I called Dad on his 90th birthday, over at Mom's house. I had laryngitis, so first had a hard time getting anyone on the other end to hear my voice! But after we got over that hurdle, I spoke to Mom, Dad and Cathy. Dad sounded happy, but confused. He was talking about all the people there, but having a hard time knowing them all, kept mentioning Ruby. Also that so and so was "manning the desk" (he said that a few times), and also that he had to get his "white shoes." I wished him a happy birthday and that I loved him, and he was cheerful. I asked if he had received my flowers, but couldn't get him to understand that. Cathy said that Dad was happy, and that's all that counts. Thanks to all in N.C. for pulling that together!

Jennie

I just remembered that I went with Mom and Dad on a picnic after his visit with Dr. Southerd, dermatologist last month. He did not see any "spots" on Dad's face, so he asked if we wanted to check any other places. Dad took off his shirt and rolled up his pants as well, but there was nothing. Yeah! Dad exclaimed as the doctor left the room, "when are you going to pull this tooth out!" (He had just been to the dentist recently).

Afterwards I drove up to Pilot Mountain in a Chevy Malibu that I was using because my car was being worked on. The weather was not too cold, but it was colder than I thought, so we didn't' dawdle as we ate the cheese and crackers, liver pate, etc. The picnic area was about 100 yards from the parking lot, but Dad navigated it well with his walker, because it was asphalt. Mom had more trouble, and wanted to lie down a bit before she walked down.

When we were about to leave, Dad asked to use the restroom. I pointed towards the building across the parking lot. But Dad must have thought I meant the corner of the shelter, where he went and relieved himself! Luckily, there wasn't anyone around. Oh well. He really DOES take directions literally.

Also a few weeks back when we were sitting in the living area, Marion was walking around touching people, especially Mr. Cranfill. He didn't say anything but a few minutes later he got up and was walking around in an angry state. Dad was watching intently, even though previously he had been in a sleepy state. He mentioned that he was asked not to "interfere" even though I knew he wanted to do "something."

Yesterday, when she got a bit annoying, Dad "clapped loudly". The other man told her to "touch Cranfill", he thinks its funny. I noticed she was wearing an "apron", with beads and other tactile things on it, to help her. They were also playing music from the '40s, "boogie Woogy Bugle Boy from Company C", (and the TV was not playing for a change). Mom had to ask them to change the tape, as it kept playing this song over and over.

Anyway, it was an okay visit all around

I just read over some of the posts. A lot has happened, so much that I have difficulty remembering if Dad has been at Homestead Hills two or three years! I think it was two though.

Dad was over for dinner. He was quiet mostly, but out of the blue he said I should not go in the water, that I would catch a cold. Not sure if he was getting me mixed up with Mom who goes to warm water exercise 3x a week.

He seemed okay, except that he needed to wipe his behind. I mentioned that I had some wet wipes in the bathroom, but he didn't get up.

Last week he took Jason's jacket home. He had it on when I went to get it a couple of days later. I couldn't convince Jason to pick it up himself, but Jason did pick out an old jacket to replace it. Dad was sitting on the couch and it was hard for me to take off the bigger jacket and put on the lighter one, because he seemed a little cold. (It was warm to me, but he had been snoozing, and that was making him a little chilled).

Anyway it was nice meeting Karen, a new activity person, who says that Alzheimer's disease is her "life", that she often goes home at night and looks up new information about it. She mentioned that she might want to do an activity involving postcards and asked us to give some if we had any. Also any ideas that we think for activities. She explained a lot of things, like try not to get offended that the residents were doing "childlike" activities. It was also nice to see all the relatives of people there.

(Homestead Hills was bought out by a new company. They plan to put in some apartments, new fitness areas, etc in the Homestead Hills section).

Here is new schedule presented at the support group last night at Homestead. They plan on having support groups each month with speakers, etc. There is new activity lady who seems enthusiastic about activities for "lifescenes" at Homestead. Each cluster is for a different level, but no one is excluded from an activity.

Daily Activity Schedule

6:00 am - 8:00 am Toileting, combing hair, brushing teeth, dressing getting ready for breakfast

8:00 am - 9:00 am Eating Breakfast; after break- fast, personal hygiene (ie: brushing teeth and/or dentures in bathroom, toileting, washing hands, etc. ..)

9:30 am - 10:00 am * * Cluster Activities:
Cluster # 1 -Current Events
Cluster #2 -Folding & Sorting Laundry
Cluster #3 -Ball Toss

10:00 am - 11:00 am Snack Time in the Dining Room

11:00 am- 11:30 am * * Cluster Activities:
Cluster # 1 -Baking Bread
Cluster #2 -Listening and Sing- a-long to Music
Cluster #3 -Ring Toss

11:30 am- 12:00 am Getting Ready for Lunch

12:00 am - 1:00 pm Lunch Time

1:00 pm- 2:00 pm After Lunch, Personal Hygiene (ie: toileting, brushing teeth, nap time, etc. ...)
2:00 pm - 3:00 pm Snack Time in the Dining Room & Toileting

3:00 pm - 3:30 pm **Cluster Activities:
Cluster #1 -Art Fun
Cluster #2 -Men's Club
Cluster #3 -Basketball Toss

3:30 pm –4:00 pm * * Cluster Activities:
Cluster #1 -Sorting Time
Cluster #2 -Parachutes n' Music
Cluster #3 -Pretty Nails

4:00 pm - 4:30 pm Mail Call

4:30 pm - 5:00 pm Getting Ready for Dinner

5:00 pm - 6:00 pm Dinner Time

6:00 pm - -7:00 pm After Dinner, Personal Hygiene (ie: toileting and/or bathing)

7:00 pm - 8:00 pm Evening Activity- -Lotion applied to hands and/or feet -Listening to Music -ending with Evening Snack and to bed.

** Cluster Activities -will change daily.
ALL ACTIVITIES ARE SUBJECT TO CHANGE.

Yesterday I picked up Dad and brought him to Mom's house for the afternoon, dinner and evening. When I arrived, he was asleep in the TV room, and I woke him by calling "Dad"...he immediately smiled and said "Hello Barbara", bringing tears to my eyes. We walked back to the room, without his walker, to get his jacket, then walked to the car.

I noticed that Dad looked like he hadn't shaved for a few days, and also that his fingernails were long. Mom brought the razor to her house so he could shave there, and I mentioned the fingernails when I brought him home that night.

At Mom's house, he relaxed. Overall, he seems pretty good, and doing less "rambling" than what I recall since last Summer. He does need "direction", but is still able, with verbal prompting, to do what you say...go to the bathroom, pull up pants, eat his dinner. I put grapes and water in front of him and he went for them right away. He seemed to enjoy watching the television during the afternoon (golf), with little or no napping. We played a game of Scrabble after dinner and a couple of times he found words on his own, but then needed my prompting for putting on the board. He also kept wanting to use his "cookie" as the letter "s" on the board. After each play, he seemed to want to make another play with the remaining letters on his tray, but I would tell him it was my turn and to get more letters and then I would ask him how many more letters he needed to make 7...he would figure it and pull the right letters each time.

Today, I went over around 3pm. When I arrived, Dad was sitting in the TV room, and there was another lady cuddled up next to him, eating snacks with him I think. He got up and followed me to his room. Mom got a new TV for her bedroom (larger to help see better due to her macular degeneration), so I took her old TV to Dad's room, if not for him, but also for when he has visitors. I also attempted to organize Dad's clothing, as his closet and drawers were in a bit of disarray, and it seems there are items that don't belong to him, as well as he is missing his own items. I've added some labels, and also did an inventory that I will post in the closet with the hope that the workers will continue to follow the organization.

I met two of the workers, La Shawn and another gal whose name I can't remember! She commented on how "committed" Mom is to come every day, and loves to see the families. She trimmed Dad's nails and also helped him in the bathroom as I was organizing the closet. Dad had wet his diaper, so needed a new one, and then had a bowel movement on the toilet, for which I suggested she use a wet wipe to ensure he was cleaned up. (Is this too much information?)

Tonight I will take Mom and Dad over to Cathy's house for a football playoff party. Beau will also be there.

My overall observation is that Dad seems calm, agreeable, and responds appropriately, for the most part, to comments and statements. I haven't got into any deep conversation with him, and he doesn't join in on conversations between Mom and me. He is quiet, but content, from what I can tell.

I am here until Tuesday the 24th. Love, Barb

There are several new people at the center. One lady there, Marie, is quite young (40) and does not seem to have too many mental problems, though she had some trouble playing Dominos. She wanted to add the points on the Dominos and then play them. I had to tell her just to match colors. Dad seemed to enjoy playing with her and he was able to explain some things to her as well.

I put together a jigsaw puzzle that depicted the world during World War II. I thought it might spark some memories. He didn't say much but seemed to enjoy watching me put it together!

I called Dad on Dec. 24, and spoke to him. He was glad to hear from me, and wished me a Merry Christmas back. I asked him what he remembered or liked most about Christmas when he was a kid, and he said that he most liked waking up early in the morning to see the tree with all the others, and his father blowing the horn. I think I had forgotten that that tradition came from Grandpa Dancy! (Mom confirmed later that's where they got the idea.) He also spoke about his medication and that he would be okay if they didn't kill him first, and something about what he saw on tv about the medication killing people and with the tree (I had asked him about a Christmas tree where he was), but that his aide told him he should just do what the aide told him (take the medicine). Overall, he was about 60% coherent, and glad to chat. He didn't seem to have changed much since the summertime.

The next day, I called Cathy's house, and spoke to him again. He was enjoying the good food and the presents, and that he didn't deserve it all (or something to that effect). He was clearly in a good mood.

Love to all,

Jennie

Dad and Mom came over on Sunday, also Suzie, Jacob and Jason ate also. I had to divide a lasagne casserole into small portions, but I made up for it with homemade bread sticks, peas and mushrooms and also a filling peanut butter chocolate pie.

Dad is doing okay though twice recently he put his pants on backwards, (they are sweat pants and dont' have zippers, though one has a pocket). Suzie joked that Dad was wearing "Zubu" pants, which are cool!

Mom still can not read normal print, but she can read the large print books I think and watch TV. One of her friends has had the operations five times in the last year. She will change the font on her computer to larger.

We played a scrabble game on Mom's birthday. It went well--Dad did not have to ask any questions about the play. Dad won the game, and I didn't try to let him either! (that may not be saying much!). It went fast because we had only 40 minutes to play.

We had cake on Sunday (two days earlier) at my house. It was a yellow cake with fudge filling and chocolate butter cream icing. Also, barbecue pork, corn, and spinach souffle.

Well, Dad went to the beach in August and seemed to enjoy himself. At least it was a change of scenery.

Not much going on lately. We mostly play Dominos and sit. Dad is quiet most of the time.

When Dad comes over we mostly watch the golf on TV. He always ask what he should do when we sit down to eat, not sure why he asks.

Next week Dad will be going to dermatologist again. He usually has one or two spots that need to be "frozen". It makes me wonder if I will be doing the same thing in 30 years!

Dad seemed to enjoy the beach ball toss that happened while I was visiting him. Most of the other people just gingerly tossed it back, but Dad had a volley going with the lady! Afterwards, we walked up and down the halls a couple of times.

The last few times Dad has eaten at my house, he has been eating very slowly. Uusally he sits at the table for at least 15 minutes later than Mom and I.

He seems to enjoy watching the golf on TV when he visits. (He doesn't get to watch it at the home.)

When I got back Dad didn't seem to notice that Mom hadn't seen him for four days. Since I dont' see him every day I thought he might not notice that I hadn't been there, but Mom and I were surprised that he didn't notice that she hadn't been there for four days.

Dad was angry at Marion though. She comes up a lot and touches people. She came up to Mom and tried to touch here and this time Dad grabbed her arm and said to go away. Mom said Charley don't grab at her. She walked away though. Usually if you ignore her she does not come up. Also Mom or I sometimes take her hand and lead her to the other living area. It is difficult.

Last week she kept touching another man and he finally slapped her and the nurses said not to slap her, she doesn't know what she is doing, just move away, and he was angry because he didn't see why he had to move away he liked sitting where he was!

I have had a lot of sickness which has affected my relationship with Dad.

But yesterday he squeezed my hand as if to say everything was okay. It did make everything seem better!

I spoke to Dad on Saturday, May 28, to thank him for his service in the Navy as it was Memorial Day weekend. He recognized me and appreciated the call. He thought that Mom wanted him to take a train ride to a memorial of some sort, and then said it was to go see Barbara and Russ. I also mentioned Norman and Allen's service in the military, and he said that they were going to be at the memorial, too, but in a "backward fashion" because they were dead. So, it was a bit funny how he worded it, but he was aware of the current situation!

As a side note, from the voices in the background, it sounded like he was either in a wheelchair, or coming over to the phone and getting in a chair of some sort. He was in his room when I called, and they went and got him.

I called Cathy's house on May 1, just to check in with everyone. After speaking with Cathy, she passed the phone to Dad. He sounded cheerful and aware, although he said that he worries about things (like money), even though Mom tells him not to.

I really appreciate that Cathy is able to keep up with having Mom and Dad over for dinner each Sunday. It's a very nice tradition.

Sometimes it is so difficult to be with Dad. I have to answer all his questions about using the toilet. He forgets if he has brushed his teeth, shaved and even whether he has flushed the toilet just a few minutes before.

But he is still pleasant to be around. Sometimes I want to cry though, for what I miss about him that is gone, for what is to come (not sure), and for my own lonliness.

It is better that I be around him than be at home where I feel alone and useless.

I just have to pray for the strength to get through each day!

Yesterday Dad and I talked about Jason. Jason is moving back in with me. I am not sure how long. He wants to work in Winston-Salem. It is the same company that he works for in Charlotte, but they have branches in WS and Greensboro. Dad said he hopes Jason doesn't go back on drugs. I hope so too!!

We played cribbage again. We stayed even most of the game. It is easier than talking sometimes.

Dad seems okay most of the time, he just doesn't make much sense when he talks. Through all the confusion I can understand his feelings--sometimes frustrated, sometimes worried, sometimes confused.

Yesterday Dad and I did something different. I set up the plastic bowling pins. Dad bowled a couple of times making a strike from a chair! I made a spare. He then walked around the room a bit like he was trying to exercise.

I'm heading back to Vancouver today. Yesterday, we took Dad to Cathy's for supper. She made a very nice soy-marinated steak, with fried rice - strawberries and ice cream for dessert. Dad was pretty much the same as he has been most of the week, not really able to have too much of a conversation. We watched golf and some basketball.

On Thursday, I was able to review Dad's chart at Homestead Hills. I was primarily interested in reviewing the notes from his recent hospital stay and seeing what medications he is currently on. The records include an admittance record, and also a detailed report upon discharge. Here is the information on diagnosis of condition (by hospital doctor, Jamehl Demons):
1. Acute renal failure with secondary hypernatremia
2. Coagulopathy
3. Diverticulosis
4. History of GI Bleed
5. Benign prostatic hypertrophy (BPH) with urgent continence
6. History of acute renal failure
7. History of recurrent hypernatremia
8. History of deep venous thrombosis and pulmonary embolus
9. Microcytic anemia
10. Hypokalemia

The acute renal failure was likely the cause of Dad's symptoms (confusion and lethargy, not eating or drinking, and eventual dehydration). His creatin level was 2.5 on admittance (normal range .5 - 1.4).

Dad was given a CT to determine if there was evidence of stroke - none. He was given fresh frozen plasma, and the coumadin medication was stopped (the level appeared to be too high - the doctor noted the condition of DVT/PE (?) was 2 years ago and there was no documentation of hypercoagulable state persisting).

Dad was prescribed Oxybutynin for the urge incontinence associated with the BPH.

His current medications include:
Aricept (donepezil hydrochloride) - 10mg 1xday
Namenda - 10mg 2xday
Norvasc (amlodipine) - 5mg 1xday
Vit B12 injection - 1xmonth
Oxybutynin - 5 mg 2xday
.
The aricept and nameda are for the dementia. The norvasc is for hypertension.

I've done a little research on the ARF and BPH to try and better understand what is involved and what potential treatment or preventive measures might be useful. Probably need to to do more to really understand - and then have a discussion with Dr. Herman as well.

BPH is essentially an enlarged prostate. This apparently causes problems with urination - constant urge without ability to fully empty the bladder. The fact that the bladder is not fully emptied is what can cause the kidney problems, or urinary tract infection. Although Dr. Herman mentioned UTI to Barb when she talked with him following Dad's hospital admittance, the records do not actually mention this at all - nor any indication that he received antibiotics for an infection. However, the ARF I think must be related to the BPH condition - which likely has existed for some time. I certainly remember Dad complaining about having to pee and not being able to for some time before he entered Homestead Hills. I haven't reviewed many earlier records to determine if he was treated for this. Research indicates several drug treatments to reduce the symptoms of BPH and in some cases to reduce the BPH itself. Surgery is also sometimes done to treat the BPH.

It appears Dad has had ARF before according to the records. I'm not sure if this was also the cause of his hospitalization in November of 2003 or not. And it would seem there is some danger of this becoming Chronic Renal Failure, As near as I can tell this is the most serious concern with Dad's physical health.

As to his mental state, I'm sorry to report that after my first visit on Wednesday, when he seemed very alert and coherent, he has reverted to a very confused state during the past 3 days. He talks in nonsensical terms (e.g., going to the toilet so he could make payments on the mortgages) much of the time when trying to have a conversation. (Mom and Cathy cofirm that this is his state more often than not). Nonetheless, he is still quite capable of playing a mean game of scrabble - and he never has any difficulty knowing who people are. He gets caught up in the other residents' problems - which are also quite confused of course - but Dad doesn't recognize that they are not aware of reality. He gets rather angry with one woman who has a habit of coming up and wanting to touch him (and others), fiddling with his clothes. When I mentioned that she really didn't know what she was doing, he insisted she did it on purpose.

Dad is still somewhat better than when he was in his worst condition. He uses a walker - but doesn't really need it much of the time. He is able to take care of his personal needs for the most part, though some prompting is required sometimes. The nurses' notes indicate that he occasionally gets up at night, and of course is not fully aware of where he is.

I noted the discharge record indicated a follow-up visit with Dr. Herman should occur wihtin 2-4 weeks, but I did not see any record of such a visit. Wanda said the record might be in someone's office and she would check into it on Monday. Mom will follow up with her, as I am travelling back to Vancouver that day.