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When to ask for Home Health?
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When to ask for Home Health?

My Mom (67) just had throat surgery Friday to remove a cancerous tumor. The surgeon removed a tonsil and a large portion of the back of her tongue. The surgery went smooth, but the recovery has not. She developed major congestion Sunday. Chest x-rays showed no pneumonia, but both lungs were partially deflated (Atelectasis). The doctor started her on antibiotics. She can't be suctioned due to the swelling and risk of bleeding. She was better Monday, but still had a bad cough. She failed a swallow test on Monday, and gets nothing by mouth except ice chips. We were told she is high risk for aspirating.
They discharged her Tuesday (too soon IMO), and my daughter and I have been taking care of her. She is still on oxygen and gets continuous tube feeding (through her nose). We have been working hard with the Incentive Spirometer to strengthen her lungs, and she is walking around the house with a walker.
She is still coughing and the congestion is still bad. She still cannot cough it up. At 1:00am today, she had another coughing spell. She coughed, choked, gagged, and vomited. It was globs of mucus tinged with blood. We called the ambulance and headed to the ER. The position of the feeding tube was checked, a chest x-ray looked identical to the last one on Sunday, and all the lab results were fine. We were told that the congestion caused the vomiting, and the blood came from her large, open wound in her mouth/throat. We took her back home, but now we are nervous, Her follow-up appointment with her surgeon is Monday, and that seems like an eternity now! I was hoping they would keep her at the hospital until the congestion cleared up.
Would this be a situation that meets the requirements for us to get some Home Health help? We've got all the basics figured out (feeds, oxygen, hygiene, etc), but we have no idea what is an emergency (or even a concern)and what isn't. We are feeling extremely overwhelmed today. Help?
8 Comments Post a Comment
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Avatar_f_tn
We battled the congestion all day yesterday, then called the surgeon. We now have a home health nurse coming daily to help, and she has arranged for a suction setup. Hopefully the recovery will start going smoother now.
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187666_tn?1331176945
I saw your post but didn't know the answer. I understand the feeling of being overwhelmed, needing help but not sure who to turn to. I'm almost in that mode with my elderly mom (she's 84). She needs a lot more help than I can give her but her doctor doesn't seem to get it (he only talks to her for 15 minutes, not a good way to determine how she handles her daily life). I keep waiting for some turning point where the doctors will take notice and insist on some kind of assisted care. Unfortunately that usually means something dangerous has happened and I don't like that.

I'm sorry your mom was hanging over that cliff but glad someone took notice and got her the care she needs and that you will surely appreciate. Remember to take care of yourself as well. No need to wear yourself to a frazzle and be too sick to help her. (I need to listen to my own advice LOL)
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Avatar_f_tn
She might be having aspiration pneumonia....You should check her out for that.
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Avatar_f_tn
So, how is your mom doing?  I know this is an old post, but the copious mucus is likely from the NG tube and diminished swallow from the surgery which will hopefully improve.  The tube is a foreign object and the body produces mucus as a way get rid of it.  The body tries to cough up the problem.  Additionally, watery substances are sometimes a trigger for aspirate if the patient doesn't have a safe swallow.  A thicker substance is sometimes better tolerated.  One can't thicken up ice, but can thicken water with thick it.  Hope your mom is much better these days.  Good luck.
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3112530_tn?1342559764
You did the right thing. This can be a difficult decision but someone in this situation need around the clock care for many reasons. Getting an at home nurse was the right thing to do.
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3112530_tn?1342559764
Speak to a social worker and explain the situation. Doctors are not always aware of how 'severe' a situation is unless they 'live' with the patient. Talk to a social worker and explain that your mom is elderly and alone. Look at the whole picture.
Does she take her medications like she is supposed to?
Does she do all her own cooking and house chores and how does she function in this capacity?
Does she ask neighbors for help or anyone else (more than once in a while)?
Look at your living and then look at your moms living and ask how you would function in a situation like this and would you need help in her situation?
That may help the social worker make a decision. Don't depend on the doctor. He is only there to 'treat' the patients illness, not her living situation and they can care less sometimes. Get the social worker to talk to the doctor. They are wondrous people when they try to be.
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Avatar_f_tn
Thank you for the advice! Only 2 days after my last post, Mom was admitted back into the hospital for pneumonia. When she was released, she was transferred to a skilled-care nursing home. After a 2nd bout with pneumonia and problems with dehydration, she finally started improving. After she was stronger and doing well with rehab, they started her on radiation treatments. She stayed at the nursing home until all 30 treatments were done. It was the best plan for everyone. I am much more comfortable being her daughter than her nurse. I took her to radiation 5 days/week. When she was feeling up to it, I took her home for a few hours at a time. The radiation made her very tired and sick on her stomach.
I'm happy to report that Mom has been living back at her own home for nearly a month now, and is doing great! She lives 2 miles from me, so I still keep a close eye on her. She still has a few leftover effects from radiation (burns and swelling), but she is improving steadily. Her feeding tube was removed last week! I am a happy, grateful daughter! :)
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3112530_tn?1342559764
Nice to hear the good news. I know this has been a trying time for you but look at the end results. Enjoy these moments and treasure the good days, they get you through the rough ones. ( I speak from experience)
I took care of a buddy of mine who had cancer. He had all the treatments but his nature was always to pass a smile in his daily life. He did so with wonder and amazement. His strength kept us all going including his mother. Out of it all, that is what I remember most. The laughter helped him heal and the joy he brought to others around him lives on to this day.
The stories I could tell....
I would be glad to pass one or two on if you would be willing to see how his laughter gave us a life to live in the moment and how the moment lives on.l
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