You may have seen some coverage of the report released this past fall on the growing importance of caregivers in providing help that would require a registered nurse if the patient were in a hospital. "Home Alone: Family Caregivers Providing Complex Chronic Care" was jointly researched and written by AARP and the United Hospital Fund. Managing prescription and non-prescription medications took up the biggest chunk of these surrogate nurses' time. But more than a third of those providing what otherwise would qualify as professional care also managed wound treatment - and two-thirds of those were fearful of making a mistake.
Wound care is a tough job, for many reasons. First, there's the "ick" factor - many of us can get squeamish around open wounds. Second, there's a real fear that doing something wrong could mean more pain or a serious infection for a loved one. I had to meet both these reactions head-on while Dad was living with me, caring for everything from diabetes-related toe wounds to skin tears resulting from a fall on my back deck. In few of these cases did the medical pros who sent him home with me consider the emotional hurdles I'd have to jump to handle these tasks.
A post by Carol Levine commenting on this report gives tips on five issues to consider if wound care is added to your caregiving duty roster, but I have a couple more.
- Be prepared. Before your loved one comes home, make sure you've gotten visual instructions on the treatment you're expected to give. If necessary, ask the nurse to redo a dressing so you can see exactly what's needed. If you don't understand something, ask questions. Is antibiotic ointment involved? Is it important to leave some room for an injury to "breathe?" Knowing why a dressing is being applied in a specific way is every bit as important as the technique itself, because you might not have the exact same supplies available at home.
- Ask for supplies. I learned to ask both the nurses at Dad's doctor's office and the visiting nurses who would come by for a week or so after Dad returned from the hospital if they had any excess bandages, stretchy tape, gauze and other needed supplies. Not only can these products get expensive when buying them yourself, you also may not be able to find the same little gauze squares or stretchy tape once you've been left to manage on your own.
- There are no extra points for prettiness. Don't fuss if you can't fold corners or wrap as neatly as the paid professionals. If the wound is adequately protected without getting in the way too much, you've done your job.
- If something doesn't seem right, call in the pros. Aged skin is paper thin and very fragile, and anyone on an aspirin regimen or taking other blood thinners can bleed profusely. Even a nosebleed can become life-threatening to an anemic 90-year-old. If bleeding starts that a pressure bandage can't stop, call the doctor or the after-hours emergency number.
Photo by Ramberg Media Images courtesy of Creative Commons