Caitlin Whyte (Host): Welcome to BayCare HealthChat. I'm your host, Caitlin Whyte. And today we're sharing some resources for caregivers, especially when it comes to joint replacement surgery. And joining us for this conversation is Samantha DeWalt, an Orthopedic Nurse Navigator with BayCare.

Well, Samantha, to start out our conversation on caregivers today, first, tell us what is the role of a caregiver and who can be considered a caregiver?

Samantha DeWalt, BSN, RN, ONC (Guest): Well, I'm glad you asked because I really think that anybody can be a caregiver as long as they can perform the roles of a caregiver. Really the caregiver, you know, care being the key word, is important because we want somebody to be willing to give care and have the patient's best interests in mind. The role of the caregiver is also to help the care receiver with everyday activities that they may not be able to perform on their own after surgery.

So again, anyone could be a caregiver as long as they're willing and can perform those tasks.

Host: Well, when it comes to scheduling and planning ahead for this caregiver, how many days should we be available before, during, and after the surgery?

Guest: There's just certain things that the caregiver can do to support the patient. Specifically in assisting them preparing their home ahead of time, there are certain things that we suggest on preparing the home. Sometimes patients are a little, stiff and not able to perform many physical activities before surgery so that assistance would be helpful from the caregiver, as well as attending any type of preoperative classes or educational appointments. Because the caregiver can also learn a lot from those classes and appointments that will help them be a better caregiver in the end.

And as far as during goes, sometimes surgeries happen very early in the morning so the day of the procedure, the caregiver should be available to take the patient to the hospital or the surgery center, wherever the surgery is taking place. And sometimes that can be very early in the morning, you know sometimes you know, you're looking at having to be there at 5am. Often patients are able to go home after their surgery. So, if that is the plan, then you're kind of looking at a whole day type of availability for surgery day because the caregiver will need to assist the patient home that day by driving them home and of course taking care of them throughout the night as well. After surgery, once a patient is home, 24 to 48 hours of close availability would be preferred having the caregiver staying in the same home as the patient. Especially for those patients who get to go home that day. At least 24 hours of closely staying in the same home and being available to the patient.

Also depending on the discharge plan, if the patient is staying overnight, just being available that following day to go to wherever they need to go, or, on the day of discharge, be available to receive some education with the patient. Oftentimes patients are taking medications that might make them forgetful so having that extra set of ears when that postoperative education is being taught to the patient is also important. And then once the patient is home, again, 24 to 48 hours of that close care, and then up to two weeks of just being available to help them with those everyday tasks that I mentioned earlier and also driving them to their follow-up appointments.

Host: Well with all of these tasks, what are some of the physical duties we should be aware of that caregivers need to take over for the patient after surgery?

Guest: Great question. A lot of times we think that we can do everything right after surgery so it's really nice to have that caregiver who can, again, driving. A lot of patients are not able to drive for up to six weeks. So driving is important if you need to go to the grocery store or, you know, run an errand to the bank or something like that, as well as follow-up appointments, like I mentioned, cleaning, cooking, any pet care such as walking an animal. Most patients won't be safe to walk an animal on a leash for quite some time until usually they're cleared by their physical therapist to do so, or by their surgeon. Also, household chores that may require bending over because some patients might have precautions that prevent them from bending.

 You know, just those things that we do every day that we don't think about and sometimes take for granted. Usually our, our daily activities and our routines that we're used to, those will have to be put on pause for just a little bit because physically you're not going to be your best right away.

And it will take some time for you to get back into doing those everyday activities, household chores, errands, like you would, so that's when that caregiver can be very helpful to help with those things. Even, you know, sometimes getting dressed, getting your shoes on, those might be a little difficult in the beginning.

And the goal will be to get the patient back to those everyday tasks and activities. But the caregiver can help them along the way while they can't do them on their own.

Host: Absolutely. Now, we talked a bit about prepping for surgery. How can the caregiver prepare the home of the patient in advance, what should we be looking out for?

Guest: The patient should be taught this as well, but, you know, it's always great to have a team to tackle these tasks. So, oftentimes, patients don't think about installing grab bars in their showers or handrails on their stairs. So that might take a team effort to get those things put in the home ahead of time.

Moving any furniture that might obstruct a clear pathway from the patient's bedroom to bathroom to kitchen. Moving those throw rugs out of the way. Installing night lights so they can have a clear path. Oftentimes patients are using some type of durable medical equipment to help them ambulate and oftentimes it's taking up a little bit more space than their body usually would so they kind of have to clear those paths a little bit bigger than, what they're doing just normally walking at home. Maybe going to the store to purchase, you know, a non-slip mat for the shower so there's no concerns about slipping and falling in the shower. A lot of it's just making the home safe for return after surgery.

Host: Great. Now what about afterwards? What can the caregiver do for the patient to just keep them organized after surgery?

Guest: I had mentioned this earlier, sometimes the medications and anesthesia in general, can make the patient a little forgetful or make it harder for them to, focus and just having that extra set of eyes on, when's the last time I took my medication? What did I take? When did I take it? And, making a medication schedule so the caregiver can assist with that. Medication schedules are very important to help with pain management, and of course, making sure we're not doubling up on our medications. As well as, you know, helping the patient remember, when the follow-up appointment is, scheduling that follow-up appointment, if it still needs to be scheduled, just keeping them on track, when some of those medication side effects might be coming into play.

Host: Well, what about emotional support? I'm sure after a surgery a patient might need a little more, you know, TLC from their caregiver. So how can we be supporting our patient emotionally while we're taking care of them in the best way?

Guest: I think this is one of the most important things that a caregiver can offer. Just having that support person, having that cheerleader, that person to encourage you, make you feel like you are progressing in a towards the light versus, kind of staying in the same place. Encouragement is really big because people can be very hard on themselves and they want to get back to those everyday things very quickly and not everybody does so having that encouragement. Also, you know, willing to care give. So just, you know, don't let the patient feel like they're a burden to you. You want to be there for them and let them know that you want to be their caregiver and you want to assist them with these things. Also pain management. Sometimes just a healing hand or a prayer or anything to help the patient through those hard times and comforting them with any type of relaxation measures can really help the patient and that emotional support.

Host: Wonderful. Well, as we wrap up here on the topic of support, what longer- term support will the patient need from a caregiver?

Guest: So I had mentioned, you know, around two weeks is when the patient is, doing that initial recovery from their surgery. Often at two to three weeks they're following up with their surgeons so support and transportation to those appointments. But sometimes, depending on the extremity being operated on, a patient might not be able to drive up to six weeks and oftentimes, physical therapy will be up to, six to eight weeks after surgery so it is important to have that caregiver available to again, provide transportation to the patient while they're not able to drive themselves to those physical therapy appointments is really beneficial. Of course, you know, these days we have all kinds of, opportunities for public transportation and private transportation, but it's nice for the caregiver to be able to help the patient get to those places and have someone that they can depend on in that up to six week period.

Host: Of course. Well, just some great tips and resources for our listeners. Samantha, thank you so much for sharing. And that wraps up this episode of BayCare HealthChat. Head on over to our website at BayCare.org for more information and to get connected with one of our providers.

Please remember to subscribe, rate, and review this podcast and all of the other BayCare podcasts. For more health tips and updates, follow us on your social channels. I'm Caitlin Whyte. Stay well.