Mom was asleep when I arrived but she quickly woke when I sat in front of her. She was sitting in a chair with the trach collar…off the vent. I said hi and she said hi back. I asked how she was and she said, “I’m Ok.” I caught her up on the family activities for the day and she listened intently, watching my face the whole time smiling. Sometimes she would comment, “Oh” or “Yes”… Then we began to do some stretching. We prayed together next. Mom made the sign of the cross and folded her hands in prayer all on her own when I asked if she wanted to pray. We stretched her hands first. Her left hand is very curled and squeezed tightly into a fist. We stretched her fingers. The left fingers hurt badly when stretched. We need to stretch them more so they remain mobile. First I put my hands on hers and stretched her as I gave verbal cues like, “Open, close” speaking while I maneuvered her fingers and hands. Soon, she just watched what I was doing and did it too alone, independently with just a verbal and visual cue and no physical prompting. She managed to open and close her fingers, wiggle her thumbs and pointer fingers in a circle and bend her hands at the wrist---on command with a visual cue. She would watch me and then do what I do. At one point, I tried to get her to watch me move my arms in and out at the chest level and then imitate me but she could only move from the wrist and not the elbow at first. Then, mom did lift each arm slowly—delayed response—and bend each at the elbow at her sides and then slowly put them back down. She did all this about 2-3 times. Next, we began to use the IPAD and use some apps…the first app was the “feature” app---“Show me the one that you plug in” and “Touch the cold one” etc. We came to a picture of a calculator, barbecue and blender. I said, “Which do you plug in mom?” She looked at me wide eyed and shrugged her shoulders and said, “I’m not sure.” So I began to name each item and then follow with the question, “Do you plug that in?” When I came to the blender, mom looked at me incredulously and said, “What’s a blender?” So I described what a blender is and does and what it is used for and told her she has one at home. She was astonished by the description---using a lot of facial expression as she listened to me talk. Then mom fell asleep. Again, this isn’t the same aimless, dazed, deep type of sleep mom did before the shunt. Now, it’s more like a typical cat nap. Using her body and mind is tiring. I asked mom what my name is and she guessed but didn’t know it until I gave her a phonemic cue, “KKkkkkk….” Then she said Kathy. I played music when she would sleep. Nurse said that mom had physical therapy today before I came. Nurse said that mom moved her arms, legs…sat her up on side of bed again and mom did it!!! Today, mom’s nurse said that she learned a lot from watching us work with mom and that it is great how we use every waking moment that mom has to rehabilitate her. The nurse commented on all the grandkids too and how much they know about how to work with mom. One of the “tricks” the nurse learned was to lift mom’s eyelids when she squints so that the nurse can get mom’s attention. The nurse said that we are a “model” family. Haha! Mom slept for an hour and a half and when she woke, we played the “Zoo Animal”app on the IPAD. I showed her 10 pictures of animals along with their names in words. Mom read 3 of 10 independently…the other 7 she read with scaffolding (I had to tell mom the beginning sound or point to the letters in the words or read them and she repeated them). Next, we played “Baseball Math” on the IPAD. In this game, there is a baseball diamond, a pitcher and a batter, along with a Hitting Table and Scoreboard. By touching the pitcher, a multiplication fact appears along side a number board where you put the product in. If the product is correct, the batter hits the ball and runs around the bases. The cycle repeats through 9 innings. Mom was not able to name any numbers or to tell me any facts, but I read them to her so she could hear the names of the numbers as she watched the game progress. Perhaps this would jar her memory. The resident came in next to remove mom’s staples (about 15-19). I held her hand as he did it. She winced and said, “Owww!!” audibly at times. The social worker came in also to say that mom is being discharged tomorrow. No time yet though. The social worker said that the original facility has no bed. The second choice facility in the next county doesn’t have a bed until Wednesday. The social worker said she may not be able to wait until Wednesday and may need to place mom tomorrow at the next available bed wherever that may be….exasperating. I found out information on bed holds too. As a new admit patient, you have to be in any facility 30 days in a row in order to qualify for a 14 day bed hold. If mom goes straight to the original facility, she has no bed hold until September 30. If she goes to another facility first and then to the original one, she has to be in the original one 30 consecutive days and then gets a 14 day bed hold (no more September 30 date consideration).
Dad came late in the afternoon to see mom. Mom’s nurse said that she needed to put mom back on the bed from the chair and that mom needed a lot of suctioning but did not have an awful lot of secretions. So the nurse is asking for medication to clear it all up. The respiratory person came next and suctioned mom and gave her a breathing treatment. The respiratory person said that as for mom’s trach cuff (which is in her throat), it is a “highly specialized” cuff made specially to fit mom’s throat. Mom’s anatomy is such that the cuff she has is a combination of 2 types of cuffs made to fit mom’s throat. As for whether it is the right cuff for eating, the respiratory person said the doctor and speech people would know best which is the correct one. The respiratory therapist said that much of the secretions are not down in mom’s lungs or throat but in the back of her mouth which means that she isn’t swallowing well yet. Mom has a lot of eczema patches on her face and around her nose now since she is in the hospital.
After dad left, mom and I played the Science app on the IPAD…you look at science related pictures and their words. We watched an episode of the Electric Company too. Then we watched Julie & Julia (all on the IPAD). As we watched the movie, one of the attending doctors came in and commented on the change in mom from last week. Mom said hello to the doctor and was attentive and perky while the doctor was with her. He prescribed Robisol for the secretions. As we watched the movie, mom tapped my arm to get my attention and said, “Oh… I’m so out of breath.” She had a lot of secretions and needed to be suctioned. Then she fell asleep and I left.
"Cultivate inner beauty, teh gentle, gracious kind that God delights in." 1 Peter 3:3-4
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