5:00-7:00     When I arrived, Rose and Dr. Vesper were watching TV/napping in the living room.  As always, Stephanie and I spent a few minutes discussing the day before she left.  Dr. Vesper stated he was hungry for a simple supper, so I took his order and began cooking.  Rose slept until it was time to eat.  Dr. Vesper enjoyed his usual hearty appetite, but Rose had none.  I varied the foods and occasionally she would take a bite, but she could not focus and most wound up on the bib.  Dr. Vesper’s blood glucose level was 100 prior to eating.

7:00-9:00     After dinner, Rose and Dr. Vesper returned to the living room while I cleaned the kitchen, washed the dishes, and set out morning medications and breakfast items.  I gave them both their evening medications, including a small dose of milk of magnesia for Rose.  I took Rose to the bathroom for her evening toilette where we followed our usual routine.  I washed her face and hands, then brushed her teeth.  Fortunately she allowed a thorough brushing, but no flossing.  I removed her slightly damp Depends which contained a trace of stool.  She produced nothing more while seated.   I also cleaned and redressed the wound near her tailbone.  I reported to Mossy our concern for Rose’s lack of bowel movement and that she might consider an enema.  She will discuss this with Rose’s doctor.  When we were finished, I took Rose to bed and applied her eye drops easily.  I waited while Dr. Vesper completed his night time routine, then said good bye to them both.

Dinner:     Dr. Vesper had salad, tomato soup, and a grilled cheese sandwich.  Rose ate a few spoonsful of soup and pureed peas.  I offered salad as she seemed to enjoy the greens the night before.  She ate a couple of bites of fruit only.  Dr. Vesper drank diet cherry 7up and Rose drank a couple of ounces of milk.  They both had ice cream (Lactaid) for dessert.  Rose drank a couple of ounces of water with her few bites of ice cream.

Visitors:     Stephanie

5:00-7:00     When I arrived, Rose and Dr. Vesper were relaxing in the living room while Stephanie and Jennifer were busy cooking in the kitchen.  Caregiver Stephanie brought me up to speed on the day’s events before leaving.  She had already set the table which left me little to do until the guests arrived and dinner was served.  Rose napped during this time, but was somewhat alert once I brought her to the table.  She seemed aware of the lively conversation around her and, with prompting, did a better job of coordinating chewing and swallowing than the night before.  She ate about 50% of her meal, though she might have been sated early due to her improved appetite earlier today.  Dr. Vesper enjoyed his usual hearty appetite.

7:00-9:00     As things wound down and guests were leaving, Rose started drifting off to sleep.  I brought her into the kitchen while everyone pitched in to clean up.  I assisted Dr. Vesper back to his recliner, set out breakfast items and morning medications, and gave them both their evening medications.  I then took Rose to the bathroom for her night time toilette.  She was quite rigid as I changed her clothes and seemed very uncomfortable in general.  I washed her face and hands, then brushed and flossed (most) of her teeth.  Once on the commode I changed her damp Depends and she produced nothing more while seated.  Her belly was distended and her bowel possibly impacted.  I was unable to stimulate her enough to produce a bowel movement.  I gave her a full dose of milk of magnesia before taking her to bed.  Her relief was audible once she was laying down.  I applied her eye drops easily and she was snoring before I said good night.  Dr. Vesper performed his night time routine and I assisted him while he changed into his pajamas.  I then said good night to him.  Jennifer and I chatted for a few minutes before I left for the evening.

Dinner:     Spinach salad, pasta with Rose’s marinara, and garlic cheese bread.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  They both had chocolate cake for dessert.

Visitors:     Jennifer, Stephanie, Andrew, Sophie, Charlotte, Mary Lou, Jeanine, Lenny, and Helen.

Thank you all so much for including me and making me feel part of your wonderful family!

5:00-7:00     When I arrived, Rose was with Michele in the dining area enjoying the river view while Dr. Vesper was out with Jennifer.  Michele and I discussed the day’s events, the best approach to provide Rose with hydration and nutrition, and she showed me how to apply her boot.  It was a quiet start to my shift as there was not much to be done.  Rose slept, but seemed uncomfortable.  At dinner time she was awake, but had difficulty coordinating eating, chewing, and swallowing. She struggled with thin liquids, like water, but did better with thicker liquids and purees.  She ultimately ate 80% of her meal, which was small to start.

7:00-9:00     After dinner, I washed the few dishes we used and set out breakfast items and morning medications.  I then gave Rose her night time medication.  Jennifer and Dr. Vesper returned just as I was taking Rose to the bathroom for her evening routine.  Stephanie arrived at the same time as well.  We convinced Dr. Vesper to use the bathroom first since it was available.  When he was finished, he returned to the living room where I gave him his night time medication.  While he visited with his daughters, I took Rose to the bathroom for her toilette.  We followed our usual routine beginning with me washing her face and hands, then brushing and flossing (75%) her teeth.  I removed her damp Depends, and she produced nothing more while seated.  The medicated patch on her tailbone fell off into the commode.  I notified Mossy who walked me through its replacement.  I had Rose in bed at this point and Jennifer was kind enough to actually replace the patch while I supported Rose.  I got Rose situated and applied her eye drops.  Dr. Vesper was also in bed and I said good night to them both.

Dinner:     Rose had cottage cheese with mango, pureed peas, pureed mac and cheese, and kefir milk.  She also had ice cream for dessert, but ate very little.   I believe Dr. Vesper had asparagus soup and a burger while he was out.  I did not get a blood glucose reading as he was gone before I arrived.

Visitors:     Jennifer and Stephanie

5:00-7:00     When I arrived, Rose and Dr. Vesper were relaxing in the living room.  As always, Stephanie brought me up to speed on the day’s events before leaving.  Dr. Vesper stated he was hungry, so I began cooking right away.  Rose napped until it was time to eat.  I gave her the antibiotic before bringing her to the table.  Dr. Vesper’s blood glucose level prior to eating was 101.  Dr. Vesper ate well, though he was unable to finish his entire bowl of soup.  Rose was more alert than the previous two evenings and better able to coordinate chewing and swallowing.  She ultimately finished 80% of her meal.

7:00-9:00     After dinner, Rose and Doctor Vesper returned to the living room while I cleaned the kitchen, 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.  She was quite rigid while changing her clothes, but I welcomed the return of her strength.   We followed our usual routine beginning with washing her face and hands, then brushing and flossing (50%) her teeth.  I removed her damp Depends which contained a smear of fecal material.  There was again some blood in the center of her brief, but less than the previous night.  I am still uncertain as to the source.  However, the sore above her tail bone is larger and has opened.  I gently cleaned it and applied triple antibiotic.  She produced nothing more while seated on the commode.  When we were finished, I took her to bed and applied her eye drops easily.  She was snoring loudly within seconds.  I waited for Dr. Vesper to complete his night time routine, then said good night to him.

Dinner:     Salad, vegetable soup, and grilled ham and cheese sandwiches.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  They both had ice cream (Lactaid) for dessert.

Visitors:     None

5:00-7:00     When I arrived, Rose and Dr. Vesper were in the living room.  Stephanie M. brought me up to speed on the day’s events before she left.  Dr. Vesper stated he was hungry, so I took his dinner order and began cooking.  Rose napped until her meal was served.  She was difficult to rouse and unfocused initially, but she ultimately ate all of her meal.  She was given her antibiotic at 6:00.  Dr. Vesper enjoyed his usual hearty appetite.

7:00-9:00     After dinner, Rose and Doctor returned to the living room while I cleaned the kitchen, 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 (75%) her teeth.  I changed her wet Depends which had a trace of stool, and she produced nothing more while seated.  I got her to bed and applied her eye drops easily.  Dr. Vesper had already brushed his teeth and made his way into bed while I was working with Rose.  I tucked them both in and said good night.

Dinner:     Salad, Italian sausage ravioli with marinara sauce, and garlic bread.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  They both had ice cream (Lactaid) for dessert.

Visitors:     None

Note:     After removing Rose’s Depends, I noticed an area of blood in the middle of the brief.  I was unable to determine it’s source.  There is a small break in her skin in the usual spot near her tail bone, but this doesn’t match the location in the brief.  I did not see any frank blood in the commode and none elsewhere in her vaginal area.  I reported this finding to Mossy.

5:00-7:00     When I arrived, Rose and Dr. Vesper were in the living room.  Michele spent a few minutes discussing her concerns and the day’s events before she left.  I chatted with Dr. Vesper, took his dinner order, set the table, and began cooking.  Rose napped soundly during this time.  At 6:00, just before dinner was served, I woke Rose and gave her the antibiotic mixed with yogurt.  I also checked Dr. Vesper’s blood glucose level which was 118.  Dr. Vesper enjoyed his usual hearty appetite, but I had much difficulty getting Rose to eat and drink.  I am unsure if she was not hungry and refusing food, or if she was having difficulty swallowing.  When consuming soft foods she would close her mouth allowing it to flow out of her mouth.  Food that required chewing would pocket in her cheek.  She also had difficulty using a straw.  I had the best success having her drink directly from her cup in between bites and watching her swallow.  She ultimately ate 50% of her meal and drank all of her milk.  She did a better job with her ice cream, but even struggled with that.

7:00-9:00     The remainder of my shift ran in quiet, routine fashion.  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.  I removed her wet Depends and she produced nothing more while seated on the commode.  I took her to bed and applied her eye drops easily.  I waited while Dr. Vesper finished his night time routine, then said good night to them both.

Dinner:     Salad and chicken pot pie.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  They both had ice cream (Lactaid) for dessert.

Visitors:     None

5:00-7:00     I arrived within a few minutes of Rose and Dr. Vesper’s return from their doctor appointments.  Per his physician’s recommendation, Mossy was going to take Dr. Vesper to the pharmacy for a shingles vaccine, but decided to call around first due to its limited availability.  Unfortunately, she found none in stock locally.  In the meantime, Stephanie M was in the bathroom with Rose for her afternoon toileting.  I took over for her so she could leave in a timely fashion.  Rose’s Depends was dry, but she produced a small bowel movement while seated.  I am unsure if she urinated.  When we were finished, Mossy persuaded Dr. Vesper to use the bathroom before she left.  When he returned to the living room I took his dinner order, set the table, and began cooking.

7:00-9:00     Rose and Dr. Vesper both enjoyed hearty appetites, though the going was slow for Rose.  She ultimately completed 95% of her meal.  Dr. Vesper’s blood glucose level was 103 prior to eating.  After dinner, they returned to the living room while I cleaned the kitchen, 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.  She was extremely rigid as I changed her clothes.  I washed her face and hands, then brushed and flossed (100%) her teeth.  I removed her Depends which was just damp, and she produced a moderate BM while seated.  After clean up I took her to bed and applied her eye drops easily.  I waited while Dr. Vesper performed his night time routine, then assisted him with his PJs.  I tucked them both in and said good night.

Dinner:     Salad, grilled ham and cheese sandwiches,  and tomato soup.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  Rose had cake and ice cream for dessert.  Dr. Vesper requested ice cream (Lactaid) only.

Visitors:     None