5:00-7:00     When I arrived, Rose was with Mossy in the bathroom, and Dr. Vesper on the couch in the living room.  As always, Mossy brought me up to speed on the day’s events before leaving.  Rose was more quiet than earlier in the day, and napped in her chair while I prepped the salads and began cooking dinner.  Dr. Vesper expressed his frustration at having misplaced his wallet and cell phone earlier.  In fact, he forgot the phone had been found until we located it in his pocket.  The rest of the afternoon was uneventful, and Doctor and Rose were seated and eating by 6:30.

7:00-9:00     Dr. Vesper enjoyed his usual hearty appetite.  Rose started out well, eating her salad with more enthusiasm than usual.  Her appetite and ability to focus waned rapidly, however, resulting in a much slower pace for the main course.  Just like the previous two evenings, her nose began running, though not as excessively.  I did not give Flonase, and it stopped by the time she was getting ready for bed.  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 for her night time toilette.  I washed her face and hands, then brushed and minimally flossed her teeth.  She was fairly alert, but faded rapidly as I changed her clothes and got her into the lift.  While in her wheelchair, she leaned fully forward, nearly touching her head to her lap, making this process difficult for her.  While on the commode, she urinated and had a moderate BM.  Once back in the chair, she actually thanked me.  Though she is one of the most gracious people I know, her comment took me by surprise due to the seemingly extreme lack of focus.  Once in bed, I applied her eye drops easily.  She appeared to be sleeping when I said good night.  Dr. Vesper was checking his blood glucose levels when I said good night to him.

Dinner:     Tossed salad, jello salad, chicken cordon bleu, carrots, and corn bread toaster rounds.  Rose drank kefir milk, and Dr. Vesper had diet cherry 7up.  Rose had ice cream for dessert.  Doctor was deferring dessert till after using his glucose monitor.  I am unsure if he indulged himself or not.

Visitors:     None

5:00-7:00     When I arrived, Rose and Mossy were in the bathroom finishing Rose’s 4:30 toileting, while Dr. Vesper was sitting on the couch in the living room.  Shortly after greeting me, he went back to his room while Mossy brought me up to speed on the day’s events.  After she left, Rose and I prepped the salads and began cooking dinner, which was ready shortly after Dr. Vesper emerged from his nap.  Dinner time was a repeat of last night with Doctor enjoying a hearty appetite, but Rose eating less and far more slowly.  Fortunately, she did eat a variety, but I had to coax her to chew and swallow.  Around this time she developed an extreme runny nose (as she did last night), which also distracted her.  I dispensed Flonase per Mossy’s instruction (one spray each nostril) at 7:15pm, which she tolerated well.  I saw no discernable improvement until approximately 9:00pm.  I am unsure if this can be attributed to the spray as this was the same pattern as the night before without the medication.

7:00-9:00     After dinner Dr. Vesper and Rose 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 of her front teeth.  She became somewhat chatty as I was putting on her pajamas and getting her onto the lift.  She had an extremely large bowel movement which began in her Depends and she completed while on the commode.  After clean up, I got her to bed and applied her eye drops easily.  She seemed very relieved and fell asleep before I could say good night.  Dr. Vesper had just finished a late dessert and was still watching TV when I said good night to him.

Dinner:     Tossed salad, Jello salad, lemon pepper tilapia, asparagus with Hollandaise sauce, and corn.  Rose drank kefir milk, and Doctor had diet cherry 7up.  They both had ice cream for dessert.

Visitors:     None

5:00-7:00     When I arrived, Mossy was in the kitchen doing some early dinner prep for me while Rose napped in her recliner.  She brought me up to speed on the day’s events, and together we transferred Rose to her wheelchair.  After she left, Rose stayed in the kitchen with me while I set the table, made the salads, and finished cooking.  Though very quiet and unfocused, Rose stayed awake until Dr. Vesper arrived home and we sat down for dinner.  She did look up as if acknowledging his greeting to her.

7:00-9:00     Dr. Vesper enjoyed his usual healthy appetite, but it was very slow going with Rose.  I managed to get her to eat a good variety, but she was struggling to stay awake and was so full that she found it difficult to finish her ice cream!  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.  Things generally ran in routine fashion beginning with me washing her face and hands, then brushing her teeth.  She would not allow me to floss them tonight.  Though rigid, she was too fatigued to resist my changing her clothes as she has in the past.  Once on the lift, I changed her wet Depends which contained a small stool, and she produced nothing more while on the commode.  When we were finished, I got her into bed and applied her eye drops easily.  She seemed to be asleep before I said good night to her.  Dr. Vesper was using his glucose monitor when I came back to the kitchen.  He did not have dessert earlier as asked me to make him a small bowl of ice cream after he obtained his values.  He was enjoying his dessert when I said good night to him.

Dinner:     Tossed salad, jello salad, steak, green beans, and corn.  Rose drank kefir milk, and Doctor had diet cherry 7up.  They both had ice cream for dessert.

Visitors:     None

5:00-7:00     When I arrived, Dr. Vesper was in the living room watching TV while Sandy and Rose were finishing Rose’s 4:30 toileting.  Together Sandy and I took Rose to the living room where we elevated her feet onto the ottoman while she filled me in on the day’s events.  After she left, I set the table and began meal prep as Dr. Vesper stated he was hungry.  Rose was fairly alert and agreed that she was hungry as well.  They both enjoyed good appetites with Rose eating a more complete meal (albeit slowly) than I’ve seen in several shifts.

7:00-9:00     After dinner Doctor and Rose returned to the living room while I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  Things continued to run in routine fashion through the remainder of my shift.  I gave them both their night time medications, then took Rose for her evening toilette.  I washed her face and hands, then brushed and flossed (hit/miss) her teeth.  She sat somewhat upright and stayed vaguely focused until it came time to put on her pajamas.  At this time she became very rigid and again, buried her left side/shoulder into the wheelchair.  She did not seem to have any pain, but was highly resistant to my efforts to change her clothing.  Once on the lift, I removed her wet Depends and she resumed the extreme listing Sandy described earlier.  Without the lift, I fear she would have been on the floor as she rested her head on the vanity towel bar and splayed her feet to her right nearly touching the baseboard heater.  I made many adjustments to the lift while cradling the left side of Rose’s body against mine and continually placing her feet and legs in the correct position.  She had a very small BM while seated, and I worked as fast as possible to get her to bed when I was sure she had finished.  At no time did she seem to have any pain, but her relief was apparent once she was in bed.  I applied her eye drops easily and said good night.  Dr. Vesper was in the living room finishing a bowl of ice cream.  He declined dessert after dinner and had planned to eat it after using his glucose monitor.  Though I put it out so he could see it, he forgot to perform the task.  I left it by his breakfast items to use in the morning.

Dinner:     Salad, Mongolian beef, wild rice, and peas.  Rose drank kefir milk and Doctor had diet cherry 7up.   They both had ice cream for dessert.

Visitors:     None

5:00-7:00     When I arrived, I was greeted on the front porch by Mossy.  Rose was napping in her recliner and Dr. Vesper in the back yard working with Sandy.  After bringing me up to speed on the day’s events, Mossy helped Sandy finish while I set the table and began dinner prep.  Before she left, Mossy was kind enough to transfer a sleepy Rose to her wheelchair with some assistance from me.  Once dinner was ready, Dr. Vesper enjoyed his usual hearty appetite.  Rose started out well, but quickly faded, requiring lots of coaxing and cuing to chew and swallow.  Predictably, she did better while eating her ice cream!

7:00-9:00     After dinner, Dr. Vesper and Rose returned to the living room while I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  While watching television, Rose became more alert and began clicking her teeth while raising her right hand and making pointing motions.  She also began to moan softly.  I was unable to determine any source of distress or pain and it lasted less than a minute.   I gave them both their night time medications, then took Rose for her evening toilette.  I washed her face and hands, then brushed and flossed her teeth (anterior only).  Though rigid while changing her,  Rose remained more alert and leaned less, making it less of a challenge.  While on the commode, I changed her wet Depends and she had a small bowel movement.  I got her to bed, applied her eye drops easily, and said good night.  Dr. Vesper stated he was tired and was turning off the living room lights when I said good night to him.

Dinner:     Salad, crab cake, chicken with broccoli and cheese, peas, carrots, and corn bread toasts (leftovers night).  Rose drank kefir milk and Doctor had diet cherry 7up.  Rose had ice cream, but Doc declined dessert.

Visitors:     Sandy Hayslip

5:00-7:00     When I arrived, Sandy and Rose had just finished in the bathroom and Dr. Vesper at church.  Sandy helped me elevate Rose’s feet onto the ottoman, then stayed a few minutes bringing me up to speed on the day’s events.  Dr. Vesper had plans to attend Sophie’s play at IHM and Mossy had made dinner suggestions to Sandy for Rose that she requested be passed along to me.  After she left, I sat with Rose watching “The Lawrence Welk Show” and did my best to engage her or at least peak her interest in the music she usually enjoys.  Unfortunately, she was very unfocused and nonverbal during my entire shift.

7:00-9:00     Though I had Rose seated and eating by 6:15,  I spent the better part of the next hour and 15 minutes urging and coaxing her to eat.  She was not sleeping and would open her mouth and chew for me, but I had to give her frequent drinks to stimulate her swallowing reflex.  I’m not convinced she loved the main course as she had less trouble with the fruit and dessert I offered!  When she was finished, Rose accompanied me in the kitchen while I washed the dishes and set out breakfast items and morning medications.  I gave Rose her night time medication, then took her to the bathroom for her evening toilette.  I washed her face and hands, then brushed her teeth.  Flossing was impossible, but I had good success at a thorough brushing.  Changing her clothes was difficult as  she was extremely rigid, again listing heavily to her left, burying her shoulder into her wheelchair.  While on the lift, I changed her Depends, which was nearly dry.  She urinated quite a bit while seated, but had no bowel movement.  Once in bed, she seemed much more comfortable and I applied her eye drops easily.  Dr. Vesper was home and opted to use his glucose monitor before having dessert since dinner was several hours earlier and he didn’t want to stay up late.  I offered to get him some ice cream, but he said he wanted to wait and would get it himself.  I tried to give him his night time medication, but he asked that I leave it on the counter.  He promised he would take it when he had his ice cream.  He was watching television and reading when I said good night to him.

Dinner:     Rose had mixed fruit, ginger spiced mixed grains bowl (with kale, edamame, and red bell pepper), and kefir milk.  She had a scoop of ice cream for dessert.

Visitors:     Sandy Hayslip (yardwork)

5:00-9:00     When I arrived, Dr. Vesper was in the living room reading/watching TV, while Rose and Sandy were finishing in the bathroom.  As always, Sandy brought me up to speed on the day’s events before leaving.  I took Rose to the living room and propped her feet on the ottoman before setting the table and beginning dinner prep.  It was a cool, rainy day and Rose napped during this time.  Dr. Vesper stated he was hungry.  Because the house was in great shape with little for me to do,  I had them seated and eating by 6:00.  Rose was fairly alert and ate well with few prompts.  Dr. Vesper enjoyed his usual hearty appetite, though he declined dessert in the interest of “watching carbs”.

7:00-9:00     After dinner, Rose and Dr. Vesper returned to the living room to watch television while I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.   Rose stayed awake, but not particularly alert until it was bedtime.  I gave them both their evening medications before taking Rose for her night time toilette.  We followed our usual routine beginning with me washing her face and hands, then brushing her teeth.  She allowed a thorough brushing, but again pursed her lips so tightly that I could not floss.  She also was somewhat verbal at this time, though I could not understand her.  She became very resistant while changing her clothes, firmly crossing her arms in front of her and leaning deeply to her left, burying her shoulder into the wheelchair.  Once we got that task accomplished, I got her in the lift with minimal effort, but she remained in that extreme left tilt until I got her in bed.  While on the commode, I changed her wet Depends and she produced a very small stool.  Once in bed, she appeared very comfortable and relaxed.  I applied her eye drops easily and she fell asleep before I could say good night.  Dr. Vesper was still in the living room and I reminded him to use his glucose monitor as I said good night to him.

Dinner:     Tossed salad, pasta salad, meat loaf, peas, and corn bread cakes.  Rose drank kefir milk and Doctor had diet cherry 7up.  Rose had a small scoop of ice cream for dessert.

Visitors:     none