Hamoudi’s journey from Hospital Care to Home Care caring for a loved one at Home

Mr. Hamoudi was a loving husband, father and well-respected research scientist until that fateful day in March 2013 when he suffered a serious brain hemorrhage at home.

The emergency medical care he received helped save his life but the trauma his brain experienced would change his life irrevocably. The diagnosis, intra-parenchymal cerebral hemorrhage – a form of stroke, was grim.

“I was devastated by the news and in a sort of daze in those early weeks in the surgical intensive care unit in Hamad General Hospital (HGH). I have to say that the team who looked after my husband was very professional and efficient but the staff was also kind and compassionate in their dealing with me. This was a very intense period of time and I relied on the professional team not only for the medical care they provided to my husband but also for the support they gave me,” said Mrs. Hala.

After several weeks, Mr. Hamoudi regained consciousness but it was evident that the trauma caused by the hemorrhage had caused significant physical damage. The paralysis affected his ability to speak and to swallow and necessitated the need for constant care. As there was no requirement for acute medical care after a while, the decision was taken to move him to Rumailah Hospital to a special rehabilitation unit, where his condition could be monitored and various rehabilitation procedures could slowly be introduced.

“In the subsequent months in the male unit 1, I watched my husband being fed through a tube, as he could not eat himself, and being rotated and massaged in bed, to prevent him from developing bed sores (pressure ulcers) and help stimulate his muscles so they would not degenerate further,” Mrs. Hala explained. “I had a lot of time to reflect on the care my husband was receiving and to think about the future. I had to learn more about what was best for him and the right care needed for a bed-bound patient.”

“In consultation with a number of experts in the hospital, including doctors, speech language pathologists and nutritionists, I realized he needed a different kind of rehabilitation care than could be provided in a hospital setting. And it was concluded that if my husband could regain the ability to eat and safely swallow on his own and I could secure nursing care support, then I could take him home and care for him there.”

The speech language pathologist in Rumailah Hospital, Mr. Mohammed Sajid Hussain, was very involved in trying to help both his patient as well as Mrs. Hala, on whom the daily trips to the hospital over many months were beginning to take a toll.

“An important milestone for patients in this situation is learning to eat orally again rather than being fed by tube and I knew we had special equipment in our hospital in Al Wakra that could help Mr. Hamoudi. In consultation with his doctor, I arranged for the hospital transport and a nurse to support us on the journey and was thrilled that the assessment by the specialist in Al Wakra was that Mr. Hamoudi would be able to learn to eat on his own with the appropriate therapy,” said Mr. Hussain.

“Patient care does not end upon discharge and we work closely with the family to assess and plan how the patient will be cared for once they move back home. The care of a patient is planned dynamically to maintain their health and safety in the natural environmental setting,” added Mr. Hussain.

It took a good few months before Mr. Hamoudi was considered stable enough to be allowed home, and a multi-disciplinary team, made up of a doctor, nurse, nutritionist and physical therapist worked closely with Mrs. Hala to make sure she was fully aware of what she needed to have in place at home and what to expect when looking after a patient who needs full-time care.

“I did a lot of research and am extremely grateful to the Occupational Therapists who provided valuable advice on what kind of equipment and other materials I would need to organize a proper care environment for my husband. And that is what I have built up now at home,” Mrs. Hala stated. “There are a lot of equipment sales people who are willing to sell you all sorts of things and it is so important to get impartial and good advice. Such as what kinds of beds are suitable, which lifting equipment is available to transfer my husband from the bed into a wheelchair or a commode chair so he could be showered daily, what are the best exercise tools that could enable my husband to gradually regain more mobility.”

“But I will forever be grateful for the support from Dr. Hanadi Khamis Al Hamad, who heads the Geriatrics Department at Hamad Medical Corporation (HMC). She helped to get my husband referred to the Hamad’s Home Health Care Service. The regular monthly home visits they arranged are essential. They have our best interests at heart and they are just as delighted as I am with every little improvement in my husband’s condition.”

Dr. Essa Al Sulaiti, Chairman of Geriatrics Services at HMC, was also instrumental in providing constructive advice and support to Mrs. Hala about making arrangements for home care. “In such situations, the family dynamic is immensely important and Mrs. Hala was very determined to do whatever was needed to ensure her husband could live a comfortable life at home. In this case it involved setting up a rehabilitation care environment in what was the former dining room in their house. But the commitment paid off as the patient responded favorably to the care over time and he now has a better quality of life.”

In the two years since Mr. Hamoudi has been at home, he has received visits from the Mobile Doctors service at Hamad as well as a trained nurse from the Home Health Care team to assess his condition and check on the home environment. It was one of the regular nurses who would come on these visits whom Mrs. Hala consulted when she noticed her husband had started to refuse taking liquids and there was a real concern he would become dehydrated. The nurse alerted a doctor who met the patient and concluded that a nutrition expert could help.

Mrs. Hala recalled: “The nutritionist came to the house specially after working hours. I found that showed amazing commitment. He gave me all sorts of practical advice on what to feed my husband. But specifically to deal with his refusal of all liquid, he had brought with him a thickening agent that I could put into any liquid so we could spoon-feed him. We also started to mash watermelon and puree cucumbers – any fruit or vegetable with high water content. I was so relieved that we could manage this at home and not have to readmit him to hospital.”

Over the past few years, the family has also benefited the patient transport service operated by HMC. Each time that Mr. Hamoudi requires transportation in his wheelchair, for instance for a medical, dental or physiotherapy appointment, Mrs. Hala requests the service of one of their small ambulances which is manned by two medics. Mrs. Hala expressed her gratitude that such a valuable support is available as she would not otherwise be able to manage taking her husband on her own: “They always arrive on time, handle the patient and the accompanying person in a caring and compassionate manner and return us safely back home – this is truly a wonderful and practical service”.

“In fact, I am truly grateful for the expert care that I receive here in Qatar, one that is on par and better with what I would have had anywhere else. Qatar can be proud of their achievements in developing such a professional and well run home healthcare service.”

“I hope that other families in similar situations will also have the courage to bring their loved ones home and care for them there rather than leave them in hospital if it is not medically necessary for them to remain there. It is better for the patient and for the family.”