Archive for March 19th, 2010|Daily archive page

Care conference 3

By all staff accounts, Mom is doing quite well. I think many staff members like her. I think they like all the residents, perhaps even love them, in fact. They are so affectionate and attentive to the residents. Mom is just pretty fun these days – friendly, social, agreeable most of the time. Not generally a source of any problems. It is so nice to hear this about her.

I met with four staff members for this latest quarterly care conference – the heads of social work, dietary and activities, as well as a nursing representative who is also Mom’s “guardian angel” under a program ensuring all residents have one staff member specifically looking after their every need.

Mom is steadily gaining weight. She has gained 5.9 pounds in the last three months. And that is just fine. She walks around a fair bit, so she does get exercise and is still very mobile. I think it’s typical for patients to eventually lose weight as they lose interest in, or familiarity with, food. Her health is otherwise good so her weight is really not an issue. She doesn’t always eat 100 percent of her meals, either. She usually does engage in any snacking that is available, like ice cream socials and things like that.

Mom continues to participate regularly in activities and seems to like them all – bingo, arts, games, etc. The activities director said she sometimes observes that Mom will experience brief periods of unhappiness that manifests in a variety of ways – sulking, grumpiness – but which always passes fairly quickly. It is much more common for Mom to just be content, dancing, smiling and socializing.

I now have clarity on the meds situation. One antidepressant was completely discontinued: Wellbutrin. Mom still takes a small dose of an antipsychotic each day, and I wouldn’t be surprised if she’s eventually completely weaned from that. The Trazodone she takes for sleep has been reduced from 150 mg to 50 mg each night. That’s terrific, I think. She still takes Zoloft, which she has been taking for years and years. With these changes, her mood has stayed stable and, it seems to me, has possibly even improved. It’s interesting. I have always been in favor of antidepressants of any kind to ensure that Mom wouldn’t feel sad or scared. With the reductions in these meds, she is certainly not scared, and doesn’t really appear to be sad, either.

The dietary director did note that Mom recently took her shirt off and was walking bare-chested along a hallway. The director asked Mom what was wrong and she said she was hot. So it wasn’t a behavioral thing – just a comfort thing. The director took Mom to her room and got her a lighter shirt. Mom was able to put it on herself. The aides report that Mom’s participation in dressing herself tends to vary from day to day, but she still apparently can handle the shirts. I was starting to help her dress this time a year ago, I think. Interesting that she can do some dressing herself this much later. This was also a reminder that I need to switch out Mom’s clothing – get her cold-weather gear out of her closet and load her up with T-shirts and lighter pants. This reminds me that I also need to make sure her Crocs are returned to her room. Both pairs were missing the last time I visited. I know they’re in the Alz center somewhere, and I assume staffers know exactly where they belong.

Mom is among the residents experiencing a scabies rash at the Alz center. I didn’t realize how common this is until I read a little bit about it. I recall her pointing to a spotty rash on one of her fingers about two weeks ago. I told her it looked like she might be having a little allergic reaction to something. It must have been scabies. And I wonder, given what I read, if this is why Mom recently suddenly pulled down her pants while she and I were taking a walk – if she might have been feeling itchy but didn’t know how to describe it. At any rate, the staff members have treated all of the affected residents. They think I probably am not likely to get it since my skin contact with Mom is never really prolonged, and I typically wash my hands after being with her. I’ll know better in several weeks – it takes that long for the rash to develop.

Meanwhile, Mom is still caught up in her romantic relationship. I visited her after the care conference, and found her asleep on a couch with Mr. R sitting in an adjacent chair. Another of his girlfriends was asleep in the chair next to him. Mom woke up when I approached her, and stood up to hug me. No tears this time. She was a little groggy. We took a walk to the lobby, sat down for a brief time and then returned to the program area. I was short on time so I didn’t wait until lunch began. I told her I needed to return to work, and encouraged her to sit with Mr. R. She seemed a little confused, like she wanted to come with me. But then I more firmly sat her down on the couch and kissed her goodbye. I walked a few steps toward the door and turned back to see what she was doing, and the two of them were in a deep embrace. Now I know another way to distract her when I leave.

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