Understanding The Homebound Patient and 5 Things You Can Do To Help

The homebound patient faces challenges beyond that of the typical patient. Not only are they sick, but they are sick enough that they can’t leave their house, and if they can, it puts a ton of burden on them to do so.

This may seem at first glance self-explanatory, however, really think about it for a second. The homebound patient (THP) doesn’t leave their house to do the following:

Societal Requirements

  • Go to work


  • Go to dinner/lunch
  • Go to the movies
  • Go to recitals/school functions/baseball games
  • Go to sporting events

Personal Care

  • Go to doctor/dentist/therapist
  • Go to a salon/get haircut/pedicure

Random Stuff

  • Go to Starbucks
  • Go for a walk
  • Have pets (could be too difficult to care for)
  • Participate in previous activities (run/bike/swim/sports/theater/church)
  • Take out the trash
  • Do laundry
  • Go grocery shopping

What this means for the homebound patient is a significant loss in life satisfaction and even the ability to truly take care of oneself. All these things above that are taken for granted by the healthy can be extremely impactful on the disabled/sick. Just one of these items could be discouraging to anyone. For THP, these situations compound each other. Days merge into weeks of not seeing anyone. Even small interactions are few and far between. Simply saying hello to someone in CVS or at the mall is gone. I know what you are thinking, how great would it be to NOT have to engage with people. Sure, but again, it’s the total inability to engage at all that is detrimental to the homebound patient.

Let me highlight one common suggestion — to get a pet. However, for a lot of homebound patients, taking care of a pet is out of the question. Taking a dog for a walk maybe too taxing. Lifting and scooping kitty litter maybe outside their range of motion or lifting ability. Perhaps driving to the vet is not an option. This can be defeating for the homebound patient — realizing that not only are they incapable of engaging periodically with human beings, but acquiring a companion for the home is not an option either. This can make things very bleak for THP.

I do not bring attention to these issues to depress, but to educate and to emphasize what even a small effort by healthy individuals can mean for THP. Lives get busy, things are constantly on the go … but not for the homebound. It could mean the world to a homebound patient if people spent even a few minutes to engage or to help.

General Things You Can Do To Help

First off, take a look at the list. Is there anything on there that pops out at you? Something you have witnessed or heard is difficult for THP. Could you offer to do the grocery shopping from time to time? Perhaps this individual really likes cake or a specific coffee that is hard for them to get. What a treat it would be for you to pick it up periodically for them. Many grocery deliveries do not offer choices from the deli. Maybe a rotisserie chicken or a favorite sandwich. That is always a nice option.

Perhaps trash or laundry is hard for the individual. You could always call and say, I’d love to come over for a visit. How about I bring some wine, we can pop in your laundry and catch up while it runs? Often times homebound patients don’t want to ask for help. When you offer, you might be surprised at how grateful they will be.

Maybe this homebound patient is able to have a dog. However, they are incapable of bringing the dog to the beach or for hikes. It might mean the world to them if you called and said that you were going to take your own dog for a hike, and would they like it if you swung by and picked up their dog and took them as well? That dog might be their best friend and they might be grateful their best friend got to do something they normally wouldn’t be able to do.

Five Things You Can Do

1. Call or text

THP knows that you are busy and can’t always stop by. However, a phone call or a text is always super welcome. On your way home from work? Use your hands-free device and call THP. Chat about your day. THP might not be able to participate in all of the activities that you do, but they still want to know what your day was like. Your boss yelled at you? Why? Tell me more! THP can engage just as well as someone who is healthy. Just because they are sick or disabled doesn’t mean that they aren’t a good listener.

Did you just finish watching the Green Bay Packers game? Shoot off a text. Did you see that play! It doesn’t have to be a long conversation. It will make THP feel normal, because they are! You can easily bring some normalcy back into their lives with quick, easy texts.

That’s one of the things THP misses the most — just the everyday normal exchanges.

2. Start an online book club with them

Going out is hard or impossible for THP. Often times, much of their activities will be things they can do within their own home, like reading/listening to an audiobook. Suggest to your homebound family member or friend that you create your very own book club. You can all read the same book and then discuss it over an internet video or chat group. THP will feel apart of something and will be able to talk about something other than their illness, disease, or injury. It will give THP something to look forward to and break up the mundaneness of their lives.

3. Cooking Party

We all want to do this. We dream of going to the grocery store and buying the items we will need for the week and preparing our meals in advance. Why not do this with THP? Chances are it might be difficult for THP to prepare meals for themselves due to physical restrictions. For the healthy individual, it might just be a matter of time. Why not combine the two? Pick out a recipe that can be completed in the time restrictions for THP and cook together? You can make large portions that both you and they can then freeze. This is time well spent all the way around. It also takes the pressure off of THP to feel like you are sacrificing your own time when you come over to help them or to spend time with them. Now they can feel like it was for your benefit as well.

4. Cocktail Hour

If making dinners seems like too much, what about something fun, like trying out new cocktail recipes? It is not as labor intensive as making a meal and can be really, really fun. Maybe something that you wouldn’t normally make for yourself, like a Pisco Sour? All you have to do is pick up lemon juice, egg white, Pisco, and simple syrup. You can both giggle away while shaking your shaker full of ingredients wondering how in the world an egg white will make your drink better. Trust me, it will.

5. Offer To Drive

This one  can be difficult, but well worth it. One of the reasons THP can’t leave their home is their inability to drive themselves. You could offer to pick them up and take them for a quick coffee, or an appetizer — whatever is within THP time restrictions. Perhaps THP has a special car, no problem! Drive on over and just hop in their car instead. Easy-peasy.

Things To Keep In Mind

THP spends a lot of time trying to occupy their time within their own home. This means they probably watch a lot of television or play video games. So as much as it may seem like a good idea to suggest watching Game of Thrones together, this may not appeal to THP because it is something they can do by themselves. What they crave is interaction and conversation. They crave new experiences. You can be the champion of that.

One Final Thought

In this globally connected world, we often think of charity work or good deeds as having to occur online, physically in some far away land, or monetarily in the form of a donation. People post on Facebook about their support against abuses in the world. This is all wonderful and I champion it all. However, don’t forget to think locally — to look around your own neighborhood, your own immediate family, or your own grandparents to find someone whose life could be improved by these simple steps.

I bet there is a lot you can do to help someone out who is closer than you think.

Until next time.


Madeline Fresco is a novelist who lives in San Diego. She is the author of CROSSED THE LINE, available for Kindle at Amazon.com, for Nook at Barnes & Noble, and as an ePub at other eBook retailers. You can also listen to her novel as a free, serialized audiobook at madelinefresco.com. Her second book THE CHOICE, is available on Kindle at Amazon. Her third book ANGUISH, is available for Kindle at Amazon.com

The Things They Carried By Tim O’Brien: My Review Plus Answers To Bookclub Discussion Questions

The Things They CarriedThis is my review and thoughts on The Things They Carried By Tim O’Brien.

Rating system:
God, I wish I had that time back in my life = 0
Eh, it wasn’t the worst book I’ve ever read = 1
Shrug, I mean, it was okay = 2
I enjoyed it = 3

Have your read this book? It’s pretty good = 4
Wow, you need to read this book now = 5

The Things They Carried = 2.5

Here are my answers to book club questions provided by Lit Lovers who, in turn, state they got the questions from the publisher. Thanks guys for facilitating a closer look at the book!

1. Why is the first story, “The Things They Carried, ” written in third person? How does this serve to introduce the rest of the novel? What effect did it have on your experience of the novel when O’Brien switched to first person, and you realized the narrator was one of the soldiers?

I think switching it personalized the stories for me. Authors have a tendency to embellish for effect. However, Mr. O’Brien raises the question that most people who tell any kind of story embellish. It just depends on what the goal is for the author — what emotion does the narrator want to evoke.

2. In the list of all the things the soldiers carried, what item was most surprising? Which item did you find most evocative of the war? Which items stay with you?

Most surprising: The stockings.

Most evocative: Pictures of soldier’s sweethearts.

Stayed with me: Despite not being religious, the bible. It was a gift from his father, a connection to his family, to his religion, to his previous self.

3. In “On The Rainy River, ” we learn the 21-year-old O’Brien’s theory of courage: “Courage, I seemed to think, comes to us in finite quantities, like an inheritance, and by being frugal and stashing it away and letting it earn interest, we steadily increase our moral capital in preparation for that day when the account must be drawn down. It was a comforting theory.” What might the 43-year-old O’Brien’s theory of courage be? Were you surprised when he described his entry into the Vietnam War as an act of cowardice? Do you agree that a person could enter a war as an act of cowardice?

Courage relates to fear. Fear can be overcome through experience. This is shown in the example of the field medic. He seemed like a coward, but he was afraid because he didn’t have experience. The more experience he garnered, the more courageous he seemed because he was no longer afraid. This is the same whether or not there is a war.

So, no. I don’t think you can save up your courage. You never know what circumstances you might find yourself in. You can prepare, and that will help, but life is full of surprises.

I think people can do a lot of things because they are afraid.

4. What is the role of shame in the lives of these soldiers? Does it drive them to acts of heroism, or stupidity? Or both? What is the relationship between shame and courage, according to O’Brien?

He states that shame is what keeps the men in line and what brought him into the war. The men that went to Vietnam were so young. It makes me think that an older Tim O’Brien might not be so easily convinced to go to war out of shame. As we get older, we realize that what other people think of us is irrelevant. I would like to know what an older O”Brien would have done on that lake between the United States and Canada.

5. In “Sweetheart of the Song Tra Bong, ” what transforms Mary Anne into a predatory killer? Does it matter that Mary Anne is a woman? How so? What does the story tell us about the nature of the Vietnam War?

This was one of his complex stories that was an example of “a real war story”.

The story speaks to men, women, and their roles before and after the war. When these men went to war, they clung to their ideals of what a woman was — sweet, innocent, agreeable, a housewife is what they held onto. That is what they wanted to come home to. They didn’t want things to change. They wanted things to stay the same as before the war.

Women, on the other hand, were in fact changing. In the 60’s and 70’s, women wanted a stronger voice. The war, equal rights, workplace opportunities — these things were important to the women of that time. They didn’t want to be only a housewife anymore. So everything changed after the war, men, women, and expectations. Things just weren’t the same.

This is what Mary Anne represents. She doesn’t want to be just a stereotypical girl anymore. She wants to be in the thick of it, in the action, to be a part of the story, and not just as a soldier’s woman. Mary Anne in the story says as much. She said she’s never felt so alive. She participates with the soldiers, not just watching them. Like in civilian life, she didn’t want to be on the sidelines anymore.

Her boyfriend couldn’t handle it. He was happy when she played the role of beautiful, supportive girlfriend. He became displeased when she exited that limited view of a woman.

They try to make it work, but something is lost. He’s lost his ideal girl and his anchor to a life before the war. She tries to be the dutiful girlfriend, but she has tasted freedom from archaic expectations and she simply can’t go back.

To reiterate, they also didn’t want their women to change so that things could remain “the same”. The men knew they were changed from the war and they wanted something to stay the same.

6. The story Rat tells in “Sweetheart of the Song Tra Bong” is highly fantastical. Does its lack of believability make it any less compelling? Do you believe it? Does it fit O’Brien’s criteria for a true war story?

The fact that it seems highly unbelievable does make it less compelling. For me, I feel like there are enough real life events in war to discuss without fantasy. In and of itself, yes, the story is compelling — filled with great metaphor and present day application. It can certainly be argued that by enhancing the story it gives traction to what the men were thinking and feeling with an outward display of those emotions. However, for me, I don’t need the added enhancement.

Yes, it fits O’Brien’s criteria for a true war story. It applies itself to what was going on with the soldiers and what the war did to and for men and women’s expectations.

7. In “Good Form” O’Brien casts doubt on the veracity of the entire novel. Why does he do so? Does it increase or decrease your understanding? What is the difference between “happening-truth” and “story-truth?”

He casts doubt on the whole novel to let you know that no real life story is always all true. We rewrite our own stories and experiences in many small ways. It depends on how we feel about an incident, perhaps how we came across, how we want to come across, and what we felt at the root of the experience. Therefore, that is the difference between story truth and happening truth.

Overall, I thought the book was thought provoking and a story that needed to be told. I thought his emphasis on what is a real war story was a unique take on the entire war experience, and for that matter, events that unfold in civilian life as well. Overall though, I felt like that point was driven home too much at the expense of the larger narrative. Metaphors can be used and story-truth can be used but the constant hitting over the head of the fact he was doing it became tiresome. I felt like the book was a bit disjointed as well. Despite my low rating, I would still definitely recommend it for a book club as I think it makes for a good discussion. I’m glad I read it, but ultimately it was not a favorite book of mine.

Since it was an audiobook, I must comment on the production quality and state it was top notch. The narration by the always impressive Bryan Cranston did not disappoint here. He was superb and a joy to listen to. This was an audiobook that was extremely well done on all accounts.

Until next time.


Madeline Fresco is a novelist who lives in San Diego. She is the author of CROSSED THE LINE, available for Kindle at Amazon.com, for Nook at Barnes & Noble, and as an ePub at other eBook retailers. You can also listen to her novel as a free, serialized audiobook atmadelinefresco.com. Her second book THE CHOICE, is available on Kindle at Amazon. Her third book ANGUISH, is available for Kindle at Amazon.com