and night. A conscientious caregiver will oversee this process to ensure correct dosages to avoid over or under-medicating. Some pain medications cause drowsiness and result in the patient becoming forgetful.
  6. Encouraging rest periods: Instructions after surgery may include certain activities based on the patient’s level of progress. Type A personalities may quickly become overjealous in performing such tasks. As much as the patient believes “more is better,” a good caregiver will monitor such activities encouraging rest periods and following doctor’s orders.
  7. Creating a comfortable sleeping and napping arrangement: If the patient is uncomfortable sharing a bed with their caregiver/spouse and if the space is too small for comfort, an extra bed in the same room might be suitable. Air conditioning in hot weather is a must, as is appropriate heat in cold environments. Avoid extreme temperatures to aid in healing. Ensuring bedding and pillows are placed for the utmost comfort is a must, even when the patient is out of bed and seated at a table or in a chair.
  8. Escape time. When going through a difficult recovery, everyone needs a period each day to escape from worrying thoughts and pain. Watching fun TV shows and movies, games to play, or other such activities reduces the time the patient feels stressed, here again aiding in recovery.
  9. Encourage feelings of self-esteem: Let’s face it, having one’s body mutilated from surgery is a difficult thing to meet for some patients. Only the caregiver will know if this is an issue and provide realistic encouragement during the recovery process and in times to come.
These points became apparent to me over these past several days, and I only have Tom to thank for making this trying time tolerable. Besides, a little laughter throughout the process can easily lighten the load for both patient and caregiver. There’s no shortage of that in this household.
Tomorrow, we’ll cover the patient’s responsibilities to aid in their recovery process and the willingness of the caregiver to carry on with love, support, and excellent care.
Be well, dear friends, and thank you all for “coming back.”

Photo from one year ago today, February 28, 2018:
Nearby at another tree, we spotted a rhino mom and her baby, born this season and still closely attached to the mother. For more photos, please click here.

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