Patient Care

[EX121]

So I have had a lot of emergency medical training & experience. But in all it was get the patient stablized & hand them off to the next level of care. Now after some surgery my wife had I'm dealing with near total patient care. While she can get up with help and walk with a walker, she needs help with most everything.
I'm finding it very exhausting and challenging.
Have you considered how in a PAW you are going to bath someone, do wound care (as sterile as possible), have a bedpan or comode & etc. ?????
Have you considered the mental aspect to the caregiver?
what if the condition is life threatening & requires 24 hour patient monitoring?

Just some food for thought.

[Patriotic Sheepdog]

Sorry to hear that she's laid up a bit...will say a prayer for her.
Good post to make you think. I did several years in hospital and thought about this many times. I watched nurses and learned a few tricks, but most of it is hard work. Thank God for nurses.

[1Admin]

We recently remodeled our house bathroom. I wanted to put in another tub. Wife said "we are getting older and your always hurting yourself in these combative sports you do, I think a walk in shower might work out better." More I thought about it, I thought "how the heck am I (or her) going to get into a big ole tub if we are half crippled/too old, etc.

Experiencing loved ones going through old age changes/adapting to injuries has made us re-think some stuff for the long term.

[EX121]

Yeah on the bathing, she can't lift her leg high enough to get into the tub. So we are doing big pans of water, it gets her clean but not very satisfying.
Also how much anti-bacterial soap do you have. Neither of us are big believers on using it on a regular basis, but it has a place when trying to be extra clean.
And yes to the thanks for nurses & nurses aids who do this daily.

[Matt In Oklahoma]

Also how much anti-bacterial soap do you have.

managed to get alot of it recently. the other stuff on care, mmm, thats a tough one because we are not equiped or ready.It's been discussed before and the answers are hard

[rockriver]

good responses.
i had 2 senior relatives in an assisted living home several years ago.

i was making contingency plans to get, care for, and help the relatives, in the event of an "event."

on another survival type forum, i asked the question... have you considered your familly that are in an assisted living home... for instance, going to get them. caring for them after you got them. what about their medicines.. etc..
some good responses then mr. a@@ hole (a popular poster) stated something to the effect that your respnse should be to go shoot them in the head.
i openly tried to suggest that was not a good choice. A@@ hole q then moved some of my post into a thread of his that supported the killing of older or infirm folks. mr. a@@ hole pos was strong in his opinion. here's the benefit of his comment. i learned that he a fella that would not be invited to my campsite/home/group under any circumstances.
he was not from my geographical area. i doubt he's on this site.. BUT i learned about him and a few others.. what a benefit to learn about folks...
--
the rest of the story... one of these folks has died. the other has been back in their own home, "taking care of business" living alone, and just last weekend spent some time telling us about the depression. still a very viable and contributing member of society.

it is such a benefit to learn about our neighbors, relatives, internet persons, etc..

[Gus14]

Luckily I too have extensive EMS training and experience. My wife is an RN (for 10 years now) and within the next 6 months will be a Nurse Practitioner. Her first couple years was post-op care at an extended stay nursing facility, then she went to a cardiac unit at the local hospital before she transferred to the ER trauma team. For the past year while she finishes her Masters degree she has been back at the extended care facility.
This very thread is a great example of why developing a community is so important. Extended intensive care is a 26 hour a day (yes I know there are 24 hours but thats how busy you are doing it) job. You need to devote an entire room, tent, shelter, whatever you are in, to the patient and you need to keep at least one person dedicated to care. We already have 3 sites within our little town that will be dedicated to the care of our people.
You can develop a hospital room over time without a huge investment if you are smart. For example; One thing people recieving medical care needs a lot of is linens. Sheets, blankets, pillows, towels, etc. are all needed. So, when you get new sheets and such, dont throw out the old ones...unless of course you wait until yours are no longer usable before you get new. Take your old stuff and give it a couple or three washes with a solution of your preferred detergent and a small shot of bleach. Dry, fold, and place in a sealable container with a dessicant bag. Stow away until you need it. Utilize dollar stores and discount retailers to pick up plenty of cleaning and sterilizing supplies. Utilize those same resources to gather wound dressings. With extended care comes wound care and improvised bandages works well for immediate intervention but you really want lint free clean or better yet sterile dressings if at all possible. I have found generic maxi pads are great for wound dressings and you can pick up value packs for only a few bucks.
When you think of how you are going to set up for cleaning the patient and the linens, dont overthink it..... remember K.I.S.S. Lots of hot water can be made with a large metal tub and fire. Even if you only grab one of those 15 gallon basins, that makes a good amount of hot water for getting stuff done. It also would not be a bad idea to keep a single burner that works off of a 1lb propane cylender and an extra large metal coffee pot handy to boil water for the cleaning of instruments, surfaces, etc.
Patient care takes a combination of training, dedication, and LOT of common sense. You also need to be able to improvise on the fly.

[EX121]

Good post Gus. I would add lots of disposable gloves. Necessary for wound care to 'bottom' wiping (not something I thought of in the "or for better or worse" part of the vows.

[Cimarron]

Eight years ago my parents (retired) moved to our area. They were raising three of their adopted Grandchildren. Eventually my family (wife and three kids) moved out on the same land. We lived 300yds from each other. Within about eight months my father suffered two strokes making his right side almost useless, including almost all of his speaking ability. On top of that he was diabetic. My mother was left to do almost everything. With two children in school and the oldest being a typical 19 yr old! Not counting 30 acres buildings, animals mowing..etc.Mom had to deal with all those problems and Mom wasn't in the best of health to begin with.
I was their only child in the area but Mom and I decided to care for him at home ourselves. Dad went from a strong, sturdy, positive person to a weak, negative one. The only thing that remained the same was his stubborness..and he was hard-headed as they come. Fortunately I am cut from the same cloth and I am as stubborn as he.

He went from a button up shirt, trousers, and a belt to a t-shirt, and bib overalls (which he could fasten on his own). At first he was able to use a cane but later had to use a walker. He didn't help in wanting care and in some cases fought against Mom and I. And when I mean fought, I mean we had to prod, poke, fuss, and sometime's push him to get the care he needed. The only thing we couldn't get him to do no matter what, was he refused to take his dentures out! The only thing he would let me do was brush his teeth and that was only on occasion. They had a corner garden tub which are really large and had a small step built on the outside which made it tedius for him to navigate even with me balancing and supporting him. The tub was large enough that we bought one of those plastic waterproof "care" chairs made for sitting in the shower and it worked great. It is a good thing the tub was as large as it was, on days Dad did not cooperate, I was in shorts, barefooted, and in the tub with him..

Because Dad had little to no feeling/total control on his right side he would swing his right leg to move about. He was always kicking something walking through the house which made us have to try and keep shoes on him, which was another fight, he was an Okie.. We had to repostion many things in the house for a walker, furniture, rugs, getting the kids to keep their clothes picked up off the floor!-I always won that fight- Including building a ramp on the deck so he could get into the house..so many things had to be changed to accomadate his status. Him banging into stuff with his feet and swinging his hand around he always had cuts that no one knew where they came from, and he couldn't tell us or didn't realize he had even got cut due to lack of feeling. It was a constant job that was not made any easier due to him being a diabetic he would take longer to heal and he would fiddle with his bandages/cuts.

The older Grandchild married and moved out. Nine months of bathing, shampooing, wiping-the-bottom, shaving, clipping nails, dressing, and combing hair, I lost my Mother to heart disease. The load of worry and stress was too much for her and she left us quickly. Two months later we were moving him in with my sister her husband and four kids. I sold Mom and Dad's place including my half and moved out there to help. I knew that my sister couldn't do it all and my bro-in-law would have difficulty with dad even though the two were close. We started out his care at home around family members and we were going to continue it, we are a stubborn lot..

Nine more months of pain, aggravation, worry, and work, we lost Dad. It truly is one thing to take care of someone, especially a family member, when they want to cooperat but it is entirely another matter when they don't.

[Klayton]

OK all, I will climb up on my student nurse soap box, LOL...

1) invest in bedbath medical soap. This chemical soap does NOT require rinsing.
2) if money restricted, I think Gus mentioned this, going to need a medical matress (ie able to get way and dry with towels) learn the fine art of a real bed bath, linens soak up excess wash water and rinse, extra is then dried with extra towels, new linens are placed on bed, and pt is in heaven once again (you will become very proficient with practice and be able to do all this with pt never leaving the bed)
3) wound care, most wound care only requires "clean" technique not "sterile" technique, if you see your nurse pulling gloves off the wall dispensing box this = clean technique, some examples of sterile: catheter insertion (not maintenance), large "open" wounds, etc etc, but again most wound dressing changes are normally clean technique.
4) as for potty breaks, hmm this is a tough one, because most people don't just volunteer for foley catheter, but bedpans make a mess, and if pt needs to go while you are out checking perimeter, it can get UGLY. side note, if you are taking a scheduled pain management drug prescription, do NOT forget the stool softner (just ask Elvis' ghost), bedside commodes are usually under $100 at medical supply stations and Walgreens even carries them now (price?).
5) 24hr monitoring, this is a tough one SHTF time, would require a large enough "team" at your location to rotate care and other SHTF tasks that need to be manned, otherwise your looking at getting a surprise attack when you are least ready, and then, all your preps were for nothing...
Hope this helps...

[Klayton]

Ack forgot, if pt is severely bed ridden, do not forget mouth care, some of these pt's I am taking care of literally have chunks of skin hanging from the roof of their mouths or chunks of skin flaps on their lips... really grosses me out :(