Weekend Update

9/22 Weekend Update

Had a good weekend with Mom though she is much weaker and more frail than when we saw her last. As Jane and Eileen have reported, she rides more than walks back to the bathroom. She also seems a lot quieter and introspective – but she’s still pretty sharp and “remembers what she wants to remember” as she says. The new bed and cushion are working very well; Mom slept well all 3 nights with only a couple awakenings each night and no trips to the bathroom. In fact, a lot fewer trips to the bathroom during the day as well.

She’s down to between 102 and 105 lbs. One day I thought she was going to be below 100 but when Bob and I weighed her together it was more like 102 – a lot depends on how steady she is on the scale.

Dr. Pugh Appt.
• Routine exam. Her ankles were very swollen that day and as they usually are later in the afternoons (appt at 3:30). He asked her about her diet and what she had for lunch – bologna sandwich – which led him to a “sodium intake discussion” similar to the one with the cardiologist several months ago.
• I told him that we tried to lower sodium in her diet to no avail. She likes the bologna, deli meats, hot dogs, cheese & saltines, etc. and won’t eat anything else.
• He is a very low-key guy but was certainly giving me the message that the diuretics she’s on are powerful and are “doing damage to her kidneys”, (referred back to last year when her kidneys were “failing”? Said she was on a much higher dose then). Net, net “The meds certainly do her good (getting the fluid out) but are also doing some very bad things. It doesn’t make sense to give her these meds and then let her have all that sodium. You need to use common sense.”
• I spoke to Maggie before I left and she understands and will pass the word along to Gwen and Pam. She and I looked through the food that is at the house, looked at the labels and discussed what would be best for Mom to have. If anyone has any suggestions as to what they have seen Mom eat that she likes that is not loaded with sodium, please pass that info around.
• No change to her meds at the moment. She had a blood test to check her kidney function and we should have the results Wednesday. I’ll call the office and let you know.

Bedsore
• Maggie discovered a bedsore at the very bottom of Mom’s spine/coccyx when she was giving her a sponge bath (note below re: baths) on Monday. It’s an open wound about the size of a nickel. While we waited for Pugh’s office to call back, we used Polysporin to dress it and Bob went out and got one of those donut cushions for Mom to sit on to get that spot elevated. It worked out pretty well and as it turned out that is what Pugh’s office suggested later in the afternoon.
• Unfortunately they also recommended she not “sit all day long” - “Sit for an hour and then get up and walk around for a while.” Of course, that’s not going to happen. The other suggestion was to have her lie down on the bed on her side “every other hour” – that will also be difficult (per Maggie) but it has to be done in order for the sore to heal. Maggie will keep a close watch and let us know how it goes.

Discussion with Morris
• Walked Morris through the care plan. Also talked in generalities about the financial situation and legal implications going forward, particularly the need for his financial disclosure for certain choices we might have to make – reverse mortgage, nursing home application/spend-down for Medicaid, etc.
• He said he would be able to give us some financial support and will be sending $500/month for now. He receives about $2800 and pays Westminster $2300 (round numbers).
• We talked about a lot of related things but since it was a lot to take in and this was the first time we had talked about it I didn’t want to push too hard. Once we have a specific action item for him, like disclosure required for X, we’ll be in a better position to know how he will respond. If you have a specific question, I might have covered it with him and have just forgotten it for the moment.

Follow Up to the Care Plan
• The most important thing is the immediate schedule. Notice is a big thing for Maggie. We need to give her, Gwen and VA notice as soon as we can about specific Fridays. Please let her, or me, know if you will need her for your weekend.
• Jane: If you know your dates, we can start to work with Maggie on her vacation plans, etc.
• Maggie asked for a copy of the family schedule, which I said I would send. Her email isn’t working so I’ll send in the mail. Once her email is up and running we might want to include her on the distribution…

I know I talked to some of you over the weekend. Did I miss anything?

P.S. Maggie and Pam took many of the things that were in the garage sale/Goodwill piles. In fact, Maggie came back on Saturday with her daughter and grandson to take a few more items - she is going to use the numerous clear glass vases to fill with candy at Christmas and give to people at her church. They were all very, very appreciative. I tried to talk her grandson into some of the old transitor radios - he was looking for an old Ipod - oh, well....