Caring for elderly parent after a heart op

[RobL]

Hey all

 

My mother was admitted to hospital on Wednesday with a cardiovascular problem, hospital informed me today that after an angiogram she's now been slated for a heart bypass.

 

My late father had a bypass in the early 2000s, but I was living on my own at the time and wasn't involved in the before and after, frankly I only found out when I had to move back home, so I don't know what sort of care he needed after the op whilst he somewhat got back on his feet.

 

If my mother survives the op I don't know what to do, as I'm not a health professional and I struggle quite a lot at times to look after myself on a daily basis (I'm 44, I've got arthritis in various areas of my body, and chronic severe asthma and eczema, among other ailments), so caring for her, if she needs it, is going to be an uphill struggle.

 

I'm between jobs, so that will have an impact also.

 

I'm home on my own, worried, and don't know where to turn.  Apologies for posting this here.

Edited January 8, 2022 by RobL

[Richard E]

Hi Rob

 

Sorry to hear your news, making contact with the British Heart Foundation http://www.bhf.org.uk might be a good first starting point.

 

Hope all goes well

[Stef N.]

Currently in a similar shaped boat Rob. After the latest Covid panic my dad was moved out of hospital back home to make room. They arranged a care package so I have care workers, who are great, come in regularly. It is hard work and worrying but there is help out there to take off a lot of the pressure off you.

 

Richard's advice is great. The charities have a lot of knowledge and contacts.

 

Also ring the social care team at the hospital where your mum is and explain your position. They should help get any after care balls rolling.

Maybe also your mum's GP if you need any extra help.

 

Get used to using your phone. I hate using mine but I've used it more in the last few weeks than I had for the ten years previous.👍

[Vince1159]

I cared for my dad for about 18 months before he died in 2019,he was in heart failure and needed care all day for dressing in the morning until helping him get ready for bed of an evening and then i slept with one ear listening in case he needed help...I don't know what it's like in the uk but over here i had carers that came in three times a week usually in the morning to do his legs because he had ulcers and i was also going mention about getting in touch with a Social Care team but Stef N beat me to it,once you get used to a routine it's hard work but does get a bit easier....

Edited January 8, 2022 by Vince1159

[Mr T]

Sorry to hear your problems. It is worth remembering that there is a split in the provision  between meeting health needs and meeting social care needs and what your mother may need is likely to straddle both. 

As others have said the British Heart Foundation is a good resource, but you may need to speak to your local Social Services and your mothers GP. Hopefully the hospital should set this in motion, andis also worth speaking to the ward she is on. 

I know this seems a lot to take in, but in general people try to be helpful, but things are not easy in the Health Service at the moment. You need to look after yourself as well and if you require help don't be afraid to ask for it. 

[Seahawk]

Based on looking after my mother after she was diagnosed with terminal cancer, I offer the following thoughts.  Do bear in mind that, apparently regardless of what the law says, policies and practices may vary between health authorities and from county to county.  It's also possible that a terminal cancer diagnosis opens doors that otherwise stay shut.

 

1.  The hospital can't just turf her out onto the streets.  Part of the discharge process will entail ensuring there is, if justified, a care package in place to meet her needs.

2.  I think there is a statutory entitlement to 2 months' social care on discharge if the need is justified, which gives all interested parties breathing space to assess the situation.

3.  There's an important difference between health and social care needs: the NHS pick up the tab for the former, the local authority may do so for the latter.

4.  As others have said, get in touch with BHF and social services: remember you will not be the first to be in this boat.  They will know what is and is not possible.

5.  There are no marks for understating the problems you face.  I am not for a second suggesting you exaggerate or lie but, as a social worker told me, "tell us how it is on a bad day".

 

Your mother's case is not the same as my mother's and we are almost certainly in different health areas.  The above is based on my experience but apologies if anything turns out to be untrue.  But overall, miserable old cynic that I am, I was moved and grateful to see how much help, support and plain kindness there was available from our much maligned NHS and State social security systems.

Edited January 10, 2022 by Seahawk

[RobL]

Thanks guys.

 

At the moment it seems to be a waiting game.  Can't get much info from the nurses. mother is lucid (or as lucid as she ever is) and showering etc. herself whilst on the ward, but she only seems to give me half the story, or bits and pieces at a time, apparently now she's had some scans but has to see a dentist before her heart bypass?!

 

Every time I have to deal with her, nurses, or anything to do with this situation (like having to pay the rent) it makes me feel unwell.  That subsides when I go off and do something else (like painting a figure) to take my mind off it though.

 

Doesn't help that I can't be there in person, even just to collar the doctors/surgeons for their input on what's going to happen going forwards.

 

I spoke to someone at another hospital in the county (it's in the same trust and he oversees people in a department at the hospital mother is in), where I volunteered and then worked back in 2017-2018, because I can't get to the hospital mother is at, so can't speak to the nurses or deliver magazines and stuff, and was assured by him that she is in the best place at the moment, and they are going to buy her some magazines/word search books and deliver them to her, to keep her mind off things, so I guess that's one good thing.

Edited January 11, 2022 by RobL

[cmatthewbacon]

42 minutes ago, RobL said:

now she's had some scans but has to see a dentist before her heart bypass?!

 

My sympathies -- I hope all goes well. I had to have the dental sign off before my heart valve replacement. They need to check that there's no infection in the mouth or blood before the procedure to make sure the whole process is sterile...

 

best,

M.

[jenko]

Hi, If memory serves me right, my father was in and out of hospital like a yoyo (long story) However ask the nursing staff (discharge coordinator) about a care package ( Intermediate care reablement or after care) that your mum can be sent home with. This might  last up to six weeks or so but it gives you breathing space to sort things out.

A good point of call is Age UK.

Talk to your surgery.

 

Remember you are not alone others are in the same boat.    Google is your friend here.

 

HTH

 

Dick

 

[Seahawk]

26 minutes ago, jenko said:

….However ask the nursing staff (discharge coordinator) about a care package ( Intermediate care reablement or after care) that your mum can be sent home with. This might  last up to six weeks or so but it gives you breathing space to sort things out.

That’s the phrase: ”reablement care package” - what I was wittering on about in my points 1 & 2.

 

Two more points:

 

- The health and care professionals will look at the situation in the round, including the demands it places on friends and family to provide support.  They will be looking to ensure you get the help you need as well.  I found the concern shown for my welfare almost embarrassing.

- The situation leading up to a heart attack may be terrifying but a heart bypass operation is a modern medical miracle.  My father had a triple bypass in 2000 and went on to have a normal, contented and anxiety-free life for 11 years (until cancer claimed him).

 

Best wishes.

[jenko]

Rob. 

One thing I forgot to mention and I would say this to anyone with parents who are getting towards elderly. Take out Power of Attorney for both Health and Finance.  You won't hopefully need it now but who knows what the future holds.

 

I did it for both my parents. Didn't need to use it with my father to much but mum is a different case . 91 and has dementia  at the worst level , bed bound etc. 

 

This is the one thing I ask every one to put in place. Best to think a head.

 

Dick

[Dave Swindell]

17 hours ago, jenko said:

I did it for both my parents.

Whilst I'd concur that having powers of attorney in place is desirable, as far as I'm aware you can't do it yourself, they have to grant you power of attorney. 

You can persuade them to do it, but you can't force them to, and it has to be done "whilst they are of sound mind" ie before the effects of dementia etc affect their faculties.

Once they're beyond this it's down to the courts who may or may not grant this.

[jenko]

1 hour ago, Dave Swindell said:

Whilst I'd concur that having powers of attorney in place is desirable, as far as I'm aware you can't do it yourself, they have to grant you power of attorney. 

You can persuade them to do it, but you can't force them to, and it has to be done "whilst they are of sound mind" ie before the effects of dementia etc affect their faculties.

Once they're beyond this it's down to the courts who may or may not grant this.

This is totally correct. I managed to get it put in place when they were both of sound mind. 

 

Not having it in place will mean if you need it at a latter stage when said parent is not of sound mind then you have to go through the Court of Protection. This is both very costly and time consuming and a pain.

 

Dick

[Pete in Lincs]

Rob, I'm sorry to hear of your troubles. I had a quad bypass ten years ago. Hopefully some of my memories might help you.

 

As said above, the bypass is indeed a modern medical miracle for which I am very grateful.

Post op, the patient needs to have a positive (survivor) attitude, rather than a woe is me, I'll never get better viewpoint.

Imagine your chest hitting the steering wheel in a 30mph collision. That's how 'bruised' it will feel for at least two weeks. The Sternum has to knit back together.

I spent less than a week in hospital. During which a walk twice daily was carried out. breathless and exhausted after 100 feet, but an achievement!

Lying down was very painful so I slept semi sitting up for a month or so. Two or more months until I could lie face down.

Very aware of wanting to eat fat free for quite some time! So good healthy meals are the norm.

Gentle but regular exercise. I used to walk one or two miles a day. Stay upright, bending exaggerates any breathlessness.

For the last six years I've done very heavy work as a drayman. An 11 gallon barrel weighs 63kg. Recovery to a normal life is possible,

But it takes time (expect several months) and you have to want it and work at it. Again, positive thought and encouragement works. 

[cmatthewbacon]

I’d endorse everything Pete says above… except the becoming a drayman part. That’s a step too far for me 😜 I was v nervous beforehand but the two things I was most nervous about — the op and the scar — turned out to be much less scary than I though. Genuinely missed the whole of the first in apparently the blink of an eye, and the scar never really hurt and healed within a few weeks. I didn’t like coughing for a couple of months. And if they give her a device for getting her breathing deeply again try to get her to use it regularly and often, it really helped me get back to normal. (If you’ve seen The Right Stuff, it’s a plastic version of the test where they’re breathing out for as long as possible…) I started Couch to 5k four months after the op and completed it a few months later…

best,

M.

[Pete in Lincs]

I forgot to mention. The anaesthetic can cause drowsyness for a week or so. It can also cause amnesia.

Along with trying to sleep sitting up comes insomnia. So a supply of good books is useful.

Yes, the Operation. Apprehension is high but, If you don't wake up, you won't know it. If you do, and you should, Whoopie!

[Seahawk]

3 hours ago, cmatthewbacon said:

And if they give her a device for getting her breathing deeply again try to get her to use it regularly and often, it really helped me get back to normal. 

 

Which reminds me.  They gave my father a little rubber bulb thing he could squeeze if he felt any pain post-op: it would give him a shot of morphine.  He was most disappointed when they said he couldn't take it home with him.

[Stef N.]

Another couple of tips and apologies if I have missed them already. 

Write down any questions you need to know as inevitably you will forget loads. And if possible, if you are meeting any officials, try and have someone with you just as a second set of ears. You'll get a lot of information so it helps in remembering. 

[RobL]

Thanks again guys.

 

Mother had her op last Friday, and is now recovering.  Spoke to her yesterday and she seems as lucid as usual, don't know what her physical state is though but the nurse I spoke to told me the that "cardiac wise everything went well and she's OK in that area now".  They just need to get her mobile again.  Doesn't help that she's got Meniere's disease (it's a progressive inner ear problem that affects balance and hearing).

 

Don't know how long she'll be in hospital, it's been a week since the op now, but the longer the better in my opinion (even though I can't get to the hospital to visit and pick up/drop stuff off, like clothes) because she'll need less care at home.

Edited January 29, 2022 by RobL

[Tijuana Taxi]

One important factor is to look after yourself.

No good to anyone if you are in a bad way, maybe get an asthma review to make sure its well controlled.

Also make sure you are looking after yourself from a mental health angle, reason things through rather than panic.

 

Don't expect lots of care worker visits for domestic/everyday tasks when they know someone can be there to do it.

My sister in law had a debilitating stroke and can't say i've been very impressed with the help offered.

My ageing brother in law is there so they consider that as having a carer even though he isn't that great healthwise.

 

Hope all goes well, not an easy task and some find it easier than others.

My old ma I thought was getting the early stages of dementia so we began thinking about how to proceed,

Then at 88 she was killed in a RTA as she crossed the road

All very traumatic especially as it was captured on CCTV and I viewed it at the inquest.

So when it gets hard going just remember its better than the other option

 

 

Edited January 29, 2022 by Tijuana Taxi

[RobL]

Thanks @Tijuana Taxi

 

Mother came home last Tuesday and is "recovering" at home now, although it seems to be an exercise in information discovery at the moment because she seems to have been just dumped at home (where I also live) with little to no information (or she has forgotten any she was told).  Physio has been refused by one NHS 3rd party group, because our carers (a private company that the NHS outsource to) are supposed to be doing it, but the physio at the hospital who is apparently arranging that wasn't informed until Friday!!

 

That and our GP surgery "lost" the discharge letter until this afternoon!

 

Proverbial in a brewery springs to mind at the moment!  I've worked in admin in my local NHS trust, so I have some insight, and I was hoping things might go a bit smoother...

 

Very frustrating as mother isn't mentally up to dealing with things herself, only seems to want to sleep most of the day (caused in part by her medication), and I seem to be on the phone all day at the moment chasing up info/other's errors.  I did get a few hours on Friday/Saturday/Sunday to myself though so mother sleeping all day isn't a bad thing I guess, I was advised on Friday by a Cardiac Recovery nurse she may do that a bit. 

 

Probably sounds selfish but I just hope her recovery doesn't take too long.  I'm already suffering with an episode of arthritic swelling in my left knee, meaning that walking is more difficult than usual for me, and I'm sure it's from "running around" helping mother during the day this past few days or so (we only get 1 carer, start/end of the day).

Edited February 7, 2022 by RobL

[bentwaters81tfw]

Sadly an all too familiar story. At least she is home where you can keep an eye on her. Browbeating the NHS into action is an art form, as you will already know. Maybe a good time to have another chat with BHF? They will have more experience of other cases to draw on. Maybe the oft maligned 'Social Services' could assist with info, if not 'boots on the ground'?