It was about 20:00 and the Ambulance phone rang. The Ambulance officer informed me that they had been called out by the after hours General Practitioner. They arrived at Doris’ (not her actual name) home. Doris had been experiencing increased confusion and decreased mobility and it was likely that she needed to be admitted to hospital.
About 25minutes later the ambulance arrives with this 89 year old lady. Doris needed to be transferred from the ambulance stretcher to the hospital trolley due to her decreased mobility which, in turn, increased her risk of falling. With Doris in the ambulance was Doris’s daughter, Anna. who was her primary carer who was aged 64 years.
As nurses, our first priority was to assess Doris and build a picture of what was happening to her. It was very difficult to pin point an exact cause of Doris’s increased confusion and decreased mobility. This was due to the fact that her medical status was clouded by her chronic heart disease. The doctor thought that the most likely cause was an infection. Finding where the infection was coming from required a good history and some medical tests.
Not fully appreciating the fatigued state of Doris’ daughter Anna, I proceeded to gain an accurate account of Doris’ deterioration over the last week. Anna gave a very good account of what had precisely occurred in the last few days. This provided valuable information to helping resolve Doris’s medical problems.
After an hour, all the blood tests, swabs and urine tests were sent for analysis and Doris was sent for a chest X-ray.
I noted that my first clue to the depth of Anna’s fatigue was finding her sitting up in a little chair, head perched on the wall: sleeping. I was so concerned about helping Doris that I missed out on identifying that Anna had a problem too.
I asked Anna why was she so tired?
Anna explained she is the sole carer for her mother with community assistance for hygiene cares 3 times a week. Anna performed all the cleaning, transferring from bed to chair, toileting making meals everything. It was more than a full time job. Over the last 3 days, Anna was so concerned about her mother’s declining health and the extra demands Doris placed on her that this had meant that Anna hadn’t sleep for 3 days.
Doris was unwell, but it was actually Anna who was at crisis point when she arrived in the emergency department. The strain of caring had reached breaking point and all Anna could think of was call a GP who called the ambulance.
After all the test results came back, Doris was found to have a lung infection that required hospital stay. Anna was relieved because she could have a good nights sleep knowing Mum was well cared for in hospital.
My time spent nursing and researching for iNightingale has allowed me to gain a unique insight into carers’ health management. The slow progress of a lung infection can catch a carer by surprise when they are unaware of the warning signs.
The observations I made were:
It’s hard to see how difficult a situation can be until you remove yourself . It’s a good idea to set boundaries to monitor when a situation escalates: it helps you be aware.
Fatigue is like being intoxicated: you cannot think clearly and you are unable to make rational decisions, let alone care for someone. There is a high risk of serious incident occurring while being fatigued.
Seek help early for assistance. Even just to help you through a night.
Are you a carer with similar experience? How did you cope? Leave a comment or your story to share with other caregivers.
Phill Tsingos is a Director of inightingale. Qualified Registered nurse. He has been a nurse his entire adult life (Circa: 1993). He thrives on the daily challenges of working in an emergency department (Clinical teacher). Phill’s mission is everyone should have the best quality of life possible. He has made caring for people a life long devotion (perhaps even an obsession). Seeing many people suffer as a result of inadequate care at home. Phill wanted to be the prevention not the cure. That is how iNightingale was born. Phill loves questions or comments or general chin wag at firstname.lastname@example.org Google