5:00-7:00     When I arrived, Rose, Dr. Vesper, and Mossy were in the living room.  Rose was napping in her recliner, but awakened briefly upon my arrival.  Mossy spent a few minutes bringing me up to speed on the day’s events before leaving.  Shortly after that, I took Doctor’s dinner orders and began setting the table while he went outside to piddle in the yard.  He returned just as dinner finished cooking and helped me transfer Rose to her wheelchair.  They were seated and eating by 6:15 with both enjoying hearty appetites.  Rose was alert, smiling, and somewhat chatty during our conversation.  She received Targretin at this time.  Stephanie called to inquire if the van might be available for her to borrow.

7:00-9:00     After dinner, Rose and Doctor returned to the living room to relax while I cleaned the kitchen, washed the dishes, and set out morning medications.  It was at this time that I noticed Rose becoming uncomfortable in her wheelchair.  She began squirming and making soft moaning noises.  It was difficult to determine what was causing her distress and at first Dr. Vesper and I thought she might be having a bowel movement.  The noise rapidly became more of a hiccup/retching sound with her chest heaving.  She appeared nauseated, so I grabbed a bowl in case she vomited.  Her face grew pale, with her skin warm and very clammy.  Her wrist pulse felt strong and regular, but at one point she did say, “Please help me!”  I found the Omron monitor which recorded her blood pressure at 151/68 and her pulse was 73.  She never did vomit and I estimate that the whole episode lasted less than 3 minutes.  The color returned to Rose’s face and she appeared much more comfortable.  I told Dr. Vesper that if this happened again, I would call 911 or Stephanie, at the very least.  He was adamant that I not make any calls;  he felt certain it was due to “tummy trouble”.  Fortunately, Stephanie arrived to pick up the van a few minutes later and I related the events to her.  She reminded me of Rose’s history of seizures and thought that could have been the problem.  She did not feel Rose required medical attention at this time.  The remainder of the evening ran in very routine fashion.  I gave Rose and Doctor their evening medications at bedtime, and Rose’s evening toilette went well.  I washed her face and hands, then brushed and flossed her teeth.  Her Depends were saturated and contained a very small stool.  She did have a very large bowel movement while seated.  She was quiet and seemed fatigued, but did not lean or exhibit any anxiety.  I got her to bed and applied her eye drops easily.  She was quiet but still alert when I said good night to her.  Dr. Vesper was in the living room when I said good night to him.  I asked him three times to accompany me to the door to lock it and set the alarm, but he refused.  He was adamant that he would not forget.

Dinner:     Sweet and sour chicken, rice, peas, and jello salad.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  Rose had a small scoop of ice cream for dessert, but Doctor stated he was too full and declined.

Visitors:     Stephanie

3:00-6:00     I was greeted at the porch by Mossy when I arrived.  Rose and Dr. Vesper were in the living area enjoying a Mother’s Day celebration with Stephanie and her family.  They had just finished the traditional brunch and things were winding down for the day.  Rose seemed very fatigued and was dozing on/off in her chair.  After the Gephardts left, Mossy was kind enough to help me transfer Rose to her recliner and then spent a few minutes discussing recent events before leaving for the day.  I fed Kemper at 4:00, set the table, cleaned the glass doors, then (with Doctor’s help), transferred Rose back to her recliner for her afternoon toileting.  Her Depends were saturated with a trace of stool, necessitating a change.  She was calm and relaxed making the process easy.  Rose then joined me in the kitchen to help me cook a simple dinner.  She and Dr. Vesper were seated and eating by 6:00 with both enjoying hearty appetites.  Rose received Targretin with her meal.

6:00-9:00     After dinner Dr. Vesper was eager to do some yard work, so Rose again joined me in the kitchen to help me clean up.  We loaded and ran the dishwasher, set out breakfast items and morning medications, then folded some laundry in the dryer.  We were running early, so we went outside on the back porch for a few minutes to enjoy the warm summer like evening.  Rose was very quiet, but alert.  She seemed to enjoy her time outside, yet appeared happy when we returned to the great indoors.  Because she was fading fast, I gave Rose her night time medications and took her back for her evening toilette.  I washed her face and hands, then brushed and flossed her teeth.  When I got her on the lift, I could see her Depends were again saturated and contained a trace of stool.  She completed a moderate bowel movement while seated.  I got her to bed and applied her eye drops easily before saying good night to her.  Dr. Vesper had returned and was in the living room watching TV.  I gave him his night time medication and made sure he set the security system as I said good night to him.

Dinner:     They both ate tomato soup and grilled cheese sandwiches.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  For dessert, Rose had a chocolate covered strawberry and Doctor had ice cream (and Lactaid).

Visitors:     Stephanie, Andrew, Lily, Sophie, and Charlotte

2:00-5:00     When I arrived, Roberta was with Rose in the dining area while Dr. Vesper was in his room napping.  Roberta and I introduced each other and then went over the day’s events.  Though brand new to the rotation, she seems confident and capable and had completed all the tasks on which she had been trained.  The first order of the day was to show her how to administer Rose’s Targretin, which we did immediately.  Rose was drowsy and starting to nap in her wheelchair, but stayed alert after that.  Because of the timing, we then made Rose lunch and dispensed her 2:00pm meds, including her vitamins, tums, and 1/2 Xanax.  Though generally quiet, Rose ate well and seemed very focused while listening to the various topics Roberta and I discussed regarding her care.  When we finished in the dining room, we applied Rose’s gait belt and performed a two-person transfer to her recliner.  Almost as soon as we got Rose comfortable and began discussing various alternatives and techniques, she fell asleep and continued to nap for 45 minutes.  I then went over some housekeeping tasks and showed Roberta where to find appliances and supplies.  Dr. Vesper appeared from his nap around this time and the three of us chatted for a few minutes before he got ready for church.  I fed Kemper at this time (plus Dentastix) and showed Roberta where to find his supplement.  After Doctor left at 4:30, Roberta and I transferred Rose back to her wheelchair to take her for her afternoon toileting.  While we were in the bathroom, Sandy Pope came to the door stating she was there to finish some yard work.  Once I understood her relationship to the Vespers, I gave her permission to begin.  When I returned to the bathroom, Roberta had the lift prepared for Rose and I demonstrated my technique for getting her on the commode.  Rose’s Depends were saturated with a trace of stool necessitating a change.  She completed a moderate bowel movement while seated.  Rose exhibited no anxiety during this time and we returned to the living room when finished.  Roberta and I tied up a few loose ends and said good bye for the day.

5:00-7:00     I took Doctor’s dinner order before he left for church, so I set the table and began dinner prep.  While it was cooking, I ran the sweeper, cleaned the glass doors, and touched up the bathroom.  I then sat back down with Rose to enjoy a few minutes of “Two and a Half Men” until Doctor returned from church.  She became more verbal and together we laughed a lot during this time.

7:00-9:00     Though we had a late start on dinner, the rest of my shift ran in very routine fashion.  Rose and Dr. Vesper both enjoyed hearty appetites.  Rose was given Targretin at this time.  After dinner, they returned to the living room while I cleaned the kitchen, washed the dishes, took out the garbage, and set out breakfast items and morning medications.  At bedtime, they both received their evening medications, including 1/2 Xanax with Rose’s.  Rose’s evening toilette was uneventful beginning with me washing her face and hands, then brushing and flossing her teeth.  Her Depends was damp, but she produced nothing more while seated on the commode.  I got her into bed and applied her eye drops easily.  She was more quiet than usual at this time, but did not appear particularly sleepy when I said good night to her.  Dr. Vesper was still in the living room when my shift ended.  He walked me to the front door and set the alarm after I exited.

Lunch:     Rose had spaghetti with marinara, apple slices, and water.  I did not see Dr. Vesper eat lunch.

Dinner:     Rotisserie chicken, steamed broccoli, mashed potatoes, and jello salad.  Rose drank kefir milk and Dr. Vesper had diet cherry 7up.  They both had ice cream (Lactaid with Doc’s) for dessert.

Visitors/Workers:     Sandy Pope

5:00-7:00     When I arrived, Dr. Vesper was on the front porch bench chatting on the phone while Mossy and Rose were in the kitchen area having just come from Rose’s afternoon toileting.  Before leaving, Mossy filled me in on the day’s events including concerns regarding Doctor’s new “workers”, the Hardins.  We kept in touch throughout the evening regarding this issue. I also had a brief phone conversation with Jennifer, who called while he was outside.   The Hardins did return while I was there during the dinner hour, and left after Doctor paid them for the work they did at that time.

7:00-9:00     We had a slightly late start on dinner due to a visit from Dave Kennedy as well as Doctor going in and out to talk to the Hardins.  Rose was very quiet, but alert during my entire shift.  She was clenching and held on to the poseys all evening.  She and Dr. Vesper were seated and eating by 7:00 with both enjoying good appetites.  Rose received Targretin at this time.  Things were generally quiet the remainder of the evening.  Kemper seemed to be back to normal with his usual boundless energy.  After dinner, I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  I made sure the garage door was down, turned off the hose to the pool, and relocked all the doors Dr. Vesper had unlocked.  (They were checked again before I left for the evening).  Rose and Doctor were both given their evening medications including 1/2 Xanax with Roses’s.  Rose’s evening toilette was routine with me washing her face/hands, then brushing/flossing her teeth.  She was very rigid and had a very large bowel movement in her Depends.  It was well contained, but clean up was somewhat tedious and I had some difficulty controlling Rose’s hands.  As always, she was quite patient with me, but once I got her to bed, the relief was obvious.  I applied her eye drops easily and said good night.  She remained non-verbal, but still gracious.  Dr. Vesper had put Kemper to bed and was on his way to bed when I said good night to him.

Dinner:     Salad, ham steaks, mashed sweet potatoes, and green beans.  Rose drank Kefir milk and Dr. Vesper had diet cherry 7up.  Rose had ice cream for dessert, but Doctor declined, stating he was too full.

Visitors/Workers:     Dave Kennedy and Buster and Susan Hardin

5:00-7:00     When I arrived, Dr. Vesper was in the living room while Rose and Mossy were in the bathroom.  Mossy asked me if I would help Rose with her 4:30 toileting while she finished cleaning dog feces from the laundry room area.  Apparently Kemper was sick through the night (diarrhea) leaving quite a mess for her to clean throughout the day.  Rose was alert as I prepared to use the lift, but suddenly leaned severely to her right while on the commode.  She had a moderate stool in her Depends, but produced no more while seated.  I took her back to the living room, put her feet up on the ottoman, and joined Doctor watching TV.  She seemed comfortable, was not clenching her hands and no longer leaning, and dozed off and on until dinner.

7:00-9:00     The remainder of my shift was uneventful.  Rose was more subdued tonight, but she and Dr. Vesper both enjoyed good appetites.  She also received Targretin with her meal.  After dinner, I cleaned the kitchen, washed the dishes, and set out breakfast items and morning medications.  I let Kemper out one last time and checked for any additional accidents.  Rose and Doctor took their evening medications, including 1/2 Xanax for Rose, at bedtime.  Rose’s evening toilette was very routine as I washed her face and hands, then brushed and flossed her teeth.  Though relaxed earlier, she was quite rigid while changing her clothes.  There was moderate stool in her Depends and she completed a large BM while seated.  Clean up was easy and she was her usual patient self.  Once in bed, she became chatty as I tucked her in and applied her eye drops.  She puckered up for a kiss when I said good night to her.  It might be wishful thinking, but I think she said my name for the first time!  Dr.  Vesper was in the living room watching TV when I said good night to him.  Kemper was in his cage and seemed to be back to normal.

Dinner:     It was leftovers night.  Rose and Dr. Vesper both had salad to start.  Dr. Vesper had spaghetti with marinara, garlic bread, and diet cherry 7up.  Rose had broccoli and beef with rice and kefir milk.  For dessert, Doctor had key lime pie with decaf, and Rose had ice cream.

5:00-7:00     When I arrived, Dr. Vepser was in the living room, while Rose and Mossy were in the bathroom completing Rose’s 4:30 toileting.  As always, Mossy spent a few minutes bringing me up to date on recent events and advising me on the operation of the new gate.  After she left, I chatted with Rose and Doctor for a bit, then began setting the table for dinner.  Dr. Vesper stated he was tired and decided to take a brief nap while I was cooking.  I cleaned the microwave, prepped the salad, then sat with Rose for a few minutes watching “Two and a Half Men” while dinner cooked.  She was quite alert and chatty, and remained so throughout my shift.  They were seated and eating by 6:30 with both enjoying hearty appetites.  Rose received Targretin with her meal.

7:00-9:00     The remainder of the evening ran in very 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 medicines including 1/2 Xanax with Rose’s.  She seemed to be getting “fidgety” as took her back for her evening toilette.  I washed her face and hands, then brushed and flossed her teeth.  The reason behind her restlessness became very apparent when I was changing her clothes and getting her on the lift.  She had an extremely large bowel movement in her Depends which wasn’t completed until she was seated on the commode.  Cleanup was quite lengthy including a sponge bath from the waist down.  To her credit, she was extremely patient with me and seemed relieved to be fresh and dry.  Afterward, I took her to bed and applied her eye drops easily.  She was gracious and loving when I said good night to her.  Dr. Vesper was still in the living room watching TV when I said good night to him.

Dinner:     Salad, chicken breast stuffed with cheese and broccoli, mixed vegetables, and rice.  Rose drank kefir milk, and Dr. Vesper had diet cherry 7up.  For dessert, Rose had ice cream and Doctor had key lime pie with decaf.

5:00-7:00     When I arrived, Rose and Mossy were coming out of the bathroom having just completed Rose’s 4:30 toileting, while Dr. Vesper was at a meeting.  The three of us enjoyed a nice chat before Mossy left for the day.  I then set the table and began prepping the salad while Rose watched television.  She seemed comfortable, alert, and would occasionally laugh out loud.  As time went on, Rose and I made the executive decision to wait no longer and start cooking dinner.  Dr. Vesper’s timing was good and came in just as Rose was starting to eat.  They both ate well while watching the live tribute to Lauren Hill.  It was quite emotional and I think Rose sensed our admiration for the young woman through our conversation.  She was not particularly “chatty”, but did attempt several questions, which, unfortunately, I did not understand.  Rose did receive Targretin with her meal.

7:00-9:00     The rest of the evening ran in routine fashion.  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 night time medications including 1/2 Xanax with Rose’s.  I put Kemper to bed, then took Rose to the bathroom for her evening toilette.  I washed her face and hands, then brushed and flossed her teeth.  Though she was smiling and seemed relaxed, her upper body was rigid while changing her clothes.  Her Depends contained a large BM and she produced more while on the commode.  Clean up was somewhat tedious, but Rose was quite the trooper, as always.  Once in bed, I applied her eye drops easily and said good night.  She did not respond verbally, but I was blessed with another good night kiss!  Dr. Vesper was in the living room, but on his way to bed when I said good night to him.

Dinner:     Salad, PF Chang beef and broccoli, and wild rice.  Rose drank milk and Doctor had diet cherry 7up.  For dessert, they both enjoyed ice cream (Lactaid for Dr. Vesper).