Disorganized and pleasant
I had a very detailed care conference today with several senior staff at the Alz center. There are new regulations dictating nursing home practices, and some of those were kicking in today. We will now complete quarterly forms reiterating what is already in Mom’s chart: She completed a living will and has a DNR, we will not do a feeding tube if she no longer can swallow, I want her daily-living care to be provided at a level she can tolerate (ie she is not forced to shower, but it does take several staff to encourage her to get into the shower). Things like that. And this is fine – more work for the staff, but a way for me to revisit my convictions about Mom. Never a bad thing.
For the conference, we went around the table.
Dietary: Mom weighs 178.2 pounds, down 2.4 from the last quarterly meeting. Her weight cycles up and down a little bit. She eats 50 percent to 100 percent of her meals. I have heard that sometimes she will skip a meal. But she loves her ice cream at every meal, and eats it first. I have seen this. In the morning, when she is served cereal, she will begin eating dry cereal with her hands before the milk can be poured. She is using her utensils more often these days. That is another cycle. So interesting.
Social work: Mom is not as lethargic as she was in the winter. Several staff seem to think the winter brought on some seasonal affective disorder, and many residents were grumpy, along with Mom, just a few weeks ago at what we now can probably consider winter’s end (it is 83 degrees today in central Ohio, a record for this date). The added sunshine seems to have lifted Mom’s mood. Her two boyfriends keep her somewhat busy. Mom isn’t napping as much. She still has disorganized speech – that is a good term for it, I think. She talks a lot, but just doesn’t say many complete sentences. (Today when I visited her briefly, one thing she said was: The United States of America. Sometimes the activity staff read the news to residents. I wondered if something about the election cycle stuck in Mom’s head.)
Activities: Mom is in and out of activities and her participation is best when it is voluntary. She rarely responds in the affirmative to staff encouragement to join a group activity. She might stay 10 or 15 minutes when she does participate, and then she indicates she is done and walks away. She sang and danced in the Tuesday morning sing-along yesterday. I was glad to hear that. She can catch a beach ball or balloon and bat it back, but most other games are too complicated for her: bingo, bowling, shooting soft basketballs, things like that. She will occasionally thank staff members or say to them, “You’re good.” She rubs their backs sometimes as a sign of affection. “She’s very pleasant,” the activities director said.
Nursing: Mom’s skin is in good shape. She saw an optometrist in February and the dentist cleaned her teeth on Jan. 12. I was very glad to hear that, as I still worry about Mom’s teeth and bad breath. He lab work is all in normal ranges. The last time a doctor checked her over, she was fine. She’ll see an audiologist in May. I am very curious about how these various appointments go and how Mom’s vision and hearing could possibly be reliably gauged at this point. But I am glad there are providers paying attention to her – as long as she doesn’t scream at them. Speaking of screaming, her next podiatry appointment will be in about six weeks or so, probably.
I mentioned Mom has been wearing the same shirt the last four times I’ve visited. That could be Mom’s choice, it could be an aide picking an easy pullover, it could be Mom is changed so often that she cycles through that shirt frequently (I think that’s actually it). Mom had lots of food on her pants today, so I imagined she would be getting a clothing change at some point. And apparently now that it’s warmer, she has yanked off her shirt once already. All the staff indicated that she has a reputation: Bonnie does not like being hot. That is something I remember about the old Bonnie, too.