VISIT, THURSDAY, MARCH 20, 2014

March 20, 2014, Thursday. I went to Cooke-Walden to see Mom about 10 AM. She was in a dimly lit room in her green dress with a blanket over her. When I stroked her head, she was as cold as ice. The director, Zachary Kent, left us alone for awhile and I sketched her. She really wasn’t there and it was nice to feel that. I got to talk at her a bit, too. It is such a complicated bunch of feelings. Geraldine has left this world of troubles and had a long ride. Joys and fun and terrible trials all gathered in this mystery we call Life.

FUNERAL HOME, WEDNESDAY, MARCH 19, 2014

March 19, 2014, Wednesday. I went to the funeral home yesterday, then to Retirement and Nursing Center. Afterwards I talked to Social Security, the Medical Examiner’s office and Mom’s bank on the phone. Enlightening.  The M.E. says that they have ruled Mom’s death as accidental with complications due to congestive heart disease and osteoporosis. I did not see any evidence of surface trauma but they say the break is consistent with some kind of trauma. Mom did forget that she couldn’t walk from time to time. I am so grateful for Mom’s pre paid cremation arrangement. The funeral home encounter was difficult, emotionally wrought but the big decisions were already made. I have trouble putting on my shoes much less trying to make big decisions. I have a very nice urn at the house ready for the ashes. They say the ashes will be ready before the Memorial Celebration on Sunday March 30, 2014, 2-5 PM. Also I found out that prepayment transfers to other funeral homes AND is refundable at about 90% if decisions change. Pre-pay your final arrangements!!! Prices are going up and up! Everyone is being very kind and helpful.

MOM LEFT THE STAGE

March 15, 2014, Saturday. I got a phone message from Nurse Mary at RNC about 1 AM that Mom had been pronounced dead by Hospice Nurse, Kathy Ballard, at 11:57 PM, March 14, 2014. August 19, 1919 – March 14, 2014 – Great synchronicity!  I called Kathy B. about 7 AM and spoke with her. She said because of the hip fracture Mom’s remains had been transferred to the M.E. office for examination. I called the M.E. office and spoke with Olivia. She said that there would not be cutting open the remains but would look at the records and look at the body to see that all was consistent then call Cook Walden to get Mom’s remains for cremation. I called Riley and told him. I will send out a family email and talk with the newspaper about the obituary today. We will have to plan a Memorial Service, probably at my house and probably next Sunday March 23, 2014 but that could change. Mom was 94 years old. She was a great personality in this world.

THURS., MARCH 13 & FRI., MARCH 14, 2013

March 13, 2014, Thursday.  I took Brooks and his luggage to the NH this morning about 10 AM. He will leave from NH this afternoon about 2 PM with his friend, Chuck. I spoke to Nurse Julia and Nurse John. They said that Wendy had bathed Mom this AM so they had given Mom pain meds for the procedure. We saw Wendy in the hallway and she said Mom told her “leave me alone!” That’s a good sign! I opened the blinds when we went in and the squirrel was performing his acrobatics on the birdfeeder and there were birds around. Mom was resting, O2 on but cannula out of place. Mom was grouchy at first but I clapped hands, clapped her hands and sang “hey good looking…” and she smiled and attempted to participate, moving her mouth and smiling. We got cannula in place. I  left, went to the car and got birdseed and added to the feeder. From outside I saw C.N.A.s replacing the bed pad with folded sheet. Nurse John said that bed pad was there temporarily to assist in drying Mom. I went back inside, said good bye to Brooks. Annie from Activities came by and  introduced them and Brooks took a picture. I left about 10:20 AM.

March 14, 2014, Friday. Regina called at 1:30 PM from the NH to say that Mom has a low grade temperature, about 100. She said Mom’s lungs sound good so she suspects urinary tract infection (UTI). I asked about the triangle pillow and Regina said it couldn’t be here until Monday. I went to the NH about 4:40 PM. I filled both birdfeeders, blinds open. Mom was asleep with many pillows around her. The TV was on TCM. I changed the DVD and then put TV on TVLand for awhile (Andy Griffith). I couldn’t get Mom to wake up really. I did get some response from singing, patting her feet and hand slapping. She opened one eye occasionally. She did feel warm to touch and was coughing occasionally. C.N.A. Sefakor brought Mom’s tray. Dr. Maxwell came by and checked Mom’s pulse, temperature, lungs and tried to wake Mom. She said maybe they could reduce her pain meds but first she would talk to the C.N.A. about Mom’s pain level. I did not perceive any moaning or pain complaint from Mom. Mom ate a few bites of the foods and all of the dessert. I got her to drink about 20% of a cup of thickened water, one teaspoon at a time. Mom did hold my hand and made small responses to touch, stroking, hair brushing. C.N.A. Yvonne came by and petted, cooed to Mom and got Mom to open one eye and look at her. I put the DVD on and left about 6 PM. At home there was a long message from the Chaplain at Hospice, offering solace and giving instructions for reaching them in case I want or need them over the week-end.

WEDNESDAY, MARCH 12, 2014

March 12, 2014, Wednesday. Brooks walked to the NH this morning about 10 AM. Suzy came in and I met them at the NH and we went to lunch. We returned to the facility and Suzy left for home. C.N.A. Sandra and Adam changed Mom in her bed. Sandra said no more bed pads for Mom with the new air mattress. Brooks said that Regina told him that the triangle pillow hadn’t come yet. I went home about 2:15 PM and returned afoot about 2:45 PM and Brooks and I went to the Care Plan meeting. Riley showed up and came, too. Nurse Rose, the Hospice social worker, the facility social worker Rebecca, Hospice nurse Regina, Donna from Recreation all attended also.

1. The prognosis for Mom’s general decline is not good over the next 12 months. Mom may recover from fracture but not to previous state of wellness.

2.  Mom is on methadone for pain.

3.  The reason for no bed pads is the aeration is inhibited by bed pads.

4. Nursing will try to put her own clothes on her instead of the NH gowns.

5. Signs to watch for are unproductive cough, congestion, flushed face and expressions of distress or discomfort.

6. She gets nebulizer treatment 2 or 3 x daily.

7. Scheduled eye exam will be postponed until Mom can sit in a wheelchair.

8. Mom gets Boost as much as 3 x daily (450 calories each Boost) Mom has gained weight.

9. Watch for signs of bed sores on back side.

Brooks and I returned to Mom’s room. I gave her a drink. Brooks fed Mom some banana. We left the NH about 4 PM. Brooks was able to sketch Mom today and spent a lot of time with Mom.

TUES., MARCH 11, 2014

March 11, 2014, Tuesday. Brooks and I walked over to the NH about 10:15 this morning. Mom was sleeping in her bed. I looked at her toenails, feet. Brooks said he would trim her toenails. We put some cream on her and I checked her clothing. Her clothing looks in good shape and not much in the hamper. She has on a NH nightie this morning. The bird feeder looked good. Mom responded to greetings and touch. I left about 10:30 AM. Rebecca, the new Social Worker at the NH, called  about 1:30 PM to confirm care plan meeting tomorrow at 3 PM.  Brooks called from the NH about 5 PM saying that Mom would not wake up to eat. I suggested patting her feet. Brooks returned home about 7 PM and reported that the feet worked and Mom ate some supper. Plus Riley, Carl and Bill A. came by and visited at the NH. Brooks reported that Mom was still very sleepy but did respond somewhat to the visitors.

SUN., MARCH 9 & MONDAY, MARCH 10, 2014

March 9, 2014, Sunday. I went to the NH about 1:40 PM, fed the birds, blinds closed. I spoke with Nurse Jessica about Mom. She said that Mom had just gotten her 2PM pain meds and that she was doing well, today. Jessica said that the special triangle pillow had not arrived yet. The pillow between her legs that I saw yesterday was not the triangle pillow for hip fracture. Mom was sleeping. I straightened her covers, brushed her hair, and got some hangers out of the closet to bring home. I put some cookies in the bottom drawer. C.N.A. Mary and another C.N.A. came to change mother and I suggested more help. They went and got Nurse Jessica. It looked like a 3 person job to me. Mom whined and yelped but it went pretty smoothly. I changed the DVD to American in Paris. Mom dozed off and I left about 2:15 PM. I went back by the NH about 5:15 PM. C.N.A. Selfena was feeding Mom in her bed. Mom was eating well. When I walked in, Mom said “Hi Melanie!”. I greeted Mom and visited with and Mom and the C.N.A. for a few minutes. I saw Nurse Steve and talked to him about Mom, too. He reported that Mom seemed to be doing well today, eating well. I gave Nurse Steve the cookies for staff. I left about 5:30 PM.

  March 10, 2014, Monday. Brooks and I went to the NH this morning about 9:30 AM. We went in the front door and greeted staff on the way to Mom’s room. I introduced Brooks to Nurse Steve.  We met Hospice C.N.A. Wendy at Mom’s door and talked about Mom. Three Staff were changing Mom. C.N.A. Sandra was in charge of Mom this morning. They left and we went in. Mom was sleeping and I opened the blinds. Med Nurse came to give Mom some Boost and Mom was not swallowing the liquid. I got a chocolate and gave it to Mom rather forcefully. Once Mom tasted the chocolate, she swallowed. I showed Brooks around then left him there about 10 AM. I returned to the car and got some feed for the birds and added some birdseed to the feeders. I talked to Brooks on the phone about 3 PM. He was having lunch at La Mancha. About 4 PM he called and asked if Mom had any eye drops. I said no, not in the room. I returned to the NH about 4:30 PM. and added birdseed to the feeders. Brooks said that the staff gave Mom eye drops and Mom seemed more comfortable. When I came into Mom’s room, Mom seemed agitated and was saying “blah, blah, blah…” Brooks reported that staff had arranged the three pillows around Mom to brace her in position. Still no sign of the triangle pillow for this type of injury. I played clap hands with Mom and got her to participate then recited “peas porridge” until her “blah, blah” started to follow the rhyme. Then we played and sang a bit. Brooks reported Mom sleeping most of the time with him today and showed me his sketches. C.N.A. Selfonia brought Mom’s tray and Brooks and I together persuaded Mom to eat fairly well. Brooks said that she ate a few bites of each food at lunch. Mom finished the dessert then Brooks gave her a chocolate. Riley came by briefly on his way to teach Dutch. Mom seemed comfortable and fell asleep soon after eating. I left about 6 PM.  Brooks left shortly thereafter.

SATURDAY, MARCH 8, 2014

March 8, 2014, Saturday. I responded to an email from Regina, Hospice nurse. I called the NH about 11:55 PM and spoke with Jessica on Unit II about changing Mom’s diet from “mechanical soft” to “puree’”. She said that the change would be made for lunch today. We discussed the change continuing as long as Mom is on pain medication. I went to the NH about 4:15, fed the birds, blinds closed. Carl was in the room just finishing up changing Mom’s flowers. He said Souhange gave some of her flowers to Mom’s arrangement, the orchids and the green mums. Carl left about 4:25 Pm. Mom was sleeping. I gave her the pillow from Helen and Mom smiled. She likes it. Mom had on a shirt instead of just a nightie. She has a triangle pillow between her legs that seems to add to her comfort. I have clean clothes but didn’t bring them. I need to reevaluate her clothing. I brought home her teeth. Mom slept until the food came. I played slap hands with her some and she had moments of being alert and waved her hands around a bit. There was no indication of itching today. She ate about 1/3 of her food. We channel surfed a bit. Mom likes some of the commercials. She looked out the window. I gave her a chocolate, closed the blinds and changed the DVD to Carmen. I left about 6 PM. Mom seemed better today, less sad.

FRI., MARCH 7, 2014

March 7, 2014, Friday. I went to NH about 4 PM. I fed the birds, blinds closed.  Mom was sleeping on her bed, O2 on, no teeth, no glasses, in a nightgown, a sheet over her and the new air mattress in evidence. It looked like one of Mom’s lap blankets were under her as a pad. The room was warm so I opened the window for the duration of the visit. Mom was still scratching, itching. She has a sock on her left hand. I took her hand, stroked her, wiped her face and brushed her hair. The distractions did help reduce her scratching, plus put cream on her face, hands, neck. I went to Nurse Sandra and requested puree’ food rather than try to fight with Mom about putting in the teeth. She was licking her lips, too, indicating thirst. I gave her water. I put a denture cleanser tablet in her teeth water. Her teeth might come home for awhile. A C.N.A. brought Mom’s tray and she ate about 1/3 of the food, which is pretty good since she was nodding off during the eating. A Med nurse brought her some Benadryl for the itching and some Boost drink. Mom drank about 2/3 of the cup of Boost. The birds came and Mom did see them at one point. We channel surfed then I put the TV back on the DVD. Mom fell asleep and I sketched her then closed the window, the blinds and left about 6 PM.

THURS., MARCH 6, 2014

March 6, 2014, Thursday.  Carl called from the NH about 3 PM saying that Mom was in a good mood. I went to the NH about 4 PM. I talked to Nurse Steve before I saw Mom. He said that she got itchy from the pain meds which is not unusual so they are changing her meds. They have ordered an air bed for her and some special wedge pillows to hold her leg in place. Mom was sleeping with O2 on, no teeth, no glasses. I cleaned her glasses and Mom awoke. She was rubbing her upper left arm with her right hand and mumbling “ouch, ouch…”. She awoke and seemed happy to see me but was also agitated and uncomfortable.  I had difficulty getting her to put her teeth in. I got a coke from the vending machine and she drank some. C.N.A. Roxanne brought her food. I talked with Roxanne and she explained to me about the strategies they are trying to keep Mom clean and comfortable. She ate some but rather sparingly; a few bites of veggies, a few bites of the rigatoni, and all of the strawberries and whipped cream. A med nurse brought her some milk of magnesia. I cut her fingernails. I noticed some swelling in her L leg and told Nurse Steve. He came to the room and brought some ointment. There is no discoloration and the swelling does not seem inappropriate. Souhange asked me what was wrong and I told her that Mom had broken her leg. I think she was concerned that it might be something contagious. Mom and I saw some birds. I changed the DVD to White Christmas. I had difficulty getting her to give me her teeth but I got them and cleaned them. Mom fell asleep and I left with dirty clothes about 6 PM.

MARCH 5, 2014 FRACTURE

March 5, 2014, Wednesday. I didn’t go to the NH today. Carl says he will see Mom today. When I got home from work, there was a message from Regina, Hospice nurse for me to call Dr. Maxwell. As I was listening to the message Carl called and said that Mom has a hairline fracture. Carl assisted Mom with supper  and stayed with Mom until she fell asleep. I called Dr. Maxwell and we discussed the treatment options. I said “no” to surgery. We are going to try bedrest for up to three weeks and see how Mom does with that. If pain increases or any of several indications of complications we can discuss those. Another X-ray will be done in 10 days. Dr. Maxwell indicated that bones can and do heal in elderly patients with bedrest. I called Carl back and he said that Mom seemed comfortable and the meds she is getting do seem effective. 

MON., MARCH 3 AND TUES., MARCH 4, 2014

March 3, 2014, Monday. I did not go to the NH today. I talked to Riley and he said he planned to go see Mom. I got an email from Regina from Hospice saying that she saw Riley today with Mom and that they both agreed that Mom was having a good day!

March 4, 2014, Tuesday. Riley called from the NH this morning saying that Regina from Hospice was there and that Mom is complaining that her leg hurts. I went to the NH about 3:20 PM. Mom was asleep on her bed. I cleaned her glasses. Nurse Steve, Regina, and another woman came into Mom’s room to examine Mom shortly after I arrived. They determined that Mom is having some pain on her left hip, thigh area but doubt that it is a fracture. A C.N.A. came and assisted getting Mom up, unsuccessfully. The C.N.A. also changed Mom. They left and I talked with Regina for a bit. Mom fell asleep. Nurse Steve returned with some medicine. Mom slept. I hung up the clean clothes I brought and cleaned Mom’s nails a bit. I sketched Mom sleeping. I woke up Mom and we ate a few Cheetos. Then Mom fell back to sleep. I sat with her a bit then left about 4:30 PM. Mom knew me and responded to me appropriately but was very tired and sore.  I gave Steve some pecans and a Teddy Bear from Sharon S. to the Nurses station for another resident.

SAT., MARCH 1 & SUN., MARCH 2, 2014

March 1, 2014, Saturday. I went to the NH about 3:15 PM. The feeders were full, blinds closed. I noticed Riley signed the visitor’s book about noon. Mom was resting on her bed, watching the DVD, sound low, O2 on but cannula out of place, glasses off, teeth in.  We hung up some clean clothes that I brought. I got Mom’s pants on her and helped her into her chair. She did not have on leggings so we put those on. We played “peas porridge hot.” I cleaned her glasses, wiped her face, cleaned her hands and noted Mom coughing. I changed the channel to TCM. Then we went to the entertainment. I got Mom a coffee. We clapped hands but Mom put her head on the table so we went for a walk outside. It was a warm day so we went around the back and sat by the pansies and the begonias. Mom was very interested in the begonias. We went back inside to her room and Adam came and took Mom vitals. I gave Adam a bag of pecans. We discussed Mom’s leggings and I mentioned the leggings to Nurse Sandra, too. I put in the new DVD, High Society, looked at the card from Brooks and also at her 6ht grade report card which Bonnie sent. I took Mom to the big TV room and left about 5:15 PM. Today Mom was able to follow and recite “peas porridge” with me after three rounds. She was attentive to hanging up the clothes and noticed when it was wrong. She knows who she is.

March 2, 2014, Sunday. I went to the NH about 3:20 PM. I fed the birds, blinds closed. Mom was resting on her bed, no O2, teeth in, glasses off, DVD playing, sound low. Mom needed changing, no pants on so I called for assistance then went and asked Adam. He changed Mom and we got her into her chair. I brushed her hair, cleaned her hands, cleaned her glasses, wiped her face and we played ‘peas porridge’ but Mom could not say the words. After three times through she managed “hot”, “cold”, “old” on cue. We went to the dining room for the Episcopal service. Mom nodded and wanted communion today. She enjoyed looking at the music but didn’t sing. We returned to her room and channel surfed then I changed the DVD to Singing in the Rain. She ate a tangerine, carefully chewing up each section then spitting out the pulp. Then I gave her a caramel.  I tried to coax her to color today unsuccessfully. We looked at photos. She correctly identified her sisters but mixed others up. She could identify Carl and Brooks but not her other children. Today she could not remember her birthday and I could not get her name out of her. I gathered her dirty clothes and took Mom to the big TV room. I left about 4:50 PM. Mom showed affection to her stuffed dogs today and was out of sorts and grouchy when I first got there. She got happier during the visit. She did not speak out loud until I was leaving then she asked me to stay.