Tag Archives: Hospice

Blazing Around the Track!

Day by Day with a Movement Disorder Posted on by 6

We’ve been walking pretty regularly around the park track for several weeks now, with a few days off due to the raw cold, and I’ve seen a good bit of improvement. I started out using the walker, and was really depending on it. We were lucky enough some time ago to find a good buy at an Estate Sale for the kind that has four large wheels and a padded seat. It’s really a Cadillac, as it has all kinds of pockets and sections, plus a large storage bin under the seat. The only drawback is that it takes up a good bit of room in the car, even folded up. But it’s been perfect for the track. I don’t have to worry about getting stranded on the far side, as I can stop and sit any time I need to. Actually, I haven’t sat down yet, but knowing I could makes me push myself further than I would otherwise.

When we started, I was doing good to get around twice, with the walker. Now I’m making two rounds without the walker and two more with it, for a whole mile. Of course, I’m slow, but I definitely see progress! DH is walking with me, and he’s up to 6 laps in the time it takes me to do 4.

I haven’t heard from the Physical Therapy place yet, so I’ll have to call the Orthopedist’s office to get the ball rolling on that.

I spent a very upsetting hour or so trying to talk to Medicare about the charges they denied when Daddy went to the hospital. It’s standard procedure for Medicare to deny any and all claims if the date of service overlaps the date of Hospice service. Each one has to be reapplied for, with a statement of Denial from the Hospice, proving the charge was unrelated to what he was on Hospice for. So the Medicare person was no help at all. I did, however, get somewhere with the Billing Clerk from the Radiologist who didn’t get paid.

Still about the Same

Day by Day with a Movement Disorder Posted on by 6

I’ve called Hospice back out here twice, because he was in pain that I couldn’t resolve with the Morphine, or his breathing was worse. They’re good to come, but it takes over an hour for them to make the drive. His heart is still strong, although the body is all but shut down.

I managed to get a little sleep last night, but mostly it’s my arm keeping me awake. It’s still very swollen above the elbow and painful all the way down to my finger tips. It’s hard to say if I pulled a muscle, irritated a tendon, or if this is from the Parkinson’s. Whatever it is, I’m not helping to change Daddy now. We have the nurses and aides coming, so Fred helps them do it. Daddy’s bottom looks horrible now, but it’s to be expected, since we have quit trying to turn him. He’s just in too much pain when we have to, to put in a suppository for pain, or to change him. He’s resting peacefully almost all the time, if we just leave him alone. So I’ve opted for bed sores, rather than upsetting him every 2 hours.

Frances is here today, so I’ve left her with Daddy, and I’ve moved up to the living room to try to get some sleep. Just thought I’d jot off how things are right now, before I try to get some rest.

Saying Goodbye

Day by Day with a Movement Disorder Posted on by 16

The Hospice nurse told me today that the nurse who stayed Saturday thought he had a heart attack that night. I had been guessing maybe two more weeks at the most, based on Daddy’s refusal to let me put anything in his mouth. She told me to be thinking more like days. I’ve said my goodbye’s, tried to finish the sentences he was struggling to get out, and he’s ready – well past ready. I didn’t have to hear the individual words to know the cadence of his “I wish this would hurry up and get over with,” as I’ve been hearing that for some time now.

Saying goodbye is never easy, but our first Hospice experience taught us that it is important. Even if you don’t think the person is aware enough to hear you, the loving words need to be said. And if they can’t respond, you need to speak out loud for them, saying what you know they would say to you if they could. Not easy.

Time I Tried to Catch Up

Day by Day with a Movement Disorder Posted on by 2

I’ve ended up doing the very thing I really didn’t want to do, and that’s not keep this blog as a daily journal. It’s just that so much has been happening lately that I just had to put blogging way down on my priority list.

So…. here goes ………

Since I wrote last, Daddy has been much worse. There was a large bulge in his upper right colon area that no amount of enemas, suppositories, stool softeners, or laxatives seemed to be effecting at all. We are fortunate enough to live in the country, where doctors still treat their patients as individuals. So Friday, a week ago, Daddy’s primary care physician came out to the house after work! After feeling around on the area, he really didn’t think it was a bowel impaction, but there was no way for him to be sure. He suggested we put Daddy in the hospital for some tests. I spent the weekend deeply upset by that prospect, not knowing what was best for him. Dr. Mc understood that we had no intention of any type of surgery, if they did find anything other than fecal matter. On top of the rest of my misery over making this decision, he would be in the hospital I swore I would never take anyone to ever again.

I finally decided that I would be in worse shape emotionally if I didn’t at least give it a try, so I was in the hospital with Daddy for several days this last week. We came home Thursday, after the tests they did showed conclusively that it was not fecal matter. We stopped them from running any more tests, so it was left as a diagnosis of a soft tissue mass. I don’t need to know what it is … only that I can give him pain medicine, because it won’t be causing more constipation on a blocked bowel.

We also brought home new pressure sores, because it took lots of complaining to get them to change him and turn him. And, when they did handle him, most of them were not gentle with his skin. Did I say I hate that hospital??

One of the two really caring PCA’s gave me four hospital gowns to take home, which is a big help at this point.

Yesterday evening, when DH and I started to turn Daddy to change his Depends, he threw up all over the place. Considering the amount of food and liquid Frances had gotten in him, everything must have been sitting in his stomach all day!! He was obviously in pain, so I called the Hospice nurse, who advised that I not try to give him his night medicines or move him for at least an hour. We cleaned him up the best we could and managed to get towels between his skin and the sheets, etc., that were soaked.

After an hour, we changed everything out to clean, but it was obvious we were really hurting him with every turn. After reporting in to the nurse, she said not to feed him or give him any medicine, but to call again if he didn’t go to sleep comfortably on his own.

I called her back at 2:00AM, as things were worse again, and she told me to give him the morphine that absorbs through his mouth. She arrived about an hour later, as we are on the outside reach of this Hospice territory. He was running a temp, and his blood pressure was very high. We managed to get the blood pressure med in him that he had missed at supper time, plus a sublingual tablet for fever. I’m not sure what that was.

She then suggested I try to get some sleep, and she sat up with him for three hours, while I napped!! There’s a lot about this hospice I don’t like, but she moved them up a few notches in my estimation, in the wee hours of this morning!!!!!

Part of the reason I haven’t been blogging is that my right arm and hand have been in considerable pain and swelling since we went to the hospital. Thinking it would be enough, I only took my cane. By the time I had walked all over the place as they took Daddy for tests, I had put too much pressure on my arm, and I paid the price for not remembering to swap to the left hand often. Thank goodness, I had thought to pack my hot pad. So I spent his hospital time doping myself up with as much pain medicine as I dared to, and still staying awake enough to be harassing them to do their job. I just couldn’t manage the computer very well at all!! It looks like I’m going to have to learn how to use a mouse left handed … I’m pitifully uncoordinated as a lefty … far more so now with the PD.

I’m also fortunate that we had bought a really nice wheel walker with the seat in it some time ago at an Estate Sale. DH was very depressed when we bought it, but it was a blessing when my arm hurt so much.

I can’t thank you all enough for your prayers and kind thoughts while all this was going on. I knew you were worried about my sudden disappearance, and appreciate the emails I received. Just know that you have been supporting me, even though you didn’t know what was going on.

My Uplifting Valentine’s Presents

Day by Day with a Movement Disorder Posted on by 9

This last week has really been a strange one, on several counts. I wouldn’t normally go this long without a post, but I tried to get a little too fancy with my Drive Partitioning software, and couldn’t get the computer to boot at all! It took me several days to figure out how to fix it, and several more to get everything back the way it belonged. Luckily, I’m good about backing up my data, so I didn’t lose any of that.

In between working on the computer, DH and I have had quite a time with Daddy. He’s been getting more and more wobbly, and less and less able to follow our transfer directions. So, we’ve had several episodes of it taking every bit of strength the two of us had to get him from one place to another. The last straw was Monday or Tuesday (I’ve lost track HA!) when we had the usual bowel problem. Thank goodness I had decided to move the commode into the bedroom, instead of trying to take him in the bathroom. By the time that ordeal was finished, he just about finished all three of us before we got him cleaned up and back in his wheelchair. The Hospice nurse came not long after that, and she could tell how exhausted we all were. This time, when I asked for lifting help, she agreed that it was time.

So, what did I get for Valentine’s Day???? A brand spanking new Hoyer Lift!!! Frances, our paid care giver, DH, and I learned how to use it this morning, and we were able to move Daddy from the bed all the way into the living room to his recliner, without any trouble at all. He’s more comfortable, and we’re MUCH happier. And our backs and nerves appreciate it, too!!

I’ve been pleased with how well the Zelepar has been helping me deal with all this physical and emotional strain. I did have a bout of hysterical crying this weekend, though, because Daddy’s foot looked worse to me, and I felt so guilty that I had let it get that way. My head knew I’d done my best, but my emotions sure didn’t. The Podiatrist was here today, and he’s very pleased with how it’s progressing, so that’s a big relief. Hey, that’s another Valentine’s Day present for me!!

And, today, for the first time in years, the pressure sore on Daddy’s bottom is all but healed! Present number THREE!!

I feel like a huge weight has been lifted off my shoulders. For the first time in quite some time, I really think we’re going to be able to keep Daddy out of a Nursing Home. The lift, the gel seat cushion, our Estate Sale sheepskin finds, and the rippling mattress have made all the difference in the world in Daddy’s quality of life. I thank God for his tender mercies.

Downs and Ups with Daddy

Day by Day with a Movement Disorder Posted on by 6

A lot has been going on with Daddy this week that has kept us both pretty busy. I called the Podiatrist’s office Monday about his heel, and they said he would come by Wednesday evening. The regular Hospice nurse came and took a look at it and changed the bandages, telling me that the key thing was to keep the blister from breaking open. She promised that we would get the rippling kind of mattress this week, too, which is supposed to help with pressure sores, such as those on his bottom and heel.

Monday night was the worst I’ve had with Daddy. His usual bedtime is 6:30, but he wasn’t sleepy then. That’s not too surprising, since he sleeps so much during the day, but part of his night medicine is a Tylenol PM, so I can’t let him stay up too late after taking that, or it would be dangerous to try to transfer him into bed. So, I put him to bed a little after 7:00PM. He spent the next 5 hours talking wildly about things like when was he going home, who were all those people, where was his bed, where was I going to sleep, and on and on. He would call me to the back every 15 or 20 minutes, and nothing I told him appeased him. When I told him he was already in bed, he would disagree, telling me he was in the car, and wanted to go home. About midnight he finally went to sleep, but the whole craziness started over again off and on every few hours until it was time to get up.

Not surprisingly, he was wobbly all day Tuesday, and I was worn out, too. So, Tuesday, Wednesday, and Thursday night I gave him 2 Tylenol PM! He slept soundly, and his walking was much better during the day. His appetite has even shown signs of improving a little.

His Podiatrist ended up coming out yesterday evening. He immediately set to cutting the whole top of the blister off!! Mind you, Hospice had told me to do everything I could to keep the blister intact. I was SO glad I had called him! He showed me a dark place in the tissue that was already beginning to develop into a deep decubitus ulcer, and said it would not have healed if it were not fixed so it could drain. He also told me to keep it open to the air as much as I could, instead of keeping it all wrapped up.

I think I’ve finally gotten my point across to the Hospice people that I expect preventative care as much as possible. So the rippling air mattress came yesterday!! It has many crosswise sections of air filled tubes that slightly inflate and deflate back and forth from the top to the bottom of the bed and back. For getting in and out of the bed, it can also be set to inflate completely for a firm surface. I think this will actually help, and may even keep him from getting any more sore places on his bottom.

He still has times when he doesn’t know whose house he’s in, but the hallucinations are not as disturbing to him as they were. His strength is returning, and with the improved appetite, he feels more like walking. So, a week that started as the worst yet has prospects of ending as one of the better ones. I’m keeping my fingers crossed!!

We Have BOOTIES!!

Day by Day with a Movement Disorder Posted on by 6

Finally, a good two weeks or more after I first asked for them, the nurse brought the sheepskin looking booties today. If I had gotten them when I asked, his heel would not have looked so bad, and may not have even blistered at all. She also brought the seat cushion for his chair. His bottom is also getting worse, so this will help considerably.

We spent the whole morning trying to achieve a bowel movement. I’ve been giving Daddy 2 stool softeners with each meal, plus a Senna laxative tablet each night. He hadn’t been since last Wednesday, so this morning we went all out to get some results. Prune juice for breakfast, plus another laxative tablet. It’s quite an involved process to get him in the bathroom now, but DH helped me this morning. Daddy still couldn’t go. So, I used a suppository. We waited, but still nothing.

By the time we had him ready to move to his chair in the living room, everything decided to start working. So, we went through the routine to get him back in the bathroom, take care of that, and then put him on the bed, so I could get him really clean and put ointment back on his sores. Then, we got him back up and into his chair. By the time we did all that, the nurse came. His chair is a recliner, which he would not use before. But we had so much trouble keeping him comfortable in his chair or the wheelchair Saturday, that we thought it was worth a try. By propping his calves up with two pillows, we finally got his legs high enough for his heels to hang without touching anything. And he’s comfortable. He immediately fell asleep, bless his heart.

He’s not the only one who’s worn out! DH had to take over and sit with him while we were waiting for him to finish in the bathroom, because my stomach started churning and cramping. I not only had diarrhea, but I came very close to throwing up. I think it was just from my nerves, but this would never have happened before I had Parkinson’s. It makes me so very nervous to work with him, because I’m so slow at everything I do. I’m afraid he’s going to fall while I’m trying to get his pants down. In fact, I’m afraid he’s going to fall every time I do anything with him. Really, I’m just afraid, period. Even though I know exactly what I want to do, I have no confidence that I will be able to actually do it, anymore.

DH and I have eaten lunch, but we’ve left Daddy sleeping for now, as he’s exhausted. DH is asleep sitting on the sofa, and I’m blogging and resting. We’re all three worn out from the morning’s doings. LOL

This nurse says the other nurse will bring the air mattress when she comes later in the week, which should help his bottom a good bit.

I managed to control my temper while the nurse was here, as I didn’t see that anything useful would come from letting her know just how mad at her I was. My DH knew I was mad, but I don’t think she ever realized it. I hope not, as we have to work with her.

But if we have another situation develop like this one, I doubt if I will be so restrained.

For the Want of a Nail …..

Day by Day with a Movement Disorder Posted on by 9

It’s pitiful the domino effect one small problem can have on the well being of an elderly person.

From the start of putting Daddy in the hospital bed, he has been very touchy on his left heel when I’m getting him dressed in the mornings. I had already, some time ago, asked for help keeping his heels in good condition, as I had noticed some splotchy areas there. The nurse said she would order booties. When they didn’t bring them, I asked the next nurse I saw about them, and she said she would take care of it. Well, the booties didn’t come, and yesterday morning Daddy had a water blister on the bottom of that left heel that is huge.

Even though it was Saturday, I called the after hours Hospice number, telling them about his heel. The nurse had a call to make in the opposite direction from us, but she said she would see him sometime that day. Sure enough, she did come about lunchtime.

When she measured the blister, it was 2″ by 3″!! His whole heel has broken down!! No wonder it was hurting. She used an ointment on it, padded it with gauze, wrapped his foot in Coban, and reminded me to hang his heels off a pillow and not let them touch anything. She said I did the right thing calling, and she thought it had been caught soon enough that it would heal quickly. Of course, Daddy is diabetic, so quickly is a relative term.

I’m just sick about that heel. I’ve been going to his house to fix breakfast and put on his shoes and socks for years now. I always checked his feet and made sure I smoothed out any wrinkles in his socks, before putting on his shoes. Now, too many people are dressing him, and I have no idea how the blister got started.

So, for want of a nail, the battle was lost. Hopefully, our battle is not lost, but it certainly has been put in jeopardy! Because of the huge bandage on his foot, he can’t wear his shoes. Because he can’t wear shoes, he’s not as sure footed when he tries to stand up. Because he’s having trouble standing or walking, he had to stay in the wheelchair almost all day long. Because he’s in the wheelchair and not walking to the bathroom, he’s not getting any exercise, so his legs are even weaker. Because he’s sitting almost constantly, with his legs up, the pressure on his bottom is greater, so the sores on his bottom are getting worse!

The nurse was obviously concerned that I had not gotten the booties when I asked for them. She said she would see to it that the medical supply company brought out the seat cushion, booties, and an air mattress as soon as possible. We’ll see.

This is exactly why I don’t want to put him in a nursing home. If his skin has broken down here, with me asking several times for the equipment that would have prevented it, how much longer would they have waited to deal with his skin, with no one around to remind them??

We spent the day yesterday trying to keep him as comfortable as we could, what with his bottom sore and his foot sore.

This was not the Hospice we had used with Mama and Pop, but the one the doctor’s office made arrangements with. I’m seriously considering switching Hospices. That means returning all the equipment and getting another set from the Hospice we liked, but at this rate, it will be worth it!! It all depends on how long it takes them to get this equipment to us this week. If it’s delayed, they’re fired, no matter how much of a hassle it is!!

What a Difference the Right Equipment Makes!!

Day by Day with a Movement Disorder Posted on by 7

This morning was my first chance to take care of Daddy from a hospital bed that worked properly. It made quite a difference, although I still had problems getting him to follow my directions. I was able to change him out of the night Depends, clean him up, and get fresh ones on, put on socks, pants part way, and shoes, before I ever let the bed down for him to sit up. That is a BIG help. He rolled away from me, following my directions perfectly, but when it came time to roll toward me, he kept trying to climb over the rail!! DH heard me struggling to get his legs back in, and came and helped me get him on his side, so I could finish the Depends. Next time, I’ll put his trousers on around his ankles first, so it will kind of “hog tie” him. LOL

Having the right equipment does make all the difference in the world when care giving. I’ve been very concerned about Ruth and Mick, after seeing the terrible bruises he gets from a wheelchair that doesn’t fit his needs properly. I wrote The Voltage Gate and A Hearty Life, thinking that they might have some scientist friends who could help her adapt the wheelchair better. If you know anyone who might be able to help her, I sure would appreciate you sending them the link to her post.

Anyway, we continue to take one day at a time, even one hour at a time, with Daddy, just trying to keep him as comfortable and as mobile as we possibly can.