Reggie and his wife Gina are a delightful couple in their early 70’s; active with their family and community, working part-time jobs and facing a variety of health care problems together. One Saturday afternoon while sitting at home, Gina suffered a stroke that has left her paralyzed from the waist down with no ability to control her bladder or bowels. She has been hospitalized over a month now and her anticipated discharge to their home is to occur in about two weeks. After several conversations, Reggie is finally more realistic of all that homecoming will entail but it has taken many crises to reach that point.
Reggie and I have spoken weekly since the event occurred. Initially, he was devastated but very certain that Gina would be coming home and everyone in the family would help care for her. His focus was on having a ramp built so she could get in and out of the home. Reggie wasn’t yet able to hear my cautions concerning all he would need in order to bring Gina home and to provide the care she would need. I encouraged him to speak with the discharge planner at the facility. His reassuring reply was; “my daughter talks with those people”. When I expressed concerns over his well-being he would laughingly say; “I take care of myself just fine, I rest when I am visiting with Gina at the hospital.”
On the next call, Reggie was hopeful that Gina would walk again after rehab as the focus would be on getting her legs stronger instead of the extenuating problems they were experiencing in stabilizing her other health care issues. Gina had developed several infections during her stay and Reggie’s mood was bleak but his focus was becoming more realistic; “…how can I ask our kids and grandkids to give up their time to help in their mother’s care… but how can I do it alone?” He would still need to work outside the home to meet their expenses. I listened and offered emotional support but my concerns were that once Gina came home, he would be carrying the very heavy workload of providing care alone with only intermittent home care services. Reggie was still not ready to really hear what was being said and he continued to allow his daughter alone to meet with the discharge planner.
Then, Reggie became ill from the stress, fatigue and lack of self care of his own health care needs. Reggie had tried so hard to stay strong for everyone else and to not concede to the normal fears and realizations the situation brought into their lives. He was hospitalized for several days. Unfortunately, it took this crisis for him to realize he needed to be honest with his wife and children about his ability to care for Gina in their home. Finally, he was going to ask for a family meeting to discuss the realities of the situation. He would then meet with the discharge planner and his family. I tried to gently broach the subject that the best place for Gina at this time may not be their home. He seemed more receptive to this possibility now.
In Reggie and Gina’s situation, family was there and willing to help but the game plan was not well developed. In crucial times like these, an experienced discharge planner can be invaluable in identifying the actual care that will be needed, informing those involved of the community resources available and recognizing obvious and sometimes not so obvious stumbling blocks that family cannot always see. Getting the primary caregiver and other family members who will be involved after discharge together with the planner as soon as possible after the individual is hospitalized is vital and can save countless hours of anxiety and misinformation.
In Reggie and Gina’s situation, family was there and willing to help but the game plan was not well developed. In crucial times like these, an experienced discharge planner can be invaluable in identifying the actual care that will be needed, informing those involved of the community resources available and recognizing obvious aetimes not so obvious stumbling blocks that family cannot always see. Getting the primary caregiver and other family members who will be involved post discharge together with the planner as soon as possible after the individual is hospitalized is vital and can save countless hours of anxiety and misinformation.
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