Thursday, March 7, 2013

TING AND I, Home Care Equipment, Supplies


When possible, we have had back-ups for our equipment: two ventilators, large and small oxygen tanks to supplement the oxygen concentrator, heating and air conditioning units in Tina’s room to supplement the central heating and air conditioning, a gasoline-powered 5,000-watt electrical generator to protect us from power outages, the longest of which was 95 hours. Our previous special van had two gas tanks.

The multitudinous disposables used daily also need to be in abundance, taking into account the possibility of delays in receiving shipments of them. We have a month or more of all of these, including the crucial special complete nutrition liquid. This much stuff required a room for storage, our dining room, and a sharp, detail-oriented home manager, Barbara George, to track them.


Our computer and computer skills aided us greatly once we replaced the nursing agency.

We pay the nurses on Thursday or on their last shift of the week. The spreadsheet program on our computer enables us to print out the details of date, shift, hours worked, gross pay, deductions (FICA and Medicare), and net pay. Two copies are made, one for the nurse, the other for her to sign and return to us for our records.

The insurers want similar information, monthly. The federal government also wants much the same information monthly, along with the deductions and the matching employer “contributions” to FICA and Medicare.

Quarterly and annual reports for the state and federal government are required

as well. I do the first draft. We have an accountant to prepare the final draft. The same happens with the preparation of the IRS W-2 income tax forms at the end of the year.


Hospital Bed

A sturdy hospital-type bed, where the upper third and the lower third can be raised or lowered electrically has proved very valuable. The full-queen bed we use is wide enough to allow easy movement of Tina onto her side and back. The width allowed me to sleep or rest beside her during the year without overnight nurses. The head rest is up for watching TV, being fed, talking on the telephone, and gastric tube and tracheostomy care. It is down for disposable diaper changes, bed baths, shampoos.

Hoyer Hydraulic Lift

Nurses tell me that back injuries are endemic to their profession. Lifting and transferring patients cause most of the injuries.

Tina weighs 125 pounds, rather slender at 5’5”, lighter than the average adult patient. Still, the Hoyer hand-pumped hydraulic lift is a back-saver. Pump, pump, pump and up she rises, like Mary Poppins as she thinks happy thoughts. Open the faucet-like valve, and down she comes, slowly if you are careful. Tina lands onto her bed or into her wheelchair like a snowflake in the winter, a flower petal in the spring, a glider in the summer, and a leaf in the fall.

Pulse Oximeter

Using laser light, these highly informative meters give pulse rate and the percentage oxygen saturation of the blood. Some are smaller than a deck of cards.

Tina’s normal pulse rate is 70 90 per minute. Lower than that may indicate she is sleeping or may be a cause for concern. Higher than that suggests agitation or a fever.

Tina’s normal oxygen saturation percentage (pO2) is 98–100 percent, quite good, in response to the additional 3 liters per minute of oxygen supplied to her by the ventilator, mixed with the room air. Lower than that suggests the oxygen line has become crimped or disconnected or that there is a leak. Without the line, she registers 92–94 percent pO2. Breathing room air for minutes without the ventilator, she can stay near 90 percent, the low end of the safe range, but we do not know for how long, and we are not eager to test it. In an emergency (say, a fire), she will be evacuated immediately, quite possibly without the ventilator.


The ventilators we have will not let Tina’s respiration rate fall below 10 per minute, a value she often reaches during deep sleep. Usually, the “vent” monitors her natural breathing pattern, adding input air as she starts to breathe in, withdrawing air as she breathes out. It assists, rather than replaces, her normal respiration.

The ventilator is one of several pieces of equipment in Tina’s room that repay some familiarity with electronics, mechanics, fluid flow and physiology, much of which I had expertise in from my career in environmental science and engineering. The ventilator displays a series of values for her breathing cycle, the most useful to us being the breath rate, f. Values of f between 10 and 20 per minute are of no concern. Values in the 20s may indicate a problem. When she started to develop pneumonia, the rate went to the 30s per minute. Time to call 911.

The ventilator is a modern technological miracle. Sure beats an iron lung.


A medium or large wash is done each of our four shifts each day. Pads, sheets, pillow cases, nightgowns, towels, all need washing and drying, with different frequencies.

When the washer needs repair? Yes, we have a backup.

1 comment:

  1. I love this, Doug, A perfect Nursing care plan!!! Have a wonderful day both of you, Ah, landing like a does not get better than that :-) Mary