Rehab Improvements and Heading Home

Since my last post Dad had 2 days of therapy. During this time he has continued to eat all of the breakfast food, most of the available lunch and some of the dinner. Maybe he is tired in the evening, or just likes food earlier in the day. I tried to pay attention to the textures of the meals to see if that has anything to do with it, but all I was able to tell is that he likes breakfast food. Over all breakfast food has more carbohydrates and fat, dinner items seem to have more protein and fat; heavier types of food to consume…it’s something to think about.

There was no rehab sessions on Sunday (he gets a break from exercising on Sunday), but Dad still got a workout. Brothers and sister visited him, along with several cousins, and other family. It was a busy day and he seemed happy to see them, but got tired in the afternoon and fell asleep, like many other days. He slept so long in the afternoon that a couple people visited but he never woke-up to say “Hello.”

Rehab efforts have continued and he is standing alone, slowly while using the wheelchair as a ‘crutch.’ The rehab folks mentioned that several steps have been taken, slowly - but at least he did take the steps. It was something to celebrate and everyone gave praise and congratulation for the accomplishment. Dad mentioned to me while alone together that he will walk soon, “Get ready.” Cognitively Dad knows he walked in the past and is a little frustrated that it's not happening now, but seems determined to do it again.

But at the same time, in the evenings and during the night he appears to be a different person; like a “Jekyll and Hyde.” Dad practically sits-up in bed, with an angry look in his eyes, firmly grits his teeth, holds out clinched fist, and mumbles orders or thoughts; it is quite scary in a way. When someone asked what he said, or meant cold-heatedly eyes stare back, but he doesn't say a word. It seems as-if he may not know what he is saying, but in either case I don't believe he understands what is being said back to him. If he were able to get out of bed it would be even scarier, but we all know he does not mean what he is doing, and we all know he has never hurt anyone.   

During the evenings Dad argues, squirms around in the bed and tries to pull his clothes off, along with the catheter. This uneasiness might be caused by the catheter, the drugs he’s taking, or maybe it’s just cabin fever from being cooped-up, first in the hospital weeks ago, then going home and then coming to the rehab center. Any case, the nights are long for the rehab staff (family has not been staying with him through the night the last couple nights) and he appears to be quite tired in the mornings. If he could just get on a regular sleep cycle many of us believe things will improve; but with all the constant drug usage Dad falls sleep during the day and is restless during the night.

I have not posted the past couple days; I am driving home now (it's almost midnight now), but wanted to squeeze every moment out of the previous days and spend time with Dad, my mother and family; writing took a backseat. Before leaving I had 2 days of my favorite local, hometown burgers. I ate too much and probably upset my stomach but after growing up on the sandwiches it’s hard to shake the urge to ‘pig-out’ when possible. I told someone in a tweet earlier in the day Tuesday I’d be stopping at Starbuck’s to post something but I got a late start and just lost track of time; starting later than expected I wanted to get out on the road, and get home.  So, here’s my late post from a truck-stop type location using free Wi-Fi; I will post this and get back on the road. I should be home by early morning (after sun-up), dead-tired but I will check-in on work, sleep and then post an update if I can. 

Dad Recap: Dad is still in rehab with no plan as to when he will return home, but hopefully this will happen soon. 

6/28

Pain

Thursday started off like the others, breakfast went well and the first rehab exercises went well too. But as the day wore on Dad started to have a lot of pain, the kind that is bone deep and unavoidable. He seemed to become anxious and continued to complain of pain. Maybe the exercises are taking a toll. His medications were reviewed and more pain medication was administered. This additional medication seemed to have had a negative impact on his behavior and recovery progress.

The second rehab visit for the day did not go as well as been the case. Later when Dad was taken to the community room he did not cooperate and tried to leave the area. This was not allowed by the 'clinicals' and was returned to his room. In a short period of time he was back in the bed, moaning about the pain and complaining that no one was listening to him.

Everyone came to the conclusion it was the pain medication causing the behavior problems. The evening continued with the same issues and my brother came to the rehab site. When Mother and I left for the evening Dad was sleeping and expected to continue through the night.

More to come in the morning.

6/23

Accomplishments

It was another good day in regard to accomplishments. Dad ate a good breakfast and lunch went OK too.  Mother and I got out there around 9am and just beat his breakfast tray arriving to his room.  He insisted on trying to eat the food alone; this went OK but we still helped in the hard-and-eye coordination category. But rehab picked him up and away he went, 30-minutes later he returned with another good report. He is trying and stood on his own and took a couple steps, but after returning he fell asleep and the person who brought him back mentioned that he may sleep several hours due to the exhaustion of his movement. He did sleep and we woke him up when lunch arrived. Afterwards he was taken away for another 30-minutes exercise excursion. 

When he returned a doctor came by to test his strength and it was mentioned that he should not be allowed to stand while alone, and advised that his bed should be lowered to the floor, so that if/when Dad is motivated to move off the bed he will not take part in a fall due ot his accomplishments. It made sense to us and we both nodded.  

Later in the evening the rehab site had an ice cream outing for residents out on the patio. Dad didn't got outside for this, but he enjoyed the ice cream. A consolation from this, he say up for 30-minutes in the wheelchair. Nice!!!  

Mother and I went home for dinner; she went to bed early, I'm still up.

Tomorrow will be another day of accomplishments.  

6/22

Small Steps

Today started off like all the others, with breakfast going well. Dad had a biscuit and some gravy, yogurt, a waffle, milk and juice. Then the 'clinicals' did their morning visits; checking vitals, mental responses, rearranging bedding, and helping him put on his clothes for rehab exercises. This clothing consist of a form of pajamas (house pants), socks with a non-skid bottom and a t-shirt; easy and comfortable. Around 10am he was wheeled away for the first session and 30-minutes later he returned. I rolled him down to the community room and he watched some TV while I enjoyed the break.

But he did not allow this intermission to last long; the next thing I knew he was trying his 'slide-down' tactic. I mentioned that it was not what the 'clinicals' wanted but he continued. They came in once and straightened him up, the second time he was moved out into the hallway, again. We were advised to let him sit there alone, so I did not stay with him and mother sat in the room. In awhile they brought him back in for lunch and then took him away again for more exercise.

I've been thinking about some comments I received since yesterday's post and how people were happy for my dad to be testing the limits of his abilities. I had viewed his behavior as being testy - when he returned from exercising we were told 'he is doing good'. So both mom and I complimented him on his effort and progress. He smiled....and then said he'd like to lay down. :-)

He napped for about half and hour and then sat up the rest of this afternoon/evening. The evening ended like the others, with my brother and family coming out and taking care of the later portion of the day.

It was a good day!

6/21

Opportunities

Well, breakfast was completed this morning with little problem. It seems Dad has come to the conclusion that breakfast food is good.  He ate everything but we still had to help him, guiding the fork and spoon to his mouth. I could feel it in his hand though, confidence seems to be building, he did not seem to be as timid in trying to eat as he was a few days ago.  Afterwards a couple 'clinicals' came in, cleaned him up, helped change his clothes and off to rehab he went. He did not seem to care that he was going but still commented that he was sore and he made sure his meds were taken before he rolled down the hallway.

Thirty minutes later he was back and some of the team helped with his bathroom duties and then lunch arrived. As you can tell, not much happens between breakfast and lunch, at least not in my notes. But during this time meds are brought in, reviews on how he feels take place, and bathroom duties are completed. Since he can not get himself from one place to the other he still depends on a catheter, and bed pans are still being used.

After lunch he tried to lay down but soon afterwards a pair of the staff came by and rolled him away to rehab. The look on his face was not of pleasure and he commented again that he would like to go to bed and sleep. That did not happen and he later returned, but was not brought in the room, but rather rolled down to the community room and was left with me and mother, along with an uncle and his wife. Dad didn't want to stay there and slid down in his seat. The rubber mat was placed under him and he 'sat still.' After an hour or so they took him back down the hall and he sat in his room. But he slid down in the chair and actually made it to the floor this time. When the staff came in and asked what happened Mother told them he managed it himself and would not listen to her. They pulled him up in the wheelchair and told him, "Since you won't behave we'll move you out in the hallway so we can keep an eye on you." The look on his face was like a kid caught with his hand in the cookie jar, but he did not complain. After a short time he was brought back to his room and moved back into the  bed.  The staff mentioned that his behavior is not something to be overly concerned about that this is not uncommon, or things like it with people newly admitted. They also commented that the drugs can sometimes add to this type of behavior, at least for a day or two. Improvement is on the way!!!

He slept a while after returning to his room and then ate dinner with no event, but he still had to be coaxed to eat all the food. My brother and family came out earlier today; Mother and I left earlier than we have to this point (got home 8pm). The adventure and opportunities continue tomorrow.

6/21

Wheelchair Trouble

Sorry for the late post. Dad had his first rehab effort yesterday and it went well. No family was allowed in the room, mostly so he would give it his all and not try to involve family in some way. Reports back to Mother were that he was successful in standing with assistance and he took a couple steps using a walker device (and watchful eyes and helpful hands). Returned to his room by the rehab team he headed for the bed. Lunch arrived about 20 minutes later and he had to go through a 'waking-up' process, including the groggy "what's going on look", and after that he was returned to the rehab team which worked with him on 'hand-eye' coordination. He can't feed himself completely but he tries to get the food, spoons, forks, etc. to his mouth; so this kind of rehab exercise will be of great use. He returned to the bed and slept for a couple hours after the last session and about an hour or so later dinner arrived. Again he went through the 'groggy phase' including the 'you eat it' and 'I want to go back to sleep' comments. As has been our developing schedule my brother and family returned in the evening and stayed the remainder of the night.

Mother and I arrived this morning before breakfast and served as encouragers. He ate everything and wanted to go back to sleep but the clinical folks had a different plan. They got him into a wheelchair and left him in the room to watch TV, talk, etc... He seemed to have been bothered by this and just kept mentioning the bed. Looking directly into his eyes I told him he had to stay in the chair until one of the staff could come talk about the plan for the day and decide what course of action to take. They did come back in and asked him to stay in the wheelchair; this is when things got interesting.

They pushed him down to a community room where other patients and  residents meet; watch TV, talk with visitors, and wait to be returned to their room, rehab, lunch, etc...  This is when Dad started squirming in the chair. He kept slouching down and sliding out of position, lower and lower in the chair and had to be re-positioned. Two girls came back in, and by the arm/shoulders lifted him back up into the chair. In a few minutes he did this again and the entire process was repeated.  When they left he started it again and the head nurse came back in, had him lifted up in the chair again while she slid a rubber mat under him. This stopped the scooting out of the chair. Not being able to slide down in the chair and cause the staff to return seemed to bug him a little but the rubber sheet worked and no one had to lift him again.

Shortly afterward some clinical types came by and took him to another rehab session. Thirty minutes later he returned to the room and was left in the wheelchair for lunch. He ate very little of the food and then was transferred to the bed (a lift of sorts was used to do this transfer). He slept for several hours and then went back for another 30-minute session, then was returned to the room. Dinner arrived an hour later and my brother and family repeated their efforts as encouragers and visitation company for him. Mother and I returned home around 9.20pm; we are preparing for tomorrow morning, the family will do it again.

6/19

First 'True' Therapy Attempt

Good morning!! Breakfast for Dad started out OK, and guess what?  It ended OK too!!! He ate a biscuit, yogurt, a pancake, milk and juice; he tried eat it alone but we helped when his aim was off (he missed his mouth by centimeters). But I believe his trying is a good sign, a sign that he wants to do it and  will continue to try. A couple clinical people just came by, got him out of bed, helped him dress in some house pants (sort of like pajamas), them took him away for therapy (hopefully standing). They told me and Mother that it will be 30 minutes and then he will come back for lunch. I will post an update later today after we see how things go.  

6/17 8.45am

Continued Progress?

Mother was ready to get out of the house this morning; she woke up around 6.30am and must have caused me to wake up (I guess), I found her already dressed. I wanted to drive her out and get some breakfast, so quickly I shaved and got dressed (good thing I pressed those shirts!!).  We arrived to find Dad awake and sitting up in the bed. He looked surprised when we walked in and said, “Hey, how are you?” We responded and Mother started to ask him how his night went, if breakfast had arrived, etc…  His breakfast had not been delivered yet and Mother started commenting to him about being ready to eat. He said something like, “You eat it” and I told him that the food would be for him, that I’d already had something for breakfast (actually we’d not stopped; Mother wanted to go straight out).

In the meantime a nurse came in to administer some drugs, and a parade of other clinical personnel came to the room over the next couple hours, breakfast being one of the things to come in. The breakfast consisted of juice, milk, a waffle of some sort, yogurt, and some bacon. He did not want to eat but after some prodding and more talk about how expensive the food is to waste (he’s always been big on the proper use of money; I thought this might appeal to the older part of his personality) he finally did taste everything and ate most of it. He loves the Activia yogurt, so that was a sure thing and I learned today that he loves juice or sweets because it went fast.  Shortly after breakfast my sister-in-law arrived and stayed with us for a couple hours.

He's been sliding his leg off the side of the bed in an attempt to get off the bed (at least that’s what we thought he was doing). But after several attempts I realized it could not happen and quit worrying about it so. But we're concerned that his leg hanging off the bed would cause it to hurt and continued to encourage him to stop. Finally the nursing staff had put up with it enough and placed his feet on a cushion of some sort that had elevated sides that kept his feet in between the sides and on the bed. Thank goodness!!!!

Lunch came around noon and the eating adventure started again and went about as well as breakfast. Mother and I stayed the day and my brother and his family arrived around 5pm…  Dinner arrived about the same time and my brother and his wife worked with Dad to get the food inside him. He tried his, “I’m not hungry” and the "You eat it" again, but they did not go for it and got him to eat the food.  We had a lot of talk about him and encouraging him; Dad kept falling asleep (this had happened throughout the day). Due to this no real therapy took place, other than sitting him up in the bed and hand-eye coordination while trying to eat.

Mother and I stayed for another couple hours and then took off in search of food to take home to eat late in the night (we're eating now). My brother and his wife were there when we left. 

6/17

Thursday Efforts for Rehab and Eating

Yesterday (Thursday) Dad did some more sleeping, a lot of it. The staff felt he was stressed or exhausted from the change in environment. During meals he continued to push the food back and say, "You eat it!"  I jokingly told him it was against the law for me to eat it and a waste of money if he did not eat it. Interestingly he did eat most of his breakfast and lunch went OK, but he did leave some of it. My brother and his wife came out around 4-5pm which provided him a new team of 'encouragement' to work through dinner. They were successful in getting him to eat the dinner and he nodded off (took a nap), but woke up shortly afterwards. For now he has a catheter but Rehab efforts were scheduled to start later today (Friday), maybe a couple short sessions of moving into a wheelchair and a chance to get him on his feet (we hope).  I will have more on the rehab efforts later today, or tonight.

First Day in Rehab

Well…an ambulance picked Dad up around 8.30am yesterday and transported him to the rehab site. We’re told he slept a good bit of the way, that people his age and with his medical condition often sleep on the drive out. In fact he was asleep when they took in him into the room and he slept most of the afternoon, about 4 hours. Of course Mother was concerned but one nurse said that the drive out usually exhaust patients and that he would probably sleep the rest of the day.

But around 5pm he woke-up and was quite groggy. He did not remember me, for whatever the reason and was a little short-tempered with everyone, except the ‘official’ nurses. Like I always thought elderly people respect doctors and nurses (for the most part) and do what they say, while ignoring family that loves them, it’s a weird thing to consider but that’s people.    My brother and his wife came out and after some time me and mother left (around 9pm), looking for some food. After a salad and some talking, mostly about Dad, I convinced her to go sleep.

After watching him for 2 days it is obvious that what was told me on the phone is true. He has lost coordination in his legs and hands, but they say the last test showed no stroke has taken place (that was a couple weeks ago). Someone has to feed him and he doesn't want it. Maybe he is not eating even when Mother, my brother or sister-in-law tries because it's hard for him to eat and he cannot do it himself. Hopefully this is something he will re-learn soon.

6/16 (early morning) I forgot to post this last night. 

Rehab Site Update

The rehab site was really nice, sort of like an elders’ spa without the golf and tennis connections. There is a nice cafeteria for people to eat in (there are some people living there permanently, they must have nice retirement plans, or some type of government support). The place is superbly clean, the nurses and other caregivers treat resident patients with care and understanding, and even the support staff of housekeeping and electricians seem to work with no complaints, at least in front of me and my mother.

Dad will be transported by some form of ambulance in the morning, and taken to his room once he gets there. We were told his roommate is a man who has lived there for 8 years, 2 years of that time his wife was his roommate. She passed away 6 years ago and he has remained. All we are required to provide is 3 sets of clothes, including one pair of shoes or socks with the grippe contacts on the bottom. While being admitted my mother was told she could wash his clothes or the site would, no charge. Mother said she would take care of it but I stopped that, she’s done that on other hospital type visits and forgotten something only to find that she has to return home and get it right-away.

Breakfast in his room is at 9am, lunch around noon-1pm, and dinner at 5pm… The girl mentioned that if he is able to make it to the cafeteria the food service starts the hour prior. So, Dad will be picked-up in the morning at the house, we’ll all go out there, and see how it goes.

So, for now that’s all I know. More to learn tomorrow.


6/14

Rehab Site Visit

UPDATE: After getting up this morning and watching Mother administer Dad's medication regiment we got dressed and are headed out to the rehab center. A friend of the family has come over to sit with him while we travel to the site. The doctor who recommended the rehab made it clear this site is not a ‘nursing home’ where people go to sit, but rather it is a 5-star type of site that is ‘acclaimed’ to be very successful. Let’s hope it works that well for dad too. The travel time is about 25 minutes, so we should have everything completed today.  I will post an update later this evening with what I have learned.

6/14 

Travel Complete

After traveling all night Sunday I got into town around 5.30am Monday morning (6/13), stopped for a bite to eat then fell asleep in-front of my parent's house for a couple hours (I didn't want to wake them up). When I woke up it was about 9am so I knocked on the door and my mother opened it with a big surprised look on her face, I’d not mentioned what my plans were so she should have been surprised. I called them Sunday evening while driving but since I was on my cell (they are quite used to me using it) my mother had no idea I was on the road and headed her way. My dad was in the bed, looked a little blotted in the face and his hair has started to grow back in. It was only a week or so back that Mother mentioned he had lost his hair and clipped off any that was left, and that it was coming back in curly. I’ve been told many times Dad and his brothers have curly hair but it’s never looked that way to me; anyway his hair is light white/gray, short, and soft. I touched it and rubbed his head, he just grinned.

Thinking about it I’m not sure he recognized me but he acted like I was someone familiar. It’s a sad day to see him look this way, to know he’s given it a great effort to this point and that this is what cancer has left. A broken man, one who has always been strong, strong-willed and hard-headed; a man who could take care of himself but is now faced with doctors and nurses to sustain him, drugs to improve him (and knock him down) and a family to love him when exhausted and under duress.

Love is everywhere but the eyes tell me a lot. This is not a battle which can be won, it only can be postponed. Concerns are now mounting as to whether the complications, pain & sickness of chemo are worse than the disease. The last 2 doses dad received where a new concoction in an effort to change up and find a more effective drug to assist in the fight against the lung cancer and the growth in his abdomen (it’s not known if this is cancer, doing a biopsy is not an option). So the idea is to administer chemo to fight both, along with a couple small-small ‘flakes’ that were spotted in his chest area (unidentified also).

After some chatting I unloaded my things, pressed some shirts for the week, hung-up my pants, positioned socks, etc… in a drawer and fell on a bed for about 4 hours of sleep.  After a shower I went out for some of my favorite hometown food, then came back to visit and for more sleep.

Later today Mother and I will be going out to the rehab center to do paperwork and get him admitted; I’ll update you if something happens, or later today when we’ve completed some things.

Headed-Home 6/12/11

My dad stayed in the hospital until May 27^th; things improved health-wise in relation to the cellulites and he was discharged. But over the past couple weeks his strength and coordination have not improved; he does not sit-up in the bed, can’t lift his legs very well, and from what I understand part of the issue is that he seems to have a cloudy cognitive status. He is not cooperating with the family when they try to help him and when they have their back turned or doing something in the next room he tries to get out of bed without assistance though it’s been explained many times that he can be hurt.  He will be admitted to a rehab center in the next day or so.

So, I’m headed out now and will travel to see him. It is a long drive, about 12 hours which means I will probably arrive sometime in the early morning; I definitely will be drinking some coffee during my travel. I just packed-up and loaded the car, fueled-up and had lunch. If anything happens while driving I will post from my mobile.

Once I arrive in the morning my plan is to evaluate the situation and post before I fall asleep.