When I arrived at mom’s this morning, she was asleep. Out like a light. I put on the Classical music CD. She must have moved around a lot in her sleep as well because she was all the way over, leaning to the left side of the bed. She also needed to be suctioned badly. I found a respiratory person who came to suction her and then do her trach care (change the neck band, put a clean pad around the opening, clean the opening…also brush her teeth and tongue). This took a while, I talked to mom and stretched out her right hand as this was done. When he finished, mom and I began her physical therapy but were interrupted by the CNA who came to bath mom and get her dressed and put her into her chair. I gave her a manicure and pedicure while she was being dressed and washed… While waiting for mom to be put into the wheelchair, I had mom practice lifting her legs with the ball under her knee. She lifted her right leg 4 times (1/2 way). Once she was in her chair, she was sleepy…before she fell asleep, I had her lift her right leg 4 more times (1/2 way) and her left leg once (1/2 way). As she slept in the wheelchair, I did her full physical therapy/range of motion exercises. Since last Wednesday when mom went to the neurologist, she has been back on the CPAP mode of the vent. They are going to try to wean her to the trach collar again on Monday. When mom woke up between naps, I tried to do the “Command Cards” that my friend at work made for her. These are index cards in a binder that have either pictures on one side with a written command on the other or just written commands on them with no picture. The idea is to state the command and have mom follow it. I have decided that this will be something I will work on diligently with mom so that, by her next appointment with the neurologist, she will be able to follow directions. I began with an assessment run---she kept falling asleep in between—but I began by showing her a card that had 3 different color dots on it and I said the color name of each dot while pointing at it over and over (maybe 3-4 times), then I asked mom to, “Touch___ (whatever color)” and waited to see if she could do it. She couldn’t even begin to touch anything much less a specific color, so I repeated the command and gave her a full manual prompt as I repeated the command again (3 times). Then I tried a different card. By repeating this process with each card, I will be able to determine which cards (if any) mom can do on her own. Then, in the future, I will start with only the cards mom can do and eventually add to the commands with cards she cannot do (one at a time). When she finally woke up, right before I left, I worked on getting mom to follow the command to open and then to close her hands---she couldn’t do it. I also asked her to clasp her hands. No luck there either. When I left her, I put on some music and left her with her lap desk and some magazines to read.
Dad, Anthony, Con and the kids, and later, Lenny and Claudia, all went to visit mom during the afternoon and evening but she slept most of the day and was unresponsive and tired when she was briefly awake. Claudia said that one of the nurses thought mom was really out of sorts too and she took mom's temp and saw that it was 99.8 so she ordered a urinalysis to see if mom has a urinary tract infection which, in older people, can cause dementia-like symptoms! I forgot about that!
“…if you have faith as a mustard seed, you will say to this mountain, “Move from here to there” and it will move; and nothing will be impossible for you.” Matthew 17:20-21
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