How to give phyisical comfort for patient with long recovery in ICU

[PAVRinPGH]

My mother underwent aortic valve replacement, and has been in ICU.
About a week now.
What could be done to help her for to be comfortable- so she can rest and recover. They put mitts on her so she doesn't accidentally pull on her wires.
She has a tracheal tube to help her breathe, which is uncomfortable. So her head is immoble. No pillow.
She also has a pressurized wrap, one around each leg for clots? I guess.
What is typically done to help people in this situation? Comfort has got to aid recovery.
Any answers would be appreciatied.

 

[Greg a]

I would say one thing is to keep her informed as to what was happening both to her and in the newspaper.....dont ask her questions while you dont expect an answer I always found it frustrating that I could not answer .....even while in a coma I could hear my wifes voice and was aware of her being there

 

[kfay]

I'm glad that your mom has had her surgery and I hope that this extended time in ICU is just purely due to her age and no complications. Not ever having had to deal with a situation like this myself, my suggestions are just things that I think might help soothe me in a similar situation. I'm sure, first and foremost, just having someone there, holding her hand, talking to her in a soothing voice, has to be reassuring. A light "massage" of her feet/hands with her favorite lotion (as long as the nurses ok the use of the lotion), playing of some of her favorite music on an ipod for her occasionally throughout the day, reading to her from some of her favorite books, reading the daily newspaper to her, just talking to her about daily events going on outside the hosptial.

Certainly, making sure you understand her care and are a strong advocate for her, making sure she is neither under medicated nor under medicated. If you sense she has a lot of anxiety, they have drugs that can help her with that. Make sure they are using them. The hospital will have some social services on staff for elderly patients, take advatage of them. I am sure between them and the nursing staff, they will have many more suggestions on things you can do to help soothe your mom.

Be sure and keep yourself rested. She will need your help more when she gets out of ICU. Best of luck to both of you.


Kim

 

[Lynlw]

Is she awake? Normal, I just hold Justin's hand, talk to him and when he was younger, I would have music for him to listen to that really seemed to help (you could see it relaxed him, just by watching the heart monitor) Does she like any kind of books? if so maybe you could read to her.
Justin always likes a cool wash rag wiping his forehead, and if I could do it, depending on the vent, chapstick on his lips.(if she has a trach, then she might really like some kind of chapstick)
IF she can answer yes no questions, or is pretty awake, have something for her to write on, so she can tell you want she wants or likes and not get frustrated. Like for example, i rememeber after one of Justin's surgery he was trying to tell me something itched and wanted me to scratch it, I couldn't understand then remeberred to give him something to write on.

Where did she end up having surgery? Remeber to take care of yourself too.

BTW When I asked of she could answer yes no questions, Justin and I had a system, where things like 1 finger meant yes 2 -no. actually by the time he had a few surgeries, we figured out to work out a couple simple signs he could use for things he usually liked when he was still on the vent.

 

[PAVRinPGH]

Thank you for the kind replies

Thank you for the kind replies

One by one:
Greg a, that was an interesting story about you hearing while in a coma. I have heard of this, an amazing phenomeon- shows that company is not time wasted.
Kfay, another talk and touch, I think a good idea. Also she is anxious and in considerable pain, so maybe there is something that could be taken for that that wouldn't have unwanted side effects. I like the patient advocate idea, didn't think of that.
I try to get more people involved as much as possible, but brothers are in other states.Very annoying, anyways.
Lynwl
Yes, she is awake, although maybe she should be sedated or borderline sedated. She tries to speak but with a trachea tube... doesn't work. I usually can read her lips and she nods to questions I ask. But I can barely get her attention because she is uncomfortalbe. A radio, I think could be a soothing companion. It is permissible too.
It is most frustrating, this post-surgery. I am thinking of my mother here. The nurses say, what can't be done. Some are caring.
THANK YOU for taking the time to offer much appreciated advice.
A question here, she seems to want water, but with a tube some nurses say she can have her mouth wetted others say that can contribute to risk of pneumonia. Anyone know anything about this?
Thanks again.

 

[ALCapshaw2]

Did your mother sign a Medical Power of Attorney so that you (or other family members) could discuss her treatment and prognosis with her Doctors?

If so, I would want to know why she is being kept in ICU for 1 week.
When there are NO complications, patients are usually sent to a regular room in a day or two following surgery.

On the comfort issue, I'm thinking a small pillow or even just a folded towel under her head would be helpful. Getting into an adjustable Hospital Bed is a BIG Help in Patient Comfort!

'AL Capshaw'

 

[PAVRinPGH]

Al, Good advice about the folded towel.

 

[Lynlw]

She should NOT be in that much pain. There is NO reason for it. IF she is in pain complain until they adjust her pain meds and figure out what helps.
As for wetting her mouth, I think thos little sponge things they have (that look like little lollypops you wet, or the swabs they have to help with the mouth dryness, I think if they would help make her more comfortable, I would use them. I never heard they increase the chances of pnuemonia.
Is your Mom improving at all? How long did they wait before they trached her? it is a trach not the normal vent right?

 

[PAVRinPGH]

She does complain. As much as possible with a trach- it is a trach. She does get the use of that lollypop-like sponge from most nurses. They may not be medicating the pain enough for other reasons. I haven't but intend to speak on this issue asap. Lynlw Thank you for detailed reply.

 

[Lynlw]

She does complain. As much as possible with a trach- it is a trach. She does get the use of that lollypop-like sponge from most nurses. They may not be medicating the pain enough for other reasons. I haven't but intend to speak on this issue asap. Lynlw Thank you for detailed reply.

I think you should ask about the meds, if they don't want to increase whatever pain meds she is on now for some reason, then maybe they can try some other pain meds to see if they help. Justin use to love those little pink sponges, since it is a trach, she probably really would like some kind of lipbalm..Justin actually preferred flavorred ones

 

[Lily]

My son was in a coma when he was in his early teens (he came out of it well). We played some soothing music. I sat by him, held his hand, talked with him, agreed with him as best as possible when he was waking up and agitated, and often put a cool wet cloth to his forehead.

If they're giving her Versed, she may not remember any of this later.
I read something once about versed and possible oxygen issues, searched the subject and found this page of information: http://www.sedationfacts.org/sedation-medication/midazolam-endoscopy#side

I feel for your situation, your mother's situation. Best wishes.

 

[kfay]

I agree with Lyn...your mom should not be in that much pain. If she is, the nursing staff is not doing their job. If you are not their when the Dr. makes their rounds (believe me, I know how very hard it is to be there when this happens because it usually happens early in the morning and if the care is falling entirely upon your shoulders, this can be very hard to make happen), however, to find out exactly what is going on with her and to communicate exactly what you see with your mom, you need to do it at least once. They need to know that you feel she is in pain and has anxiety. These two things will make her heal more slowly. I would be very surprised if the surgeon didn't write an order for an anti-anxiety drug already. I think most of them do.

Do you have a pad and pen by the bed for her to write with? My husband and I both know sign language, so it was very helpful to communicate that way when I was still intubated, but when he left, and I tried to do it with my nurses, they thought I was from Mars, so they gave me some paper, and although what I wrote wasn't exactly coherent, they got the idea.

I really feel for you and am sorry for your situation. Have they given you any idea how long they plan on leaving her trached?


Kim

 

[PAVRinPGH]

Updating

Updating

Hello again to all.
I just visited.
One: my mother is doing much better. They got her a pillow, I asked if they would get her some lip balm. The nurse did and she appreciated it. I asked about meds for pain, and the nurse said that she could receive meds if she requested. She was much more communicative and more complaining than agitated, if you know what I mean.
I want to thank you all for excellent tips from your experiences. Plan to edit this later. Got to go now. THanks again.

 

[Lynlw]

Hello again to all.
I just visited.
One: my mother is doing much better. They got her a pillow, I asked if they would get her some lip balm. The nurse did and she appreciated it. I asked about meds for pain, and the nurse said that she could receive meds if she requested. She was much more communicative and more complaining than agitated, if you know what I mean.
I want to thank you all for excellent tips from your experiences. Plan to edit this later. Got to go now. THanks again.

I'm glad to hear she is doing better and that our suggestions helped. I think the having to ask for pain meds before you are completely alert is pretty ridiculous, they should be able to tell a person is in pain. but at least now they know it is a concern.

 

[ALCapshaw2]

Sounds like your mother is making progress.

Some Doctors take complaining as a GOOD Sign that the patient is beginning to feel better,
or at least more energetic, which is a Positive Indicator of their condition.

'AL Capshaw'

 

[Debbrn]

There are many different pain scales so that medical personnel can objectively score a patient's pain level. I deal with many kids that can not verbally tell me they are in pain. I talk to the parents and look at the patient's heart rate, blood pressure, muscle tension, etc to help me decide if a patient is in pain. Agitation can definitely be a sign of pain.

I am glad your mother is doing better.

Debbie

 

[PAVRinPGH]

Putting in my current perspective

Putting in my current perspective

Thank you all again for giving me some ideas and your thoughts and insights -very helpful. My mother can write now and is improved much in the last three days. Thank God.
Will update

 

[Lynlw]

Thank you so much for taking time to update us. I'm glad things are getting better. It must be a relief for all of you now that your Mom can write what she wants, so you don't have to try and guess and she doesn't have to get frustrated trying to let you know something.
I hope you are taking care of yourself.

 

[swim mom]

I was just in the hospital with those horrible plastic things on my legs. They put cloth (sort of like what they put on under casts) on my legs before they put them on this time. It made an amazing difference. You could probably just cut the tops and feet off of thin cotton tights to get the same effect. I definitely wanted my feet uncovered, but the cotton knit next to my skin kept me from sweating profusely!