Bev’s life had always been a whirlwind of activity, family, and service. Known as a great cook, she catered events and baked goodies for church fundraisers and farmers markets. She helped take care of her grandchildren and great grandchildren, tended to her beautiful flower garden, and in her spare time, crocheted gifts for friends and family. She also enjoyed biking in and around Belle Plaine.
That full and active life came to a sudden stop in 2014 when a bike accident shattered her leg in four places. After multiple surgeries, infections, revisions, sepsis, and a bout of pneumonia that left scar tissue on her lungs, Bev never fully recovered. After Ray retired, he took over all the household duties, ushering Bev to her recliner where she had stayed for the past two years, dependent on oxygen and a walker.
Complex medical issues
The first time Kathy Swanson, RN, Lifespark Life Manager, met with the couple, Ray did all the talking. A retired truck driver, he had a number of medical conditions, including peripheral vascular disease and cardiac issues, but his chief concern was back pain. He had recently been to the ER where he was diagnosed with muscle spasm and possibly some sciatica.
“Ray’s health issues weren’t limiting his mobility, but he talked about them at length, while Bev sat silently in her recliner, hooked up to her oxygen tank,” Kathy said. “Finally, I asked her to tell me her story.” That’s when Kathy learned about Bev’s bike accident, her loss of independence, and her spiraling depression. “Bev told me she didn’t think she’d ever enjoy life again.”
Although Ray was taking good care of his wife and doing all the housework, it was tough for Bev to no longer be contributing to her family, home, and community, as she had her whole life. Lack of purpose was taking a huge toll on her emotional well-being and physical recovery. As for Ray, his efforts had probably also contributed to his back pain.
Filling the primary care gap
Bev and Ray hadn’t had good medical care in several years, not since their primary care doctor had retired, so Kathy immediately got a Lifespark Nurse Practitioner (NP) involved. After a thorough medication review, the NP cut their medications in half and took them off high blood pressure drugs which neither of them needed.
Kathy also requested an order for in-home physical therapy and occupational therapy for Bev. Concerned that her client wouldn’t advocate for herself, Kathy asked the OT to not discharge Bev from therapy until she had tried to do everything that used to bring her joy, including cooking, baking, planting flowers, and taking care of her family. “Before the accident, Bev was completely independent,” Kathy said. “Eight years later, the goal is to help her regain independence, within her physical abilities.”
At a visit a few weeks later, Bev told Kathy that the therapy was helping. “She was smiling and talking about all the things she’s looking forward to this summer,” Kathy said. “I really believe she’s going to thrive over time. She just needs to get stronger and develop more confidence in herself that, yes, she can do these things.”
Kathy is also coaching Bev to stand up for herself and not feel intimidated by her husband. “I have to remind Ray to back off, be patient, and let her take charge, even if she’s slower than he is,” she said. Their granddaughter, Haley, is on board and supporting Bev to do more as well. Not coincidentally, Ray’s back pain has subsided over the past two months. “The physical therapist and I keep telling him to stop when it starts to hurt—not a trivial ask of Ray,” she added.
In fact, Ray has struggled to let go of control. Kathy’s approach has been to focus on how overwhelmed and stressed he felt when she first met him two months ago. “I asked Ray, ‘Wouldn’t it be nice if Bev made breakfast for herself in the morning?’ He wasn’t so sure but agreed to let her try,” Kathy said. “It’s a big adjustment for him, but I’ll be here to support him.”
For Kathy, helping clients like Ray and Bev see the possibilities is one of the highlights of her job. “I’m really excited for this couple and for what lies ahead for them,” she said.