A Day of Care Giving – Gregory Scott Daniel
I am going to do this update a little different from previous updates. Scott is doing just fine, or at least as well as can be expected but there may be some who are considering taking care of a loved one in the home or perhaps will have to make that decision in the future. The following will give you some idea of what to expect.
As you are probable aware, Scott suffers from a TBI (Traumatic Brain Injury). Scott is on a ventilator 24/7 and is fed through a feeding tube (g-tube) going through his abdomen into the stomach. Below is a list of things that have to be done. I am beginning the list at 8:00 AM in the morning and going through the schedule for 24 hours.
8:00 am—Take blood pressure and temperature. Check to make sure he is comfortable and positioned correctly. Check Pulse/Oximeter to make sure oxygen saturation is ok. Listen to the lungs for clarity or bronchial sounds. If bronchus is heard, suction and if still heard, use an ambu bag with a small amount of saline to break up the mucus so it can be suctioned out. This is something that must be done (on Scott) several times a day and sometimes may take as long as 30 minutes. In the past I have had to do this for up to 3 hours.
9:00 am—Give Scott a bed bath and at the same time check body for pressure points to treat and make sure they won’t turn in to bed sores. Pull up in the bed and wash hair. Ventilator patients must be kept in a sitting position in the bed of 30-45 degree angle as much as possible. Scott has an electric bed so this is easy.
10:00 am—Suction with catheter through trach then give him a breathing treatment with nebulizer and albuterol. When breathing treatment is finished, suction trac and mouth then ambu bag and suction until lungs are clear.
11:00 am—Change Scott’s position on bed, ie left side, right side or on his back. This has to be done every 2 hours at least, or more often if Scott lets you know he is uncomfortable and wants to turn. Turning like this accomplishes several things including helping break up mucus in the lungs, keeping him from getting pressure sores, and helping his internal organs function better.
12:00 pm—Check on Scott to ascertain if he is comfortable, breathing evenly, and if his skin coloring is good. Do range of motion (ROM) on both legs, both arms and his neck starting with fingers and toes then working arms and legs. Done correctly, this takes 30-45 minutes.
1:00 pm—Mix up Scott’s supplements and administer through the g-tube via a 60cc syringe. Pour feeding into gravity bag and administer through the g-tube.
1:30 pm—Clean and wash gravity bag for next feeding.
2:00 pm—Home health nurse here to draw blood. Help hold Scott’s arm so blood can be drawn.
3:00 pm—Turn to left side and clean and pack bedsore on right hip. Turn back on his back and suction secretions broken up from turning. Ambu bag to break up remaining secretions. Give fiber in 8 oz water by 60cc syringe through g-tube.
4:00 pm—Suction and make sure he is comfortable.
5:00 pm—Administer medications for seizures, suction and start a breathing treatment. When breathing treatment is completed, suction through trach, around trach and in his mouth, then use a stethoscope to make sure lungs are clear. Change the drain sponge around trach and g-tube.
6:00 pm–Check on Scott’s condition and comfort.
7:00 pm—Mix up supplements and feeding as done at 1:00 pm.
8:00 pm—Discard gravity feeding bag and check on comfort and positioning of Scott.
9:00 pm—Suction Scott’s trach and mouth and do Range of Motion as previously described.
10:00 pm—Turn Scott on his side and position his feet so that he is comfortable.
11:00 pm—Suction Scott’s trach and mouth and ambu bag and suction until lungs are clear.
12:00 midnight—Suction mouth and/or trach if needed. Take blood pressure and temperature and access how he is doing.
1:00 am—Turn on back and administer supplements and feeding with a new gravity bag as done at 1:00 pm. Suction trach and administer breathing treatment.
3:00 pm—Turn on side and administer 300cc of filtered water thru gravity bag on a slow drip.
4:00 pm—Suction if needed and make sure he is comfortable. If awake do range of motion as at 12:00 pm. If asleep do at another time. Clean gravity bag if needed.
5:00 pm—Administer medications and reposition.
6:00 pm—Suction if necessary and see to comfort.
7:00 am—Turn on back and administer nutritional supplements and feeding as done at 1 pm.
I have probable left out some of the things that are done, but not necessarily on a daily basis such as ordering medicine refills, food and supplies, nutritional supplements, etc. This will give you some understanding of what it requires for caring for someone in the home. I really must be a labor of love and I believe this is what God intended.
Of course there are people who cannot do this for one reason or another, ie health, finances, etc. That is where Nursing homes and Independent Living homes are needed.