Dad's Friday & Monday

On Friday morning, I had planned for the caregivers to hold off on getting Dad out of bed until I could arrive at 8am so I could observe the morning routine. With my prompting and assistance, we were able to get Dad to get up out of bed without the lift (though we did have to sort of "pull" him up using the lift blanket as his pattern is to push back instead of lean forward.) During that time, I also observed the "grabbing" he does with his hands, where, because of what I think is his presumed fear and/or unhappiness about moving/being moved, he will grab a person's arm or hand. Caregivers had previously reported this and that sometimes the grabbing is quite hard and/or he will scratch them (not intentionally, but inadvertently I believe.) Anyway, he did ultimately stand by the bed so that Anna could remove his wet pjs/diaper and then transition him to the wheelchair. From there, he moves into the bathroom and we transitioned again by using the walker to help Dad stand up from the wheelchair and then sit down in a bath chair (that has a hole in it). From there, he was crying out when they were removing his Pajama top...not sure what that is about except yet another example of having to touch his arms to assist him. Don't think it could be about being could because the bathroom was quite warm. From there he seemed to enjoy his shower, and then after he had one more transition from the bath chair, stand to the walker, and sit back in the wheelchair. In all cases, I would say he did well with the standing. After that he had a hearty breakfast (raisin bran, scrambled eggs, english muffin with jam) where he digs right in and goes for every last drop.

Shortly after, the PT Lucinda arrived. Dad was a little more sleepy and not quite as cooperative as the day before (which we attributed to the earlier time and having just gone through the morning routine), but did help some with the counting and exercises. We also got him to stand up two or three times, and on the third try, had him sit in the recliner.

In talking to Anna, who is the 3rd caregiver that currently works Thurs/Fri/Sat, I found out that she was looking for more work. I discussed with Janice the administrator and said it would be fine if we wanted to hire her privately to be the one-on-one support for Dad in the mornings (though of course she would only be available Sun-Wed). Haydee would be available on Saturday mornings, so I decided that would be at least worth a try, rather than having to hire someone new.

Anna's first day was this morning...I arrived at 12:45 to meet with the PT for therapy. The PT had already gotten Dad started with exercises and he was doing well and seemed in fairly good spirits, assisting well with the counting and not complaining of any pains with the leg exercises. Anna was still there (though officially had stopped working for Dad at 11am.) She reported that the morning routine went better and they did not need to use the lift, and that Dad wasn't complaining as much (though did do some grabbing.) She had done the leg exercises in bed before getting him out, and she thought that was helpful. She had also helped him participate in card playing and had walked around in the wheelchair outside (beautiful day here today.) The PT showed her some more exercises to do while there.

During PT, Dad was counting and assisting with all the exercises for the most part. He wasn't quite as responsive to specific questions (instead answering "thirteen---fourteen", in other words continuing to count and not answering the questions, though sometimes we got the words out of him on various things. When time to stand, he got up from a lower position in the chair which was good, but once up, would move his right foot to be right next to his left foot (I think because he is favoring it, but obviously that gives him much less of a base of support. We got him to start walking and he did take several steps. First time we did eight, and then stood for awhile (Lucinda and I giving him support under his arms at all times). Second time he walked ten steps. Did the same a third time. Each time, towards the end, he was sort of saying "I can't do it" but not too loudly or with near as much complaint as previously.

All in all, I'd like to say things are improving, if only slightly. Thursday was good, Friday was not quite as good, but today the therapist thought it was Dad's best day, so it's up again. Tomorrow I'll be checking in in the afternoon with Haydee and then will return on Wednesday at 10am with PT again.

Summary of additional help:
Sun - Wednesday, 7am to 11 am (Anna)
Tues/Thursday or Friday, 1pm to 3pm (Haydee)
Saturday, 7am to 11am (Haydee) though she's not available the next two Saturdays.
PT currently 3x/week (45 mins to 1 hour)

The hope is that with the additional assistance, and reinforcement of exercises and transitions, Dad will develop the strength and confidence to do it more and more on his own. I'll re-assess after about a month to see if the additional help is making a difference.