Monday, October 8, 2018


Let whoever is in charge keep this simple question in her head: not, how can I always do this right thing myself, but how can I provide for this right thing to be always done?”

Emperor Marcus Aurelius is one of my favorite authors. Living during a time when the world was constantly at war, disease was rampant, and there was a great deal of human suffering, the Emperor, a stoic, believed in self-restraint. He also lived with the knowledge that the decisions he made would impact the lives of millions of people.

Marcus Aurelius firmly believed that wisdom was obtained by examining oneself, so he took time to journal his private thoughts each night as a method of personal improvement. His philosophical reflections were never intended to be shared with the public; rather, they were his true and visceral responses to what he was experiencing, and a free expression of frustrations associated with the challenges he faced daily as a person with many flaws.

His once-private meditations continue to be relevant to coping with challenges we humans encounter two thousand years later. Marcus Aurelius did not set out to be an author, yet his published works highlight the importance of sharing your wisdom.

In How to Manage Nursing Care at Home, authors Douglas Winslow Cooper and Diane R. Beggin, address one of the most complex global issues faced in the 21st century: caring for someone you love, one who is also diagnosed with a severe medical condition, doing this safely, and in the home.

The truth is that there is no easy way to address the immense fiscal and logistical barriers that must be considered as you take on the responsibility for providing nursing-level care at home. I can personally attest to the challenges associated with ensuring that a loved one safely receives full-time complex medical care–24 hours a day, seven days a week–for an indefinite period of time.

As a registered nurse and the co-founder of Caregiver Support Services, a non-profit organization that exists to improve the health and wellbeing of both family and professional caregivers, I have dedicated my life to improving the circumstances of the elderly and their caregivers.

I am also a caregiver for my mother-in-law, Emma. Earlier this year, she was infected with a virulent strain of influenza, was placed on a ventilator, went into a medically induced a coma, and suffered a stroke. We didn’t know if she would survive. Mom has since transitioned to a rehabilitation center to receive therapy, but our goal is to bring her home.

A major barrier to Mom’s transition to home is coordinating the complex care that she needs.  One of our biggest concerns is that Mom wakes up three or more times each night to urinate, but she can’t remember that she is unable to walk to the bathroom safely on her own. So, when she tries to stand up from bed, she often falls. In fact, my husband and I receive a call from the rehab center once or twice a week reporting that Mom has fallen. This repetitive circumstance is heartbreaking.

Waking up multiple times a night has led to decreased daytime functioning for Mom, and even more concerning, to anxiety and depression. These additional issues have made it extremely challenging to engage her in the recovery therapies necessary for her to return home. In fact, we meet regularly with the staff and the doctors to modify her anxiety and depression medications to help her achieve the highest level of functioning.

We want to bring Mom home, but we are physically and emotionally overwhelmed. Our biggest concern is pulling together everything needed to make the transition safely. In fact, just the thought of trying to figure out where to start to gather the resources that we will need to bring her home has been downright stressful. This book addresses such issues.

Dr. Cooper includes firsthand experiences associated with caring for his wife, Tina, who is quadriplegic, on a ventilator, and suffers from multiple sclerosis. Together they have overcome tremendous obstacles, yet because of Dr. Cooper’s advocacy and with the help of her head nurse, Diane R. Beggin, Tina is lovingly being cared for in her home.

What likely began as a way to cope and to document his very personal experience with caring for Tina has been nurtured and is now a valuable guide that will ease your worry as you begin your journey as one of the millions of untrained family caregivers who want to safely provide complex medical care services so that your loved one can remain home.

I know that this text has helped my family with starting the process to bring Mom home. In fact, these distinguished authors go a step further than most books written about caregiving, as they address both the emotional and navigational aspects of caring for someone you love.

I am honored to have gotten to know Tina, Dr. Cooper, and Tina’s nurse, Diane Beggin, through reading their very personal experience of providing complex care in the home. Like Marcus Aurelius, the authors of this important work have openly shared their wisdom so that you do not have to face the immense challenges associated with caregiving alone.

I leave you with this final thought,

Knowledge comes, but wisdom lingers. It may not be difficult to store up in the mind a vast quantity of facts within a comparatively short time, but the ability to form judgments requires the severe discipline of hard work and the tempering heat of experience and maturity.2

The care of your loved one will require planning and the continuous acquisition of knowledge to ensure all needs are being met, including your own.  Juggling all of the challenges will likely be difficult, yet this useful contribution to caregiving highlights your intangible contributions as a part of the healthcare infrastructure.

I hope that you will take advantage of the wisdom shared in the pages that follow, that you are empowered to use this material to make your life easier, and that you continue to seek additional learning opportunities as your caregiving situation changes.

Eboni I. Green, PhD, RN
Co-Founder of Caregiver Support Services

1Florence Nightingale. Retrieved on October 17, 2016 from
2Calvin Coolidge., Xplore Inc., 2016., accessed October 24, 2016.

Available from Outskirts Press and from Amazon:

How to Manage Nursing Care at Home



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