The home nursing component addressed the most critical medical needs during the postoperative period. A trained nurse visited regularly to perform surgical wound assessment, checking for redness, swelling, discharge, or increasing pain that could indicate infection. Given Mrs. Sandhu’s diabetic status, this daily wound surveillance was clinically essential rather than optional.

Blood pressure and blood sugar monitoring were performed at prescribed intervals. These measurements were documented and shared with the visiting doctor to guide medication adjustments. The nurse also administered prescribed medications on schedule, reducing the risk of missed doses or incorrect timing, which is a common problem when elderly patients manage complex medication regimens independently. Medication monitoring and management at home is particularly important for patients with multiple comorbidities who are taking several drugs simultaneously.

Neurological observations were carried out to detect any subtle changes in limb power, sensation, or bowel and bladder function. The nurse also conducted fall risk assessments, monitored skin integrity to prevent pressure injuries during rest periods, and maintained direct communication with the neurosurgical team to report any concerning findings.

While the nurse handled clinical tasks, the patient attendant provided the continuous daily support that Mrs. Sandhu needed to remain safe at home. A trained patient care assistant was assigned to assist with safe transfers from bed to chair and back, ensuring that proper body mechanics were used to protect both the patient and the surgical fusion site.

Walking supervision was a key responsibility. Because Mrs. Sandhu was using a front-wheel walker and had significant balance impairment, she needed someone present during every walking session to prevent falls. The attendant also assisted during bathing, which was a particularly vulnerable activity for a patient with neck fusion, lower limb weakness, and osteoporosis. An anti-slip bathroom chair and grab bars were installed to make the bathroom safer.

Beyond physical assistance, the attendant provided emotional reassurance. The fear of falling is a significant psychological barrier to recovery in elderly patients after spinal surgery. Having a calm, trained presence during daily activities helped Mrs. Sandhu gradually rebuild her confidence in moving independently. The attendant also coordinated appointment schedules and ensured that the daily routine prescribed by the rehabilitation team was followed consistently.

Physiotherapy was the cornerstone of Mrs. Sandhu’s functional recovery. The surgery addressed the structural problem of cord compression, but it could not reverse the muscle weakness, loss of coordination, and balance deficits that had developed over a year of progressive myelopathy. The importance of physiotherapy in postoperative recovery is well established in spinal surgery literature.

The physiotherapy programme was structured around specific treatment goals. Lower limb strengthening exercises targeted the quadriceps, hamstrings, and ankle muscles to improve her ability to bear weight and walk with less effort. Hand coordination exercises focused on fine motor tasks like picking up small objects, writing, and buttoning clothes, which had become difficult due to the cervical myelopathy. Balance retraining exercises challenged her postural stability in progressively more difficult positions, starting from seated balance and advancing to standing balance with and without support.

Gait training with the walker focused on improving the quality of her walking pattern, including step length, symmetry, and walking speed. Core strengthening exercises provided trunk stability, which is essential for maintaining upright posture after cervical fusion. Postural correction was integrated throughout each session to prevent compensatory patterns that could strain the surgical site or other joints.

A home exercise programme was designed for days when the physiotherapist was not present. These exercises were simple, safe, and clearly explained to both Mrs. Sandhu and her daughter-in-law, who supervised the home exercise sessions. Customized rehabilitation programmes that include both supervised and independent components tend to produce better outcomes than either approach alone.

A doctor visited Mrs. Sandhu at home every two weeks to perform a comprehensive clinical review. This included a formal neurological assessment to track recovery of motor and sensory function, evaluation of the surgical wound to confirm continued healing, and a review of mobility progress based on the physiotherapy team’s reports.

The doctor also reviewed the home nursing records of blood pressure and blood sugar trends, adjusted medications when necessary, and modified the overall rehabilitation plan based on the rate of progress. This regular medical oversight ensured that the home care plan remained aligned with the neurosurgical team’s expectations and that any emerging concerns were addressed promptly without requiring the patient to travel to the hospital for routine follow-ups.