For any newcomers to our e-mail list, the blog for mom is at http://dottysupdates-kgranelli.blogspot.com
Just to give us all a benchmark from which to start again (sad as it is...), Claudia wrote/recorded the following:
Mom used to be able to use her hands to complete fine motor tasks - trace on a dotted line, write letters, lace a sewing card, pull and push a pop bead, fix her eye glasses on her head, take her glasses off and on, scratch her nose, clasp her hands together interlocking her fingers, catch a ball, throw a ball, work a Nerf gun, hold a hand of playing cards, push pegs in a peg board, complete single piece wooden puzzles, trace a line to circle words in a words search, trace letters in a cross word puzzle (modified with large boxes and a limited amt. of words 3-4), cut on the line with scissors, write (copy some shapes --mostly circles, and copy letters), place paper clips on the edge of paper, open and close clothespins and place them on the rim of a cup, use tweezers to pick up pom poms and place them in a cup. Gross motor wise, mom was standing in a stander for 6 minute intervals. She was able to lift both her right and left leg off the bed to touch an outstretched hand. She moved her feet on command at the ankle. She was able to push against a theraband with her right and left feet while she held the theraband in her hand. Mom was also able to read both words in isolation and in a sentence or phrase. She had just begun to point to express a want the night before the incident. Laugh at jokes and funny actions and stories.
Mom is no longer able to complete any of these tasks now.
Claudia started the day with mom today. She said that mom was wide awake and alert and was in a great mood and that she did all mom’s physical therapy/range of motion exercises. Two respiratory therapists came in the room to check mom and the vent and gave her an albuterol treatment (they check her and give this as needed). She also said that we really need to work on mom's hands because they go back into the curled position when left alone. Claudia suggested we keep mom's hands on top of a therapy ball all spread out and stretched whenever we are with her. She read the "All About Me" book while propping it up on the tray table on her lap, but it took a really long time for mom to focus her eyes to look at it---a lot of redirecting to get her to look at the book. Mom was very distracted. Claudia managed to get mom to direct her attention on the book. She also gave mom a pep talk---"No more sad faces, be positive. We'll get you back to where you were before Christmas. You aren't that far away from there ability-wise. We're gonna work to get you back to where you were and it WILL happen! We've been here before and you didn't do anything when you first came here and now you do so much. You have to be positive." Mom had that peaceful calm, happy face--almost like a smiling face. Claudia tried giving mom a sewing card but mom didn't even grab it; so Claudia put the card in one hand and the lace end in the other. But mom did nothing with it (she had it the whole time Claudia did PT. While she worked with mom, a nurse came in to say that, from now on, whenever we want mom’s mitts taken off, we have to ask a nurse to do it. We are also not allowed to leave her alone without the mitts (not even to go to the bathroom) unattended. When we leave, we have to ask the nurse to put the mitts back on. It was explained that the nurses are now responsible for any mishaps like mom’s incident. Good, but sad too, that now, after all this happened to mom, they are finally getting more strict and diligent about caring for and watching their patients. They all also come running to check on mom (and I assume other patients as well given the conversation in the hallway I have overheard today) whenever a buzzer goes off or an alarm of any kind sounds.
When I arrived to be with mom, she was asleep…out like a light. No waking her. I did her range of motion exercises as she slept. While I was there, the same nurse, who saw Claudia and talked to her, came in to talk to me. He relayed the same message to me. I am noticing, thank God, that mom’s ankles and feet stay at more of a 90 degree angle (as they should) with her sneakers on in the chair. In bed, they appear to drop a bit---this means the toes point out straight, almost like a ballerina on his/her toes. Mom’s site, where the wound from the chest tube was, looks great! Healed really well without any oozing or even major scar! It is hard to figure out how to keep mom’s fingers straight inside the mitts. She immediately curls them into a fist as soon as the mitts go on. I asked to have one to take home to play with in order to see what I might be able to devise to keep her fingers straight in them at times. They said I had to go to the HEAD nurse. The medication nurse came in to give mom some “medicine” so I asked what it was and was told that it was her blood pressure medication. I asked about her not getting it unless her pressure rises and she said the order for it says—don’t give it only if her top number drops below 90…nothing about when it is normal. I have to get hold of the doctor about it. No report/care plan sheet was given to me yet. I have to go hunt for that now too. I am going to request a full care plan and all medical reports from that day to review in order to prepare for our meeting next week. (Team meeting on Thursday with staff).
John spent the late afternoon and evening with mom and she was "out like a light" the whole time he was there. He did her full physical therapy/range of motion exercises and shook her and tried to wake her but didn't wake up. She only woke up during a suctioning. He tried getting in her face and getting her to look at him but when she opened her eyes once and sort of got bright in the look on her face but went back to sleep. John felt that mom was looking through him and not at him. He is very upset by this but Claudia reminded him that yesterday was amazing so we may be back to one day awake, one or two days asleep. John noticed that the staff ran into the room a lot (respiratory, nursing...) many times during his visit. He noticed the change in the staff and their level of attention. They also asked how mom is, does she need anything?... " Mom's CNA came in to ask how she was and if she needed anything at least 4 times in 3 hours (this is amazing!). A woman came in and said to John, "I'll be right down the hall. Come get me when you leave. She's good in the bed and really clean right? Everything's OK right?" There must have been something on the floor but John didn't see anything but some housekeeping person ran into the room and sprayed the floor and cleaned. John asked if what they were cleaning with was toxic--it wasn't. John tucked her in and put her glasses away and took her hearing aids out. He shut the lights and left.
I checked on mom around 10 p.m. and she was sound asleep. A peculiar thing was that, when I opened the door to the wing mom is on, the nurse ran into mom's room. I became alarmed and quickly walked to get there but the CNA blocked me from going in the room right away with a shower guerney. She moved the guerney after the nurse left mom's room calmly. Mom was fine. Her roommate's light over her bed was on brightly---I will never understand this. Lights out and shades down during the day and lights shining brightly at night. That poor woman is never awake during the day anymore...and we struggled for so long to get mom in a bedtime/nighttime/daytime/awake routine. It just seems like such common sense to me. I prayed over mom and whispered, "I love you" and left for the evening.
"Be Bold and strong! Banish fear and doubt! For the Lord your God is with you wherever you go." Joshua 1:9
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