5:00-7:00     When I arrived, Dr. Vesper was relaxing in his recliner watching TV.  He looked over his mail as Michele filled me in on the day’s events.  After she left, I set the table, took Dr. Vesper’s dinner order, and began cooking.  Jessica, Danny, and Tyler came over to say hello, but did not join us for dinner.  Danny was meeting some friends, but Jessica and Tyler kept us company when dinner was served, which Dr. Vesper always enjoys.  He ate well and his blood glucose level prior to eating was 93.

7:00-9:00     After dinner, Dr. Vesper returned to the living room, but got a little exercise on the way by “racing” Tyler around the kitchen island.  After he was seated, I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  We watched some TV, had good conversation, and continued to enjoy the company of Jessica and Tyler until it was time for bed.  I gave Dr. Vesper his evening medications, waited while he performed his night time routine, and made sure he got into bed safely.  He was fairly adamant that he did not require my help tonight!

Dinner:     Salad, grilled cheese, tomato soup, diet cherry 7up, and ice cream (Lactaid)

Visitors:     Jessica, Danny, and Tyler

5:00-7:00     When I arrived, Dr. Vesper was watching TV in the living room.  Mossy, Jessica, and I chatted about his afternoon visit to the doctor and his recommendations.  After she left, I set the table, took Doctor’s dinner order, and began cooking.  Though they didn’t eat, Jessica and Tyler joined us at the table, which I know he greatly appreciated.  Having company and good conversation greatly lifted his spirits and he ate well.  His blood glucose level prior to eating was 125.

7:00-9:00     After dinner, I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  After doing a few more small chores, I gave Dr. Vesper his night time medication, then assisted him with his evening routine.  Once he was in bed, he stated he wasn’t really ready to fall asleep and asked me to turn the TV on.  I gave him a brief lesson on the remote’s operation, but Jessica said she would check later to make sure he got the TV turned off.  After I tucked him in, he asked me if I would bring Rose to bed.  I am unsure if his memory lapsed briefly or if he was being somewhat facetious.  I replied, “I wish I could!”  After that he thanked me, asked when I would return, and said good night.  I spoke with Jessica and Tyler briefly, then said good bye to them.

Dinner:     Salad, sweet and sour chicken, wild rice, garlic bread, diet cherry 7up, and ice cream (Lactaid)

Visitors:     Jessica and Tyler

5:00-7:00     Dr. Vesper was in his recliner when I arrived, but soon got up to use the bath room.  Stephanie M and I discussed the day’s events and his overall well being before she left.  When he returned and got settled, I replenished Kemper’s water bowl, touched up the bathroom, took Doctor’s dinner order, and began cooking.  Jessica notified me earlier that she would not be eating, but returned in time to join us at the table for good conversation.  Dr. Vesper enjoyed his usual hearty appetite.

7:00-9:00     The remainder of my shift was quiet and routine.  After dinner, Dr. Vesper returned to the living room while I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  We watched a little TV together and stayed entertained with Jessica and Tyler.  I gave Doctor his evening medications, then waited while he performed his night time routine.  He changed his Depends, but needed some assistance putting on his pajama bottoms.  Once he was in bed I tucked him in and said good night.  I chatted briefly with Jessica for a moment before saying good night to her and Tyler.

Dinner:     Salad, chicken stroganoff, peas, garlic cheese bread, diet 7up, and ice cream (Lactaid).

Visitors:     Stephanie and Tyler

5:00-7:00     When I arrived, Dr. Vesper was relaxing in his recliner.  As always, Michele spent a few minutes bringing me up to speed on the day’s events before she left.  Jessica and Tyler made their way over to say hello before I got started on Dr. Vesper’s dinner.  They elected not to join us due to a late lunch and Tyler’s need for a nap.  While I set the table and began cooking, Dr. Vesper read his paper and went through his mail, consisting of mostly condolences cards.  When dinner was served, he ate well and seemed eager for conversation, but changed the subject whenever Rose’s name came up.  After dinner, I tried to engage him in a game of cards.  He seemed briefly interested, but then declined and returned to the living room to watch TV.  Dr. Vesper’s blood glucose level prior to eating was 145.

7:00-9:00     The remainder of my shift was quiet and low key.  I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  Jessica and Tyler returned and kept us company and entertained with good conversation.  When the time came, I gave Dr. Vesper his night time medication and waited while he completed his bathroom routine.  Once he was in bed safely, I said good night to all of them.

Dinner:     Salad, sweet and sour chicken, wild rice, peas, toaster corn bread round, diet cherry 7up, and ice cream (Lactaid)

Visitors:     Jessica and Tyler

5:00-7:00     When I arrived, Dr. Vesper was in the bathroom and Rose in bed surrounded by various family members.  Stephanie M brought me up to speed on things, then together we changed Rose’s brief.  I continued to check on her and moisten her lips periodically throughout my shift.  Her breathing remained rapid and shallow, but she seemed less agitated than the night before.  Once Dr. Vesper made his way back to the living room, I took his dinner order and began cooking.  He ate well, but was both confused and worried for Rose’s situation.  His blood glucose level prior to eating was 82.

7:00-9:00     After dinner, I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  I took Dr. Vesper back to his room so he could lay in bed with Rose.  When it became evident that he did not want to get back up, I brought him his evening medication.  I noted no obvious change in Rose’s condition.  Per Jessica and Stephanie, I gave Rose .25 ml morphine sublingually at 8:25pm.  Also per their request, I called Hospice and spoke with a nurse to determine the best way to administer lorazepam and when it’s indicated.  I passed that information along to Jessica and later to Mossy (on the phone).  During this time, Stephanie G and her family received the unexpected news that their horse had to be euthanized.  They left in a hurry and I am unsure if she returned after I left.  These events certainly compounded what was already a very difficult evening.  I continued to check on Rose and Dr. Vesper and kept Jessica company until my shift ended.

Dinner:     Dr. Vesper had salad, meat loaf, peas, rice, toaster corn bread round, and diet cherry 7up.  He declined dessert.

Visitors:     Stephanie, Andrew, Charlotte, Jessica, and Tyler.

5:00-7:00     When I arrived, Rose and Dr. Vesper were in the living room.  I chatted with Stephanie M before she left and learned there had been no change in the few hours since I visited.  I checked on Rose frequently, took Dr. Vesper’s dinner order, chatted briefly with Jessica on the phone, and began cooking.  He had a good appetite, but Rose ate and drank virtually nothing.  I moistened Rose’s lips and mouth throughout the evening with a dental sponge in hope of providing some hydration.

7:00-9:00     After dinner, I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  I took Rose to the bathroom where she allowed me to brush her teeth (no toothpaste).  I did not attempt flossing.  We decided earlier that to keep Rose as safe and comfortable as possible, we would no longer place her on the commode for toileting.  Instead I took her to bed where I checked her Depends.  It was clean and dry and required no changing.  While I was arranging the straps for the lift and actually transferring Rose to bed, she became very agitated.  I could not determine the source of her anxiety or if she was in pain.  Her breathing was rapid and labored, but she did not cry out.   It took a few minutes, but she ultimately calmed down.  I did apply her eye drops.  I left her to give Dr. Vesper his ice cream and night time medications.  After a few more minutes of watching TV, he went to the bathroom to perform his night time routine.  I sat in the bedroom with Rose until he came to bed.  Mossy arrived around this time.  I said good night to them all.  I ran into Stephanie G by the gate as I was leaving and spoke with her for a few minutes.

Dinner:     Dr. Vesper had salad, sweet and sour chicken, wild rice, and toaster corn bread round.  He drank diet 7up and had ice cream (Lactaid) for dessert.  For Rose I attempted pureed sweet potatoes with beets, frozen ensure, kefir milk, and water.  She  may have swallowed a couple of spoonsful of the ensure.

Visitors:     A courier from Kroger pharmacy arrived with “comfort care” medications for Rose (Ativan and morphine).  I gave these to Mossy when she arrived.

5:00-7:00     When I arrived, Rose and Dr. Vesper were relaxing in the living room.  As always, Michele and I discussed our concerns and the day’s events prior to her leaving.  I chatted with Dr. Vesper for a few minutes, took his dinner order, set the table, and began cooking.  Dr. Vesper ate with his usual hearty gusto.  I was unaware he had chosen the same entrée as the night before, but he enjoyed it all the same.  Rose ate and drank very little.  I attempted different foods and techniques over the course of almost two hours, but had little success.  Because I haven’t seen her in two weeks, Rose’s further weight loss was quite marked.  Dr. Vesper’s blood glucose level prior to eating was 139.  I was pleasantly surprised given his late lunch.

7:00-9:00     After dinner, Rose and Dr. Vesper returned to the living room while I cleaned the kitchen and microwave, washed the dishes, and set out breakfast items and morning medications.  I gave them their evening medications, then took Rose to the bathroom for her night time toilette.  I washed her face and hands, then brushed and flossed (25%) her teeth.  She exhibited minimal rigidity while changing her and was extremely flaccid while on the lift and commode.  It was fairly difficult supporting her.  I changed her barely damp Depends which contained a small marble sized stool.  She produced nothing more while seated.  I got her to bed and applied her eye drops.  She was snoring heartily when I said good night.  I waited for Dr. Vesper to complete his routine, then said good night to him.

Dinner:     Dr. Vesper had a salad, chicken pot pie, and diet cherry 7up.  Rose had salad consisting of mostly cottage cheese and fruits (mashed), pureed sweet potatoes with beets, and pureed green beans.  She ate almost half of each container and little salad.  She drank about 6 ounces of kefir milk.  They both had ice cream for dessert.  Again, Rose managed to swallow only a couple of teaspoons of ice cream, but she did drink 2 ounces of water with it.

Visitors:     None