My husband was recently hospitalized. When he was rolled out of the hospital he asked me if I had money to tip the young man who assisted him. I had two dollars. My husband apologized as he gave the two dollars to the young man. Halfway home my husband turned to me and asked, " Do you have my shoe?" This shoe had fallen off my husband's bandaged foot on the way to the car and the young man had tucked it in the back of the wheelchair.
"Two dollars and a shoe," my husband observed. "That was his tip, two dollars and a shoe."
Open-toe, Adjustable Shoe for My Husband to Come Home in
I thought, when he made that statement, what a great metaphor for the whole hospital experience. While the people who cared for my husband were, in my view, heroic in their efforts to keep him safe, still the hospital experience is humbling. It strips one of independence. It strips one of the basic dignity touchstones. Everything about one is modified to accommodate institutional requirements.
Two dollars and a shoe. That summed it up for me.
A 2022 article in the journal Nursing Philosophy, (from UC/Irvine) describes more objectively a patient's experience in acute care hospitals. The title of the article is "Hospitals as Total Institutions".
...the person is stripped of the ‘domestic’ identity and support provided by ‘outside’ arrangements...
Upon entrance to the hospital, one must leave behind the autonomous role one plays outside of hospital walls. Inside the hospital, a person may be become a patient...generally cohorted with other similar patients...often referred to by their diagnosis or speciality area.
The acute care hospital employs specifically constraining techniques to reduce social interaction with the outside world...Hospitals employ security officers, or even off‐duty law enforcement to guard entrances. Visitation is limited or even restricted by staff. Doors and hallways are restricted...
Despite the generally accepted premise that meaningful partnership with patients and nurses enhances patient care delivery and outcomes, investigation has demonstrated that in fact, very few interactions elicit patient involvement in decisions about their care...
This last point was clearly illustrated in my husband's hospital experience. He is not a young man. As a matter of fact, he and Rudy Giuliani attended the same high school at the same time, although my husband was two grades behind the ex-mayor. My husband's operation had lasted seven hours, two surgeons working in shifts, and the procedure had taken a toll on his body. Still, with outstanding care that he was given, after a week the acute phase of his recovery was over.
We were ready to go home.
Hold on. Every time a physician or nurse addressed the issue of discharge the individual spoke in terms of 'rehab'. That is, my husband was to be discharged into another institution for care.
"He's going home," I had told his doctor even before the surgery.
"Are there stairs?"
"Yes, but we'll get a stair lift."
"He won't be able to sit."
The surgeon explained that my husband would have a stiff brace on his leg for six weeks and not be able to bend the knee at all.
"We'll get a stair lift where he won't have to sit."
That's exactly what we did.
I found a vendor who was able to sell me a lift on which my husband could stand as the lift carried him up to the second floor. It was a refurbished lift, and we had to pay cash for the urgent installation.
A physical therapist worked with my husband in the hospital. He remarked that my husband was strong, that he was able to walk as well as most who are discharged from rehab. In-house physical rehab was not necessary.
Yet, when the plastic surgeon came, he referenced discharge into rehab. When the orthopedic surgeon came, he referenced discharge into rehab. In each case I asserted firmly that we were committed to taking him home, and to receiving home care.
With each orthopedic surgeon, and each plastic surgeon that came, we had to dissuade the physician from the idea that my husband was being discharged into rehab. Finally, I called the social worker, who would oversee discharge arrangements.
Her paperwork indicated that he was going into rehab! I set the record straight.
With Home Care I Go Through a Lot of Disposable Gloves
"He's coming home." I told her. "The physical therapist has assessed him and determined that he can do outside rehab. But if he is coming home, I need home services. And I need those right away. I want to be ready, to keep him safe."
On the day of discharge I was a little surprised to see that he still had tubes in him...but no IV, thankfully. I was instructed on how to manage the tubes and how to change his surgical dressing.
To be honest, I was worried I might not be able to do all this. But I raised two children so I had experience in dealing with illness. And my mother spent the last four months of her life in my house, as an invalid, so I had experience in dealing with home care. I decided I would screw my courage to the sticking place and do what had to be done to bring my husband home.
Sterile Cotton Swabs an Essential Tool
He came home three days ago.
So far, the visiting nurse has 'visited' twice. Both times she took his blood pressure and pulse.
"Perfect," was her verdict, on both occasions.
When I picked my husband up from the hospital he looked green in the daylight. On the way home he leaned against the car's back door wearily and stretched his legs across the back seat.
Today his color is good. His appetite is good. He's wearing clothes he chose, sitting in a chair he bought, watching the Mets on TV and the World Series of Poker on his computer.
The cat visits him regularly. The dog paid him a visit yesterday. My granddaughter just popped in and gave him blueberry muffins.
Tomorrow the physical therapist comes, and Monday the nurse again.
I won't say it's been a smooth run the last few days. The first night I thought I messed up a tube and was on the phone with the discharge nurse for almost an hour until I was reassured that I had managed the procedure properly.
My son and daughter are great helps. It would be hard without their support. But I would do it.
My husband is happy today. I don't know what tomorrow brings. But I also don't know what would have happened had he gone into rehab. My son's best friend lost his mother in rehab...she was dehydrated and died in a pool of her own vomit. My brother was in rehab recently and came down with a case of C. diff.
There are no ideal solutions. My husband and I came to this decision, to have home care, and we are content with it. We haven't delegated his care to others but have assumed responsibility for it ourselves. Will we regret this? Never.
My activity on Hive the last couple of weeks has been lean, and may continue to be so until things have settled down around here. It's good to touch base with my Hive community, though, and to share what is most important in my life right now.
Thank you for reading. Truly, I wish health and peace to everyone.
I took the pictures in this blog with my cell phone.
BTW: We found the 'lost' shoe in the car. Still, Two Dollars and a Shoe--I couldn't resist the title :) .