Even though we’ve hired an aide to help her at home during part of the day, I’m really concerned about her safety when she’s alone. What should we do?
Nancy’s comment:
If you’re caring for someone who doesn’t live with you, it can be helpful to have an occupational therapist (OT) make a home visit to the patient’s house to evaluate the patient’s needs for safety and mobility. This may be covered by insurance. An OT can suggest placement of grab bars in a bathroom, a ramp rather than steps for easier access, and other safety and comfort measures, which can make a great difference in how the person you’re caring for can manage when he or she is alone. Just improving a person’s mobility can buoy his or her spirits and speed recovery from a difficult round of chemotherapy or radiation treatment.
There are times when people are unable to manage alone, either because of physical limitations, mental impairment, or both. Decisions about how to handle this involve both practical and emotional considerations. Ask yourself: Is the impairment temporary or treatable? Or is the impairment long-term and not likely to improve? If your mother has recently been in the hospital for a couple of weeks or longer, it may not necessarily be the cancer that leaves her unable to care for herself, but rather the weakening and deconditioning of the body that occurs when people are inactive for prolonged periods of time.
In either case, talk with the doctor to see what she thinks is contributing to your mother’s physical condition. Ask her about having a physical therapy evaluation. A physical therapist and physiatrist will both assess your mother’s ability to manage safely at home and suggest a program for her rehabilitation. Similarly, if your mother just had surgery and seems confused or “just not herself,” it could be a temporary side effect of the anesthesia or other medications. If this continues, do not be surprised if the physician wishes to consult with doctors from other specialties to discuss possible solutions.
If your mother is currently admitted to the hospital, it may be that after a few days of physical therapy, your mother will be able to return home directly and be able to manage with support from family members staying with her. A physical therapist may be able to visit her at home to help her get back her strength, and a home health aide may be included in these services to help your mother get back on her feet again. With this assessment and assistance at home added to what you’ve already arranged, your mother may be able to manage well out of the hospital.
Although you may still be uncomfortable with the idea of your mother going home, it’s important that you take into account how she perceives her care needs, before imposing any plans or solutions. If she feels she can manage at home with the help of an aide, or even by herself, you can voice your concerns and discuss with her additional ways of ensuring her comfort and safety: having more family involved; hiring additional help privately; or installing a Personal Emergency Response System (PERS), which she can wear on her person so that she can call for immediate help in a crisis.
On the other hand, it may be that your mother does require a longer or more intensive program of physical therapy to get better, or simply needs more help than can be provided at home. In this case, your mother can transfer from the hospital to a skilled nursing facility for rehabilitation (see the next question), where she can receive both nursing and personal care around the clock, in addition to participating in a daily program of physical therapy.