I did my best to get the apartment ready before my wife’s spine surgery. She got all of the paperwork in order, including a POA and living will. She gave me her complete medical history and contact information for all of her doctors. We rearranged the furniture to minimize the distance she would have to walk. I taped down the rugs to prevent tripping hazards. We rearranged the kitchen and bedroom to make sure the things she uses every day were at chest-height. We hit the stores to find sweatpants and slip-on shoes she was willing to wear out in public. We made sure we were caught up on laundry, finished up all of our home improvement projects, and cleaned everything. As soon as she made it home, I realized we were totally not prepared.
Somehow, we have quite a collection of pillows. I’m not sure how this happened, but I figured we were covered. Nope. We kept shifting the pillows and building a little nest, but we couldn’t find a combination of pillows that was comfortable. Sleep problems due to chronic pain are nothing new in our home, but the increase in pain and the medication was making it impossible.
Off I went on a tour of the surgical supply stores of Brooklyn to find foam wedges. It felt pretty melodramatic to be going from store to store in the rain – and I got some weird looks as I lugged it all home on the subway. Spare yourself and order it online ahead of time. I recommend a wedge to sit up, a wedge to lay back, a knee wedge, and knee support for lying on your side. We made sure that she changed position regularly and got up for walks around the apartment. She iced her back a few times a day. She used a reusable gel pack, but other people swear you’re better off with a bag of frozen peas. A lumbar support pillow for sitting is great, too, if you don’t already have one. Prolonged sitting generally isn’t recommended, but her doctor said it was fine for 20-30 minutes at a time.
Make sure you have a firm mattress and a firm couch. A piece of plywood under the cushions can go a long way. We have a Danish-style daybed with a solid wood base, so we took the cushion off and made a pile of rugs and blankets to create the correct firmness.
I made sure she was set up with a bottle of water (to prevent spills), her medications, a notepad, the remote control, and our tablet within easy reach. She was able to manage her own medications as soon as she was released from the hospital, but many people will need their caregivers to manage their medication to make sure they keep on schedule and take the correct dosage. Make sure your patient is staying hydrated and getting the nutrition they need. We ate a lot of smoothies and used the juicer a lot during the first few days. And ice cream.
You won’t be there at every moment to reach things for them, so a grabber is really useful. Don’t bother with the cheap ones at the toy store, since a few dollars more will get you a much more useful tool. Your patient’s healthcare team will tell you if they should be minimizing movement as much as possible or if they should quickly work to re-establish range-of-motion. My wife wasn’t supposed to bend or lift anything over 5 lbs for several months. She was also fitted with a back brace to restrict her movement while standing and walking.
A temporary bed rail can make it much easier to get in and out of bed. We didn’t bother with that, though, since I was going to be home with her until she was well enough to get up and down on her own.
It’s likely that their doctor will tell them not to bathe or shower for the first few days. Baby wipes fill the gap well enough. You can install a non-slip mat or strips in the tub. You’ll also want to get a raised toilet seat to make it easier to get up and down. Many medications are notorious for interfering with digestion. You can make it easier for them by being ready with prune juice, milk of magnesia, docusate sodium, or senna. It’s not recommended to rely on laxatives; it’s safer to make sure your patient is getting enough fiber and liquid.
A stock of nutritious snacks to leave out on the counter is great. Having prepared or easy-to-prepare meals will make your life a lot easier. I never understood why someone would install a dishwasher in a one-bedroom apartment until my my wife had surgery – it was the first time we were preparing three meals a day in the apartment. She quickly returned to being the cook of the house, with me as her sous chef and dish washer.
Her physical therapist encouraged her to take short, frequent walks as soon as we got home. A foldable cane makes this a lot easier. Be sure to pick one with a rubber grip – she has one with a slick surface that falls down 9 times out of 10. The cats are terrified of the cane, so she carried it around the apartment more for protection from the cats than for as a walking aid. We already had night lights in every room and integrated into some of our outlets. Some people will pull up all the rugs for fear of tripping, but many floors are too slippery to be bare. You can be prepared with a few pairs of non-slip socks. We did just fine with our non-skid rug pads.
My wife will be home recovering for a few more weeks, but she’s doing well. Hopefully you can benefit from my mistakes and be prepared for your patient to be released from the hospital.