5:00-7:00     When I arrived, Rose was with Sandy in the bathroom and Dr. Vesper in the living room reading.  Because I was early, Dr. Vesper and I took a brief walk around the back yard to view the flowers before clocking in.  By the time we returned, Sandy and Rose were finished and Sandy filled me in on the day’s events.  We took Rose to the living room and propped her feet up on the ottoman.  She was leaning less, but I did give her a pillow to support her head.  She napped lightly while I set the table and began dinner prep.  Dr. Vesper requested a simple meal and they were seated and eating by 6:00.

7:00-9:00     Dr. Vesper enjoyed his usual hearty appetite and ate quickly.  Jessica declined dinner, but she joined Rose and me while feeding Tyler.  Rose was more alert, somewhat focused, and ate as well as I have seen this entire weekend.  When she was finished, I returned her to the living room to sit near Dr. Vesper while I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  She continued to sit fairly upright until it was time for her evening toilette.  I gave Rose and Dr. Vesper their night time medications, then took Rose to the bathroom.  We followed our usual routine with me washing her face and hands, then brushing and flossing (most!) her teeth.  She was somewhat chatty and rigid while changing her clothes, with some renewed strength.  Once I got her on the lift, I changed her soiled Depends which contained a moderate bowel movement.  She urinated and produced another small stool while seated on the commode.  She grew limp and began to fade rapidly with extreme leaning to her left.  I cleaned her up, then took her to bed and applied her eye drops easily.  She closed her eyes and appeared to fall asleep immediately.  Dr. Vesper was on his way to bed when I said good night to him.  He told me he utilized his glucose monitor.   I also enjoyed a brief conversation with Jessica as I was making my way out of the door.

Dinner:     Soup and sandwiches.  Rose had ham and cheese with mayo on a bun and garden fresh cherry tomatoes.  Dr. Vesper had grilled cheese.  Rose drank kefir milk and Doctor had diet cherry 7up.  They both had ice cream (Lactaid) for dessert.

Visitors:     Jessica and Tyler

5:00-7:00     When I arrived, Rose and Dr. Vesper were in the living room while Mossy was in the dining room giving me a head start by setting the table.  She also had chicken roasting in the oven (thank you!), and took a few minutes to fill me in on the day’s events before leaving.  Thanks to her help, we got an early start on dinner with Jessica and Tyler joining us midway through.  Rose napped until dinner time, but was alert throughout the meal.

7:00-9:00     Dr. Vesper enjoyed his usual hearty appetite and Rose ate more than usual, too.  She made no eye contact, but the laughter and lively conversation may have helped her to focus.  After dinner, they returned to the living room while I cleaned the kitchen, washed the dishes, took out trash, and set out breakfast items and morning medications.  I gave them both their evening medications including 1/2 dose (2 tablespoons) Milk of Magnesia for Rose per Mossy’s instruction.  I took Rose for her night time toilette where we followed the usual routine of washing her face and hands, then brushing and flossing (anterior only) her teeth.  She became more chatty, but the leaning was more severe as well.  She exhibited more strength than the previous evening making changing her clothes and getting her into the lift more challenging.  There was no stool, but her Depends was saturated through to her pants.  When we were finished, I got her into bed, applied her eye drops easily, and said good night.  Dr. Vesper was watching TV when I said good night to him.

Dinner:     Salad, Italian chicken with rice, peas, and crusty Italian bread.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  For dessert Rose had a banana nut muffin topped with ice cream and caramel sauce.  Dr. Vesper requested ice cream only.

Visitors:     Jessica and Tyler

5:00-7:00     When I arrived, Rose and Sandy were in the kitchen, and Dr. Vesper at church.  Sandy spent a few minutes bringing me up to speed on the days events before leaving.  Jessica appeared with Tyler, whose acquaintance I was excited to make!  We chatted while I got Rose’s feet on the ottoman, set the table, and began dinner prep.  Rose napped during the early part of my shift with extreme forward leaning.  I was somewhat successful propping her up with pillows.  Dr. Vesper was a bit later than usual, but I had them both seated and eating by 7:00.

7:00-9:00     While Dr. Vesper enjoyed his usual hearty appetite, the going was much slower for Rose.  She ate her salad with gusto, but it took the better part of an hour to complete half the food on her plate.  Sandy told me that Rose ate well earlier, so perhaps she was already sated.  She did find room for a small scoop of ice cream, however!  She also swayed a bit and tapped her feet to music from “The Lawrence Welk Show”, which Doctor was watching as they ate.  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 then gave them their night time medications and took Rose for her evening toilette.  Stephanie arrived around this time to pick up the truck and Dr. Vesper went outside to visit with her.  While in the bathroom with Rose, I followed our usual routine beginning with me washing her face and hands, then brushing her teeth.  Fortunately, I was able to be thorough with brushing as I was unable to floss any of her teeth.  She was more alert, but changing her clothes was challenging due to the extreme leaning.  She also drew her arms in and grew rigid, but her diminishing strength was evident and I was able to manage this task with less effort than I anticipated.  Once I got her into the lift and on the commode, I changed her Depends which was damp and contained a very small stool.  She produced nothing more while seated.  I got her to bed and applied her eye drops easily before saying good night.  Dr. Vesper was in the dining room using his glucose monitor when I said good night to him.

Dinner:     Salad, crab cakes, wild rice, and peas.  Rose drank kefir milk and Dr. Vesper had diet cherry 7 up.  Rose had ice cream for dessert.  Dr. Vesper declined, but I am unsure if he ate any later.

Visitors:     Jessica and Tyler.  Stephanie briefly.

5:00-7:00     When I arrived, Rose and Sandy were in the bathroom.  Dr. Vesper was visiting with Mossy in the living room as she had just returned from having the van serviced.  We all chatted briefly before they left, and I began my shift as usual with setting the table and preparing for dinner.  Rose kept me company in the kitchen while I performed these tasks.  She was somewhat alert and enjoyed the occasional bite of fruit while I assembled the salads.  Doctor stated he was hungry and I had them seated and eating by 6:15.

7:00-9:00     Though her portions were small, Rose’s appetite was much more robust than last night.  She ate everything on her plate with minimal coaxing.  Dr. Vesper ate well as usual.  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 then gave them both their evening medications before taking Rose for her night time toilette.  She remained fairly alert and somewhat verbal as I washed her face and hands, then brushed and flossed her teeth.  As a hygienist, I was happy that she allowed me greater access than usual and could see that her dental health still presents well.  Once I got her on the lift, I could see a small stool in her Depends and she produced a moderate BM while seated.  Afterward, I got her to bed and applied her eye drops easily before saying good night.  Dr. Vesper had changed into his pajamas, but returned to the living room to use his glucose monitor when I said good night to him.

Dinner:     Salad, sweet and sour chicken, and peas.  Rose drank kefir milk and Dr. Vesper had diet cherry 7 up.  For dessert, Rose had a brownie a la mode, and Doctor opted for ice cream only (Lactaid).

Visitors/workers:     Mossy

5:00-7:00     When I arrived, Mossy and Rose were in the living room while Dr. Vesper was on the back porch chatting with Stephanie.  Mossy brought me up to date on the day’s events and together we transferred Rose to her recliner.  The Gephardt’s were finishing their visit while I began dinner prep.  Once everyone was gone,  Rose and Dr. Vesper were seated at the dinner table and eating before 6:30.  Doctor enjoyed his usual hearty appetite, but I had quite a bit of difficulty keeping Rose awake and focused.  Even the delicious dessert was not enough to keep her attention for more than a few seconds at a time.

7:00-9:00     After lengthy coaxing and prompting, I was satisfied that Rose consumed enough nutrition.  She and Dr. Vesper returned to the living and watched TV 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 for her night time toilette.  We followed our usual routine beginning with me washing her face and hands, then brushing and flossing her teeth (anterior access only for floss).  I got her on the lift, then changed her saturated Depends which had leaked through to her pants.  While seated she had a small bowel movement.  Once we finished, I got her into bed and applied her eye drops easily.  She was somewhat more alert, but closed her eyes as I said good night to her.  Dr. Vesper was getting ready for bed when I said good night to him.

Dinner:     Salad, ham steaks with pineapple, baked sweet potatoes, and green beans.  Rose drank kefir milk, and Dr. Vesper had diet cherry 7up.  They had brownies a la mode for dessert (Lactaid).

Visitors:     Gephardt family

5:00-7:00     When I arrived, Sandy and Rose were in the bathroom, and Dr. Vesper at church.  When Sandy returned Rose to the living room, we propped her feet on the ottoman as she brought me up to speed on the day’s events.  After she left, I set the table and began prepping dinner salads.  Sandy said that Rose slept very little during her shift and she napped lightly while I did these tasks till Dr. Vesper came home.  He stated he was hungry and I had them seated and eating by 6:45.

7:00-9:00     Doctor enjoyed his usual hearty appetite and Rose ate well, too!  Though her portion size was small, she ate a great variety with minimal prompting from me.  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 for her night time toilette.  I washed her face and hands, then thoroughly brushed and flossed (hit/miss) her teeth.  While changing her clothes, she began her usual pushing to the left with her head and shoulder, but was not terribly rigid.  She was alert and somewhat verbal.  Once I got her on the lift, I removed her wet Depends, and she produced an extremely large bowel movement while seated on the commode.  Clean up was a snap and I got her to bed where I applied her eye drops easily.  Once there, she appeared very comfortable, but was wide awake as I said good night.  Dr. Vesper was watching TV when I said good night to him.  I reminded him to use his glucose monitor as I was leaving.

Dinner:     Salad, pot roast with carrots and potatoes, and garlic bread.  Rose drank kefir milk, and Dr. Vesper had diet cherry 7up.  They both had ice cream (Lactaid) for dessert.

Visitors:     None

3:00-6:00     When I arrived, Rose was napping in her recliner, and Dr. Vesper on the couch watching TV.  Sandy was at the dining room table with her daughters, who had been enjoying the pool.  Sandy brought me up to speed on the day’s events and together we transferred Rose to her wheelchair.  I think Sandy was very capable and thoughtful with Rose’s care and gave me a checklist of the services she provided.  After getting her out of bed, Sandy gave Rose levothyroxine with 8 oz of water.  She took her to the bathroom where she urinated, but had no bowel movement.  She gave her a sponge bath,  dressed her, then took her to the kitchen for breakfast.  She reported that Rose ate very slowly, but well, and her meal included oatmeal, one slice of bacon, and toast.  She also had Mirlax in orange juice.  Rose drank approximately 12 more ounces of water through the rest of her shift.  Sandy stated that she put Rose in her recliner around 1:30 where she slept soundly till I arrived.  After relieving Sandy, I gave Rose her afternoon medications, vitamins, and tums.  Because breakfast ran late, I did not make a formal lunch, but gave Rose extra yogurt  and the remainder of a glucerna shake.  At 4:00 I took Rose to the bathroom for her afternoon toileting.  She urinated only and I brushed her teeth at this time as well.  She would not let me floss at this time.  I returned Rose to the living room, readied the bathroom for Rose’s night time routine, fed the dog, then set the table and began prepping the salad for dinner.  Rose dozed in her wheelchair while I performed these tasks.

6:00-9:00     Dr. Vesper and Rose were seated and eating dinner by 6:00.  Doctor requested a simple meal, but he and Rose both enjoyed it.  Rose was more alert and had a better appetite than I had seen in a while.  Dr. Vesper was up an down throughout the meal checking on his yard worker, but when finished, he and Rose eventually returned to the living room to watch TV 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 evening toilette.  I washed her face and hands, then brushed and attempted to floss her teeth.  She remained fairly interactive and chatty as I dressed her and got her on the commode.  She had a moderate bowel movement while seated.  I then took her to bed and applied her eye drops easily.  She was still awake and even puckered up for a good night kiss.  Dr. Vesper was still watching TV when I left.  I reminded him to use his glucose monitor, but am unsure if he did.

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

Visitors/workers:     Sandy Hayslip and family, Jimmy Smith and family