5:00-7:00     When I arrived, Rose and Dr. Vesper were in the living room visiting with Lily.  While they chatted, Caregiver Stephanie brought me up to speed on the day’s events.  After they left, I took Dr. Vesper’s dinner order, set the table, and began cooking.  I checked Dr. Vesper’s blood glucose level prior to eating (6:15) which was elevated at 220, but he refused insulin as his “numbers have been very good.”  I did not debate this with him as that was true and he was eating a late snack (breakfast bar) when I arrived.  I did ask him how his left eye was doing and he stated his vision was fine tonight.  He and Rose ate well, though the going was slow for both of them.

7:00-9:00     After dinner, Rose and Doctor returned to the living 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.  We followed our usual routine beginning with me washing her face and hands, then brushing and flossing (anterior only) her teeth.  I changed her wet Depends which contained a trace of stool and had soaked through her pants.  She urinated only while seated.  I got her to bed and applied her eye drops easily.  Dr. Vesper completed his night time routine and I tucked them both in before saying good night.

Dinner:     Salad, broccoli and cheese stuffed chicken breasts, rice, peas, and corn bread toaster rounds.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  Rose had ice cream for dessert while Dr. Vesper declined.

Visitors:     Lily

Note:     I noticed an oval spot on the skin of Rose’s left buttock measuring approximately 1″ x 1/2″.  The skin is very fragile, but has not ulcerated and does not seem painful.  I applied triple antibiotic cream and reported it to Mossy.  Caregivers, please take care that the pad we attach to her Depends does not roll and become stuck to Rose’s skin.  Also, we should change the complete Depends at toileting (not just the pad), even if it seems ok to reuse.  This will lower the risk of exposing her skin to the chemicals in the brief or to the pad adhesive.  Rose does not have a prior history of pressure sores, but she has reacted to the pad adhesives.  However, we should follow this carefully and report any changes.

5:00-7:00     When I arrived, Dr. Vesper was in the living room watching TV and Rose with Lucy in the bathroom for her 4:30 toileting.  Things were going slowly for them, so I offered to complete that task for her.  Once I finished with Rose, we returned to the living room.  I took Doctor’s dinner order, set the table, and began cooking.  Rose napped lightly until it was time to eat.  During dinner her eyes were open, but very unfocused.  I had to occasionally prompt her to chew, but she eventually ate most of her dinner.  Dr. Vesper had a hearty appetite and ate well.  Though he struggles with his memory, he seemed more himself and we enjoyed good conversation.  His blood glucose level prior to eating was 89.

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.  She was very rigid as I changed her clothes, yet “sleepy” at the same time.  I washed her face and hands, then brushed her teeth.  She would not allow any flossing tonight.  I changed her damp Depends and she had a very small stool while seated on the commode.  I got her to bed and applied her eye drops easily.  Dr. Vesper had come to bed just minutes prior to me getting Rose there.  I tucked them both in and said good night.

Dinner:     Salad, crab cakes, rice, peas, and garlic bread.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  Rose had ice cream for dessert, but Dr. Vesper declined.

Visitors:     None

Note:     Dr. Vesper told me he was having difficulty with his vision off/on with the left eye “for the last month”.  He stated it didn’t hurt and he hadn’t said anything because it would mean “another trip to the doctor.”  He has no recall of the problems he had with it last summer.  I emphasized the importance of getting the proper diagnosis and asked his “permission”  to contact Mossy or Stephanie.  I spoke with Mossy who said he has an appointment scheduled with Dr. Schott, but will try to expedite it.

4:00-7:00     When I arrived, Dr. Vesper was in the living room watching TV while Rose and Mossy were in the kitchen prepping the dinner salad and meal.  Mossy updated me on everything before she left for the day.  I always appreciate the extra help, but especially today.  Rose was extremely fatigued and it took us quite a while in the bathroom for her 4:30 toileting.  She had a moderate bowel movement, but literally slept soundly while seated on the commode.  Because she was unable to focus at all, it took a long time to complete.  Once she was finished, I returned her to the living room to sit with Dr. Vesper while I finished cooking.  Stephanie was on the east side of the house cleaning and poked her head in to say a quick good bye.  When dinner was served, I had to wake Rose and continually prompt and stimulate her, even while eating ice cream.  She and Doctor both ate well, but the process was very slow going for Rose.  Dr. Vesper’s blood glucose prior to eating was 112.

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 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 (most) her teeth.  She was very rigid while changing her clothes, yet she allowed better access than usual for her oral care.  Once on the commode, we had repeat of her 4:30 toileting and fell asleep immediately.  She had a small BM, which took a long time to complete.  She seemed happy and comfortable once I got her to bed, and I applied her eye drops easily.  I waited till Dr. Vesper was ready to perform his night time routine.  Once he was in bed, I said good night and locked up.

Dinner:     Salad, Italian chicken, glazed carrots, wild rice, and French rolls.  Rose drank kefir milk, and Dr. Vesper had diet cherry 7up.  They both had ice cream (Lactaid) for dessert.

Visitors:     Stephanie (cleaning), then Andrew and Lily (to return Grandpa’s car and pick up soup)

5:00-7:00     Rose and Dr. Vesper were in the living room relaxing when I arrived.  Stephanie M brought me up to speed on the day’s events before she left.  I took Dr. Vesper’s dinner order, set the table, and began cooking.  Rose slept soundly during this time, but was wide awake when dinner was served.  Dr. Vesper’s blood glucose level was 114 prior to eating.  They both ate slowly, but well.

7:00-9:00     The remainder of my shift ran in quiet, routine fashion.  After dinner Rose and Dr. 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 both their evening medications, then took Rose to the bathroom for her night time toilette.  I washed her face and hands, then brushed and flossed (about half) her teeth.  She was very rigid while changing her clothes.  Dr. Vesper’s sister, Joan, called while I was working with Rose.  Their conversation kept him entertained while I finished Rose’s toileting.  Her Depends were wet through her pants and she had a large bowel movement while seated on the commode.  Just as we finished, Dr. Vesper came down the hall to perform his own night time routine.  He was coming to bed just as I applied Rose’s eye drops and got her tucked in.

Dinner:     Salad, crab cakes, peas, wild rice, French roll (Rose), and garlic bread (LJV).  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 relaxing and watching TV.  Michele took a few minutes to bring me up to speed before she left.  As Rose napped, I chatted with Dr. Vesper, took his dinner order, set the table, and began cooking.  Rose was awake just as dinner was ready.  Dr. Vesper’s blood glucose level prior to eating was 99.  He and Rose both ate well, though Doctor served himself smaller portions than usual and declined dessert.

7:00-9:00     Things continued to run in quiet, routine fashion till the end of my shift.  Rose and Dr. 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 both their evening medications, then took Rose to the bathroom for her night time toilette.  I washed her face and hands, then brushed her teeth.  She allowed only minimal flossing.  Just as we finished, Dr. Vesper came down the hall, so Rose and I vacated the bathroom so he could perform his own bed time routine.  After he finished, he went to bed as Rose and I completed her toileting.  Her Depends were wet with a trace of stool.  She had a very small BM while seated.  After clean up, I took her to bed and applied her eye drops easily.  They were both tucked in when I said good night.

Dinner:     Salad, sweet and sour chicken, wild rice, and garlic bread.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  Rose had ice cream for dessert.

Visitors:     None

5:00-7:00     When I arrived, Dr. Vesper was relaxing in the living room while Lucy and Rose were in the bathroom finishing Rose’s 4:30 toileting.  After they came out, Lucy spent a few minutes updating me before she left.  Dr. Vesper stated he was hungry, so I took his dinner order, set the table, and began cooking.  Rose napped lightly until dinner was served, but was wide awake when it was time to eat.  They both enjoyed hearty appetites.  Dr. Vesper’s blood glucose level prior to eating was 96.

7:00-9:00     The remainder of my shift ran in very quiet, routine fashion.  After dinner, Rose and Dr. 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 both their evening medications, then took Rose to the bathroom for her night time toilette.  I washed her face and hands, then brushed her teeth.  Fortunately, I was able to brush thoroughly as she allowed me no access for flossing.  I changed her damp Depends and she had a small bowel movement while seated on the commode.  Dr. Vesper made his way to the bathroom as I was getting Rose into bed.  I applied her eye drops easily, and had them both tucked in before saying goodnight.

Dinner:     Salad, meatloaf, wild rice, peas with carrots, and garlic bread.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  Rose had ice cream for dessert, but Dr. Vesper declined.

Visitors:     None

5:00-7:00     When I arrived, Rose and Stephanie M. were in the kitchen/living room area while Dr. Vesper was making his way back from the bathroom.  As we were chatting, Andrew arrived with Charlotte to drop her off so she could enjoy some quiet study time.  I invited her for dinner, but she declined.  I cleaned the glass stove top, set the table, took Doctor’s dinner order, and began cooking.  Rose was quiet, but fairly alert at this time and remained so during my entire shift.  Once at the table, she and Dr. Vesper both ate well.  His blood glucose level prior to eating was 105.

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 breakfast items and morning medications.  Andrew arrived to pick up Charlotte and they spent a few minutes visiting as I performed these tasks.  I gave Rose and Doctor their night time medications before taking Rose to the bathroom for her evening toilette.  I washed her face and hands, then brushed and flossed her teeth.  She was more rigid tonight as I changed her clothes and performed her oral hygiene.  While on the lift, I removed her Depends which were saturated through her pants.  While seated she had a very small BM.  After clean up, I got her to bed and applied her eye drops easily.  Dr. Vesper was ready for bed at exactly the same time.  I tucked them both  in and said good night.

Dinner:     Tomato soup (LJV) and potato soup (Rose) and grilled cheese sandwiches.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  Rose had ice cream for dessert.  Dr. Vesper had a late afternoon snack and declined dessert.

Visitors:     Andrew and Charlotte