Prepare for a hospital stay: tips from the experts
Use the time spent waiting for a hospital procedure to ensure you’re as prepared as possible. A surgeon, a specialist nurse and a nurse practitioner share expert tips with Sarah Brealey.
Many heart procedures are planned (or ‘elective’), meaning that you’ll know about them weeks or months in advance. These might include heart bypass, valve surgery, angioplasty or implantation of an ICD or pacemaker. Knowing you’re going into hospital means you have time to prepare.
Jackie Younker, Lead Cardiac Surgery Nurse Practitioner at Bristol Heart Institute, says there’s plenty people can do. “If you smoke, the most important thing is to stop,” she says. “Smoking affects your lungs and heart and also the ability of wounds to heal quickly.”
Being told you need surgery is not a reason to stop exercising
Losing weight if you are overweight and eating a healthy, balanced diet is important too, says Jackie. “It’s not that you can’t have fish and chips on a Friday, but make sure you are well nourished.”
Being told you need surgery is not a reason to stop exercising, says Stewart Craig, Consultant Cardiothoracic Surgeon at Golden Jubilee Hospital in Clydebank: “Physical activity is encouraged. The stronger and fitter you are before your procedure, the quicker you are likely to go home afterwards.
Walking is an ideal activity, but if your symptoms include chest pain/tightness or breathlessness, ask your doctor or nurse about your level of exercise. Patients are usually the best judge of what they are able to do within their symptoms.”
Conditions such as diabetes or high blood pressure should be well controlled – so if your blood glucose is higher than it should be, or if your blood pressure is variable or high, go back to your GP and request a medication review. Make sure you don’t stop taking your medications unless you’ve been told to.
Once you’ve been referred for hospital treatment, you will see a consultant such as a cardiologist or a cardiothoracic surgeon for an appointment.
“We will explain what the problem is, why you need surgery and what will happen to you. Sometimes, we might draw a diagram if that helps,” says Mr Craig. “It is important that by the time you leave the outpatient appointment, you fully understand your condition and the risks and benefits of the proposed treatment.”
You will also have a pre-admission assessment (this can also be called a pre-operative assessment). This happens later, usually a couple of weeks before your surgery date, and you’ll typically see a specialist nurse or nurse practitioner.
You get a lot of information, which can be overwhelming
The medical team needs to know what medicines you’re taking (including non- prescription drugs), so either take them all with you or bring a full list.
It’s useful to have someone with you at both appointments. Carolyn Shepherd, Arrhythmia Specialist Nurse at Bristol Heart Institute, says: “You get a lot of information, which can be overwhelming, so it helps to have someone to remember it and to ask questions you might not have thought of.”
Making a list of your questions in advance and taking a pen and paper so you can make notes during the appointment are both good ideas. Even if you think you’ll remember everything your healthcare practitioner says, it’s surprisingly easy to forget, especially if you’re feeling stressed.
The pre-admission appointment typically lasts an hour. Carolyn says: “We want to make sure you are coming in for the right procedure, that nothing has changed since the consultant appointment and that we have explained it to you fully.”
The appointment will also include physical checks such as height, weight and blood pressure. You’ll be tested at this point for infections, but it’s important that you let the hospital know if you feel unwell between now and the surgery date. Mr Craig says: “We will have to postpone your operation if you have a head cold, a urine infection or a stomach upset, so please let us know in advance. Usually we can reschedule the appointment quite quickly.”
Don’t forget to cancel any deliveries, such as newspapers and milk, and any regular appointments (such as hairdresser/chiropodist/dentist) scheduled during your hospital stay – or shortly afterwards if you won’t be up to them.
Don’t forget to cancel deliveries, such as milk and newspapers, and regular appointments
If you have a pet, ask if friends, family or neighbours can look after it. If they can’t, try The Cinnamon Trust, a charity for elderly people and their pets that runs a national fostering service to cover hospital stays.
For long stays in hospital, there may be outstanding bills or financial issues to deal with. Contact your gas/electricity/water/credit card company if you think this might be a problem. If you pay by regular direct debit, your bills will be paid automatically (as long as there’s money in your account) and you won’t have to do anything.
If you have a lawn, mowing it before you go to hospital may stop you worrying about its state while you recover. But don’t be afraid to let a few things slide – your health and wellbeing are more important than having a perfect house and garden.
Carers going into hospital should let hospital staff know about their caring responsibilities. You may be able to ask family members or friends to help out. It’s also a good idea to contact social services to ask for advice. Or you may want to pay for a private carer or temporary stay in a care home for the person you look after.
You might not be having treatment yourself, but might be asked to look after someone when they come out of hospital. You’re entitled to take time to think about it and don’t have to agree. Temporary or long-term carers are entitled to a carer’s assessment to see if they need any extra support. If you would like this, contact social services in the area the person lives in.
A bit of forward planning can make life easier when you get home. Ask a family member if they can look after you if you think you’ll need it. As a rule, hospitals won’t send you home until you’re able to wash and dress yourself or have help to do so.
But driving, shopping, cleaning, ironing and lifting are all things you may be unable to do for a while afterwards. Let the hospital know in advance if you don’t have any help available. You may be kept in a little longer or discharged to a community hospital to continue your rehabilitation.
Ask a family member if they can look after you if you think you’ll need it
Intermediate care is provided free of charge for people who no longer need to be in hospital but need extra support to help them recover. It lasts for a maximum of six weeks and can be in your own home, a community hospital or nursing home. The hospital should be able to arrange this for you, but tell them early on if you’ll need it.
Jackie says: “If you’ve had heart surgery, for the first six weeks you shouldn’t lift anything heavy, not more than a kilo or two [about a bag of flour]. You shouldn’t do anything that puts a strain on your breastbone, which includes driving, ironing and walking dogs on a lead.
“Gentle cooking is OK, but lifting a big roasting tray out of the oven would not be a good idea.” You can do things in advance, such as filling your freezer with individual meals. Try cooking an extra portion and freezing it each time you make a meal. Soup is easy to make in a large batch and can be easy to eat if you don’t feel like much.
Many supermarkets will deliver (for a small charge) when you order online, which will save you from carrying shopping. If you don’t have internet access, few supermarkets take orders by phone, but Sainsbury’s does.
If you live alone, leaving your house clean and tidy will mean there’s less to do when you come home. You might want to pay a cleaner to come in for a couple of hours before your hospital stay.
Find out what to pack for your hospital stay.
Where to get help
Age UK – services vary in different areas, but may include benefits advice, advice on hiring carer/cleaner and shopping services. For general information, or to find your local Age UK, call 0800 169 65 65.
Care Quality Commission – this inspects and registers private care agencies, hospitals, and other types of health and social care, and will also take feedback. Visit the Care Quality Commission website or call 03000 616 161.
The Cinnamon Trust – for help with pets for elderly people, including a national fostering service to cover your hospital stay, visit The Cinnamon Trust website or call 01736 757 900.
Citizens Advice – for independent advice on money, legal issues and more. Visit the Citizens Advice website or call 03444 111 444 (03444 772 020 in Wales).
Heart Matters Helpline – 0300 330 3300 or [email protected]
Money Advice Service – for free and impartial money advice, visit the Money Advice Service website or 0300 500 5000.
Social services – these are usually based at your county council/London borough/unitary authority, if you live in one. Your local adult social services department should be able to provide you with details of approved private homecare agencies. Check the phone directory or look online at Find your local council.
UK Home Care Association – for a list of home care providers that follow its code of practice, look online at Find care or call 020 8661 8188.