Fifty-Fifty

[KarenC]

It's been about a week since Mom was released from the hospital (where she had spent two days getting rehydrated).

We visited Mom (at Silverado) and then Dad (at his nursing hom) today. Mom was more awake than when we saw her at the hospital a week ago, but not in good shape. She was tired, lethargic, and still has not been eating well. She did not seem to be in pain or any particular discomfort. Today's one-on-one caregiver was a gentle, pleasant young man, who is trying to gauge what she might be willing to eat -- e.g., cutting up some melon real fine and getting her to eat a little. I've talked to the nurse today, too, about adjusting the pain medication to make sure she stays comfortable, but not keep her more dopey than necessary. I think they are doing everything that can reasonably be done. Yesterday I talked to the nursing supervisor at Silverado, and asked her general assessment as to whether things were going uphill or downhill. She said "fifty-fifty." We would agree it seems about even odds at this point as to whether she pulls out or not.

Dad seemed in pretty good shape and spirits. I think he had had time to start getting used to the idea that Mom is really in a decline; I was glad to see him not overly depressed, etc.

Karen

 

[Sheila]

Dear Karen, it is good to know that the one to one nursing is helping your Mum. Even if it can't make her better, at least you know that someone is attending to her every need including pain control.
It must be hard for your Dad too right now, if you have spent much of your life with someone as he and your Mum have, there is bound to be a big hole in his life now they are apart.
Having to cope with two nursing homes and still keep their spirits up must be a very hard job. Do give yourself some quality time as well as caring for everyone else though wont you please. Lotsaluv, She. XX

 

[Sandy]

Dear Karen,

It sounds like your mom is getting excellent care. It is good news that the one-to-one caregiver was able to get her to eat a little bit. The pain relief situation sounds like a delicate balance, but the staff are keeping a close eye on it.

Take care,

Sandy

 

[KarenC]

Up till yesterday, they had been giving Mom oral morphine twice a day, just on a scheduled basis. Since she seemed comfortable but lethargic when we visited yesterday, I asked the nurse about using the morphine on an as-needed basis if they thought it might be contributing to her not eating. The nurse agreed that was a good idea. I tried to stress that keeping her comfortable is the first priority, but if we can do that with less drugs, that's better.

I talked to the nurse again today. She said Mom seemed comfortable, and I gather they did not give the morphine last night and/or this morning. She is still lethargic, however. The nurse said the lethargy was about the same as yesterday, and the last two days it has been worse than a few days earlier.

I asked if she were dehydrated. (They can tell from how moist the mouth is and how resilient the skin.) The nurse said no. If she were dehydrated, it might be worth one more round trip to the hospital. But it appears she is tired mainly from not eating enough, and there's nothing to do about that short of tube-/force-feeding.

Although the outlook is not real good, I feel better in light of the most recent information because (a) it seems Mom is not in pain or really suffering, and (b) they are trying everything that makes sense.

Tomorrow I plan to talk to the nursing supervisor, get her assessment, talk about how long it is worth continuing the one-on-one, etc.

One thing that probably helps my dad is the fact that, due to his physical debility, he and Mom have not actually been living together the past few years. He has been in the nursing home a few years, and as she got to needing more care on her own account they have to some extent faded out of each other's day-to-day lives.

Karen

 

[Sheila]

Dear Karen, well you seem to have sat and thought this thing through pretty thoroughly, good on you! The pain is controlled, you understand what is happening and are coming to terms with it. Your Dad is sad but has already "lost" your Mum because of their separate lives these past few years. Sounds like you have done your very best to get it right to me. Although there is much to do, please spare a little thought for yourself and your own family in all this. You can do no more than you already are, but please do comfort yourself and your dear ones with this knowledge, what ever the outcome. Thinking of you, lotsaluv, She. XX

 

[KarenC]

Thanks, She, for the vote of confidence.

It turns out the nursing supervisor is not there today. (It's Labor Day, our late-summer bank holiday weekend.) So I said to continue the one-on-one through tomorrow when I'll have a chance to talk to her. (The one-on-one care is at my parents' private expense, and is not cheap; Silverado is sensitive to this.)

I've been pretty emotional this weekend -- probably will be good for me to go back to work tomorrow and have the latest idiocy at the office to grumble about.

Karen

 

[Sheila]

Hi Karen, yes, know what you mean about needing something else to focus on for a bit like the office. Hope all goes well when you have your meeting about the one to one care. Please let us know how it goes. Love She. XX