“How will we cope when you get out of hospital?”  I asked my husband during his week-long stay on the Cardiac ward awaiting surgery.

“Let me figure that out,” he promised.  “There’s plenty of time to worry about that.”

I asked him again just prior to surgery, picturing a frail man returning home, and me, struggling with my own disability, trying to care for him.

“I’ve already spoken to the nurses about it.”  He likes to take charge, I understand, but anxiety over the unknown seems to be part of this disease.  I am known to perseverate.

Spoke to the nurse and it’s all arranged, he texted me days after his triple bypass.

They know our situation?

Yes, they do.

Tuesday, he had a setback day – low energy, hard to breath – and could neither walk, nor shower.  Won’t likely be home until Thursday, he messaged.

I arranged for grocery delivery, and prepared what I was able in anticipation of his return, but still I could not relax.  Early Wednesday morning, I put my phone on ‘do not disturb’ in hopes that I would finally sleep.

Is the side door unlocked?  was the first text I read upon waking.  They are releasing me.

Within the hour, Ric was home, our oldest daughter haven driven in from out-of-town to pick him up.  I scrambled to put on some soup and prepare a spot for him, not knowing what to expect.  It had been two days since I saw him last, and at the time he was incredibly swollen and still in a lot of pain.

The man who walked through the door was still weak, but looking pounds lighter and visibly relieved to be home.  He happily consumed the meal I prepared, and with the help of our daughter, got settled in.

“Will a nurse be coming to the house?”  I asked.

“Someone will call us later today to set it up for tomorrow.”

When hours had passed and family gone home, I took the initiative and called CCAC, the Canadian company that handles transitions from hospital to home. After being transferred several times, I finally found a person connected to our case.

“Oh yes,” she said, “You have been assigned one nurse visit and one PSW visit.”

I put the phone on speaker and carried it to my husband, so he could participate in the conversation.

“How would you rate your health right now?”  the woman asked.  “Good, fair, poor?”

“I just had my chest cracked open a week ago – how do you think my health is?”  my husband retorted.

“I’ll just put that you refuse to answer the question,” the voice said.  “That’s fine.”

“We’re just a little frustrated,” I tried to smooth things over.  “We were told there would be care to help us at home – my husband is the primary caregiver and now he needs support services.”

“I’ll need someone to take my staples out on Monday,” Ric tried to tell her.

“You can go to your family doctor for that,” he was told.

“Monday is a holiday.  The surgeon was emphatic that they need to be taken out on Monday, by a qualified nurse.”

“Well, we’ll see about that.  The PSW will help you shower when she comes, meantime, your wife can help you sponge bath.”

“My wife can barely bathe herself!  I specifically stated that my wife would not be able to perform such duties.”

“Well then, surely you have friends and family that can help.”

I shook my head.  “We’ve exhausted friends and family over the course of his hospital stay,” I tried to explain.

The nurse came the next day, a PRN who explained how to change his dressings and care for the wound sights.  She confirmed that she will back Monday.

“Who came out to access your situation?” she asked.

“We were assessed over the phone only.”

We spent the afternoon calling different agencies trying to find the services we needed to fill in the gaps.  By evening we were both so exhausted, we let it go and collapsed – my nightmare was coming true.

We awoke today with determination to take charge of our lives, made some phone calls and hired a home care service.  When the PSW arrived with 45 minutes to help my husband shower, or microwave his lunch, we received her politely knowing that we weren’t reliant on this one of visit.

Hospitals cut costs by releasing patients earlier and earlier, but without the transitional help needed to make the home stay safe, they are gambling with a huge loss.