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Taking some of the stress off me, without feeling guilty from the pain it causes. My husband now has a tracheotomy (at night only) and it is my responsibility to care for it. The more he does for himself the better he will get and the more weight he will lose which is the only way for the trach to be removed eventually. I know that getting up causes him physical pain but if he stops getting up he will eventually become unable to get up. I guess I am seeking the words to motivate him without making him feel I don't want to do it for him. I know that if he stops it will kill him and that is a great fear. We are both 50, I work full time and provide full time care for him. Thanks for your time.

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Can you get the MD to order in home PT for strength and range of motion? You are right, he's got to move. He may be more cooperative with a therapist than he is with a wife. Funny how that works.
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GrammyK, first make peace with the fact that you are going to feel guilty. It is part of the caregiving role. If you insist he does things for himself you feel guilty that it causes him pain. If you do things for him you feel guilty that he isn't building up the strength necessary for his survival. Neither of these guilt feelings is earned -- you did not cause this situation -- but I don't know how you can simply turn them off.

So you'll have to make decisions in spite of the unearned feelings of guilt. Do your best to do what you understand to be right for your husband. Move on and ignore the guilt.

Have doctors explained what the pain is from, whether there is any way to lessen it, when to be concerned that it is "abnormal" under the circumstances?

I agree with Pam that some in-home "professional" help might be more motivating and less easy to dismiss as nagging.

What to say? Well, I see that you are a writer, but I don't guess there are any magic words. "I'd really like to save you the pain of doing that by doing it for you, but I know you need to do it in order to get better. I really, really want to see you better!"

Has your husband bought into the theory that if he loses weight his health will improve? Does he basically believe that he can improve? Does he want to? What is his overall attitude toward his condition?
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The insurance will not cover in home physical therapy and it is not something we can afford on a cash basis. I have written much about the guilt I feel, not published because I am afraid of hurting his feelings.

I know that he must make the changes that are necessary to survive. I do like the words you used """I'd really like to save you the pain of doing that by doing it for you, but I know you need to do it in order to get better. I really, really want to see you better!""" This may be the best words and put it back on him for allowing me to feel guilty about making him do what he knows he has to do.

The pain is caused by a broken back (4 places all within 1/2 inch) but he still walks around and can do for himself.

He understands that if he loses the weight he gets better and to live longer but he has had other waiting on him for so long "feeling sorry" for him that he has come to expect it. (We have only been married 6 years). Although I realized at the time that his health was an issue I never bargained on a tracheotomy or the care it would take me to give him.

One think I know for sure is that illness can tax a marriage to the max, love and understanding must pull together for things to survive, especially when you are newlyweds (under 10 years).

Thank you both for the advice.
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Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) covers eligible home health services like intermittent skilled nursing care, physical therapy, speech-language pathology services, continued occupational services, and more. Usually, a home health care agency coordinates the services your doctor orders for you.
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There are some helpful tips above. Is your husband disabled? Is his primary aliment the back injury or weight issue? If it's the weight issue, then any attempts to encourage movement, weight loss, etc. are likely to be taken as insult and with contempt. I've seen it with family members and it's extremely challenging. I'm not sure it can be properly addressed without a professional who handles issues like that.

It's very challenging for the spouse of a person with this kind of health condition. If this is the case, then you know how the patient can blame and deflect from the real problem. I might seek support for myself with a counselor or therapist. Your husband may continue to be resistant, without similar help. I wish you all the best.
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I found myself backed into a corner with my husband and unable to control my agitated frustration. Having accepted all the blame and excuses that I could take I looked directly into my husbands eyes and stated flatly "You need to choose your nursing home if you are not going to change what it is that you are doing because I have had all of this my mental status can take". I am a Master's student and I know that this was the WRONG approach; however, that being said he has been looking to joining a local health club, he is not so angry when I go set outside with a cup of coffee for alone time with a book (no longer calls to ask me for a favor), and he is recognizing when he has pushed me too far with asking for things he could do himself would he just get up. Tiny Baby steps, but at least we are moving.
Yes, I did apologize and explain why I said what I said. Things are tense but at least we are doing something.
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