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Zestril (Lisinopril)

For the family, the aftermath is a very active phase. If you (as spouse) ever wanted to be chief cook and bottle washer, now is the time! But, in addition to all these roles, you yourself are going through your own journey. In the hospital you are included in the instructions and education about heart disease. You want to understand what is being told to your loved one, all that will impinge on your role as caregiver, as there will be a mantle of responsibility when the patient comes home. Your help can be invaluable if the patient does not comprehend everything that is told to him or her, as is often the case in the early stages when many are in an emotional state they describe as “dazed and confused.” But you yourself may already be reacting to the cardiac event, a reaction that you may understand better when you become familiar with the next phase the patient will go through. To avoid repeating ourselves, we will only highlight one fairly typical scenario with cardiac patients.
On arrival home, the patient returns to a familiar environment—the usual people, the usual place. However, physically and emotionally, they do not feel the same as before. Like it or not, there will be a period of uncertainty. Is everything going to be okay? During this time, the spouses concern is translated into a type of watchfulness, of scrutiny, where there is the understandable need to check on the patient. Initially, this is adaptive—meaning it is normal, even important, that this be done. However, if fear should override this attitude, then overprotectiveness can result, which is not healthy for the patient or spouse. This state has been termed “hypervigilance” and is classically seen in the aftermath. Sometimes it can be so extreme that the spouse won’t let the patient go anywhere alone. This rapidly leads to the patient feeling “suffocated” and cannot continue for long without harm to the patient, the caregiver and their relationship; fortunately, this pattern tends to subside in almost all cases. We must accept that if the patient has been medically permitted to leave the safety of the hospital, then constant observation is not required. For this phase, though, it is normal, appropriate and helpful for the caregiver to generally observe and monitor the patient and to take what actions seem appropriate.
So, there is a natural caring that can spill over into protective-ness in the very early homecoming period. The spouse is the “parent”; the patient, the dependent “child” in the sense of showing dependent needs. This is a temporary situation, something that will need to change as the patient moves into the next phase, and toward independence.
Remember, the aftermath is a time when the patient feels unsafe, and their loved ones may feel unsafe about them. But awareness of this period of vulnerability will help to prepare the patient for the journey ahead.

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