You need somebody to take you home, and you need them twice, because cataract surgery is done one eye at a time a few weeks apart. A hired escort usually counts. Home health aide care is $45 an hour , with no minimum contract, so a single procedure day is a normal booking.

Why an escort for a twenty minute operation?

Sedation and vision. Most cataract procedures use numbing drops or an injection plus light intravenous sedation, and even light sedation means you cannot drive. Many centers also will not let you leave alone, because judgment returns later than alertness does.

Your pupil is also dilated, that eye is blurry, there may be a shield over it and bright light is uncomfortable. It is not a walk to do alone even feeling clear headed.

What counts as an escort?

Ask your center these five questions before the day. Freestanding surgery centers are often stricter than hospitals because they have no beds to keep anyone in.

• Can the escort be someone I hire?
• Do they stay in the building, or come back at discharge?
• Do you accept a rideshare if a responsible adult rides with me?
• Does anyone need to stay with me at home, and for how long?
• Do you need the escort's name in advance?

The pattern across Massachusetts: a rideshare with you alone is almost never accepted, one with a responsible adult alongside often is, and a hired escort is usually fine if they can be named. A driver who never comes inside is not enough, because the nurse hands you over to a person.

What happens between the two eyes?

Your depth perception goes, and that is the real risk of this whole process. After the first eye you have one corrected eye and one still looking through a cataract, so your brain is getting two different pictures.

Depth perception is what tells you where the bottom step is. For an older person with stairs, a raised threshold or a step down into a garage, the weeks between the two operations are a genuine fall window. Families watch for eye pain and infection, which are rare, and not the stairs, which is where the injury comes from.

If your mother lives alone with stairs, those in-between weeks are when to have somebody in the house, not the afternoon after each surgery. Tell the surgeon about the stairs and ask how long the imbalance should last.

Can she manage the eye drops?

Often not, and the drops are not optional. You go home with more than one bottle, several times a day, for weeks, sometimes on a tapering pattern that changes week to week.

Getting a drop into your own eye needs steady hands, a head tilted back and enough sight to aim the bottle. Tremor, shoulder arthritis or any memory trouble defeats it, and many people will not admit that. Ask at discharge whether anyone actually watched the patient put a drop in. If not, assume help is needed.

What restrictions come home?

Your surgeon's instructions are the authority and they vary. Commonly: no rubbing or pressing the eye, a shield at night for a period, sunglasses outdoors, no swimming, and limits on bending, lifting and straining because those raise pressure in the eye.

Notice what the bending limit rules out in an ordinary week: laundry from a basement machine, a full kettle, groceries from the car, the bottom shelf of the fridge. That is a household problem for a week or two, and it is what an aide is for.

What does help cost?

• Escort for the procedure day. Collected, escorted in, waited with, discharge instructions heard, driven home. Priced by the hours it takes at $45.
• Drops and cover for the first week. 2 hours a day for seven days is $630 .
• The gap between the two eyes. 3 hours twice a week is $270 a week .
• Wheelchair transportation if needed: $115 each way, $230 round trip within five miles, then $2 a mile.
• Stair assistance if the front steps are the obstacle: $200 a visit .

Two procedure days plus a short stretch of help is a few hundred dollars. Weigh that against postponing the surgery, and against a fall on the stairs.

Our aides are trained, background checked and insured but they are not nurses, so they cannot administer medication. They can be present while the client manages their own, help if something goes wrong and call for help.

What if you cannot pay for it?

Do not cancel. Tell the scheduler you have no escort, in plain words, before the day. Ask for the social worker or patient navigator. Call your town's Council on Aging, which in many towns runs volunteer drivers who will wait and walk you out. If the person has MassHealth, ask the provider about a PT-1 ride. If they are on Medicare Advantage, call the member number about transportation trips.

And ask the neighbor you assume is too busy. It is a three hour favor twice, not a week of somebody's life.

Arranging cataract surgery help

Care Remedy covers eastern and central Massachusetts from offices in Woburn, Brockton and Springfield, and escorts clients to hospital eye departments and freestanding surgery centers regularly. Call 781-957-8076 or email info@careremedyinc.com with the date, the center, and what the discharge instructions say about an escort and about somebody staying afterward.

Book both eyes at once. You already know the second one is coming.

Your eye surgeon's instructions are the authority on your recovery, restrictions and drops.