Thursday, October 18, 2012

His last days

Little did I know that the "walk" I had with him on October 7, 2012, would be the last on this earth. On Wednesday, October 10, 2012, at 11:36pm, my beloved father passed from this earth to his eternal home.

On the evening of October 8, the nursing home called to tell me that after he had eaten his meal, he vomited and had loose bowels and then became unresponsive. His breathing rate also increased some, and his oxygen saturation went down. They had cleaned him up then put him in bed and put him on oxygen. My husband and I went with our daughter to go see him. I went in first, and when I spoke to him and told him who I was and rubbed his arms, he began to move around and I could tell by his body language and facial expression that he knew I was there, even though his eyes remained closed.

We stayed with him about an hour or so, and I held his hand and tried to make sure he was comfortable. My daughter held his hand briefly a couple of times as well. At that point I didn't know if this was a temporary or permanent downturn in his condition. His breathing wasn't that bad yet, just a little bit faster than normal. He wasn't taking food or drink, though, despite their best efforts, but again, I didn't know if it was only temporary. He would also move his hands to his stomach area from time to time and wince a little as if in some pain. A couple of times, he did try to open his eyes, as if to look at me, but was only able to do so for a few seconds before closing them again.

The physician's assistant came by and examined him and talked with us briefly, then said he would be back the next morning to check on him again. They said they would put him on some Tylenol for the pain. I had already called my brother, so he came as well. As soon as he came in the room and spoke to my dad, my dad began moving around and even tried to sit up, and his eyes opened slightly for a brief moment before they closed again. My brother told me later that after my husband, daughter and I had left, our dad had opened his eyes again briefly to try and look at him.

That night I had trouble sleeping, despite my best efforts to relax. Then next morning I went to see him again after dropping my daughter off at school. He seemed about the same, except he appeared to be in more pain, though his eyes remained closed. I spent a couple of hours with him, and spoke with the resident RN who was there at that time, as well as the physician's assistant when he came by again. We discussed what might be going on and what the next steps were. Their best guess what that he had an infection in his lungs, which the antibiotics he had been on had not helped. The physician's assistant talked about doing another chest x-ray. My dad had just finished a second round of antibiotics, which was a different type from the first one he had been on. We talked about trying another round. After giving it some thought and praying for wisdom, I felt it would be best not to, and the physician's assistant and RN agreed, as well as my step mom when they called her. Their thinking was the same as mine, that if two rounds of antibiotics had not helped, then why do a third round at this point and risk giving him nausea as a side effect. We also all agreed to go ahead and order a low dose of pain medication to be given every few hours.

After picking up my daughter from school that day, we went to visit my step mom in the Rehab Center. On the way back home, something was urging me to go back by and see my dad again, despite having my daughter with me and needing to get her home since it was a school night. I'm so glad now that I listened. When we got there, his breathing was markedly worse. Not only was he breathing much faster, he also had the sound of thick congestion in his lungs, which you could hear with every breath. The one positive thing is that the pain medication was helping, he was no longer wincing in pain. I stayed as long as I could, holding his hand and making sure he was comfortable.

Thinking it might help some, they suctioned him while I went out of the room with my daughter, then began trying to give him a breathing treatment. Giving him the breathing treatment was no easy task. Since he couldn't hold anything in his mouth, they had to put a mask on him so that he could breathe it in, but he clearly didn't want the mask, and began fighting to take it off. We tried, in vain, to stop him and convince him to leave it on. I was amazed at how strong he still was. Finally they had me hold the mask right in front of his face so that he would simply breathe it in naturally, which he allowed me to do. It didn't seem to help with his breathing or congestion, however, at least not that I could tell.

At one point I hugged him and told him that it was from (my step mom's name). I told him she would be there with him if she could, but that she was still in a Rehab Center, and that she was slowly getting better. As clear as day, his facial expression changed and he nodded in acknowledgement. Later I told my step mom about that moment, and my hope is that it helped ease the pain in some way of her not being able to be there in person.

I didn't want to leave that night, but I had to get my daughter home. I knew he had all the signs that it wouldn't be much longer, and was expecting them to call sometime during the night. I still held out hope, of course, that something would change and that he would suddenly get better again, but I also knew that it may simply be his time to go. My dad was upgraded to critical care status with Hospice, and a nurse was called in to sit with him overnight. That made me feel better to know that someone would be with him.

At about 11:40pm, the phone rang. I knew who it was. The hospice nurse said it was that it was peaceful, that he simply slowed down his breathing gradually, then stopped.

The Memorial Service in celebration of my father's life was held this past Monday. It was very nice. Five of my father's former employees spoke about him, and I was awed by their words. My father helped so many people and had a much greater effect on peoples' lives than I ever realized. I take comfort in the fact that my father's influence will continue to live on through many in this community and all over the country.

I also take comfort in knowing that he very likely at some point along the way returned to the faith he knew in his younger years as the son of a Baptist preacher--according to the book of John in the Holy Bible--and therefore is now in no more pain or suffering, but is in Heaven praising God, full of joy and peace, reunited with family and friends who preceded him and held the same belief, including someone very close to my heart - my precious mother.




Sunday, October 7, 2012

"Walking" hand in hand

Today my dad was having one of his better days. When I arrived, he was slumped over in his wheelchair sound asleep and it concerned me at first when he didn't respond to my touch, but then I hugged him from the side and spoke louder to him, rubbing his arm, and he woke up then.

It was only moments before he was ready to rock and roll, so off we went. Because of my foot being hurt and still swollen a bit, I wanted to sit with him at a table the whole time, so my daughter and I could sit down while visiting with him, so I directed him to a table that had a missing chair, rolled him up under it, and locked his wheelchair. About ten minutes went by with him growing more and more restless, though we did get to enjoy being with him during that time, but then I decided to let him roam, since it makes him happy. So I unlocked him and off we went again, and my daughter went to the counter at the nurses' station to play with a puzzle.

This time I decided to walk beside him and hold his hand as he rolled himself along with his feet, versus guiding him from behind. I could tell he really liked that. We walked to one end of his residence area, then he turned himself around and we walked to the other end, and back and forth again a couple of times. I could sense how relaxed and content he was.

At one point, a nurse was coming on shift who really likes my dad and she came over to say Hi to him while we were walking, but he didn't like that too much. It was comical watching him let her know with facial expression and body language alone that he was with his daughter and enjoying walking with her and wanted nothing to do with anything else.

Someone reading this might ask, "Are you sure your dad knows who you are? That you're even his daughter?" And my answer is, "Yes, I think he does." While we were still sitting at the table, there was a moment when his facial expression came alive, he looked right at me, then smiled and said, "Well Hello there." It wasn't a Hello you would give a stranger you had just met, or even just someone familiar. It was a Hello a father would give to a daughter. The same Hello he used to give me all the time before Alzheimer's even entered the picture.

I enjoyed walking with him, too. My foot hurt after that, but it was worth it. It was something I could do with him, since we can't have any kind of real conversation anymore. Funny how just being together can mean so much sometimes, no words required.

Saturday, October 6, 2012

Hospice

It's been a long time since my last post. I didn't really feel much like writing in my Blog for a period of time, but now I'm ready.

I'm not sure where to start, so I'll just start with the most recent happenings. My dad's ability to swallow has declined considerably, and he is now on a thick-liquid-only diet. He aspirates fluid on a regular basis now, and it goes into his lungs. Sometimes I find him not doing well, and can hear a gurgle when he tries to talk. Other times, I find him doing better, like the last visit on Friday morning when he was talking clearly, breathing fine, and VERY feisty. He was "running" all over the place in his wheelchair, going into other residents' rooms, on a mission of some sort.

A feeding tube was recommended for my dad, but in his Will, way back before he was even diagnosed with Alzheimer's, he specified that if his health ever declined to the point where a permanent feeding tube would be required, that he did not want one.

His doctor recommended that Hospice be brought in. They do that when they believe their patient is declining to the point that they feel they have less than a year to go. I was the one who had to meet with Hospice to discuss it, and thankfully my husband was there with me. It was harder than I thought it would be, but I got through it. The reason I was the one who had to do it versus my step mom is because something has happened to her as well, and she is now in a Rehab Center.

Let me explain. A few weeks ago, my healthy, very active step mom was meeting with some of the staff at my dad's nursing home to talk about my dad, and had a brain hemorrhage. Thankfully, there were nurses present. She said she was dizzy, then became weak and closed her eyes, and began vomiting. I was also in the nursing home that day, with my daughter, in visiting with my dad, with no clue whatsoever that my step mom was meeting with the staff in another part of the nursing home. They had tried to call me when it happened, but when my phone rang, I didn't recognize the number (that nursing home had never called me prior to that), so I let it go to voice mail. Something was telling me to answer it, but I didn't want to interrupt the time with my dad. I figured I would check the voice mail later. Then as I was leaving the nursing home with my daughter, we walked out the front door and saw the emergency vehicles parked at the entrance to the nursing home, idling, lights flashing, but no one inside the vehicles, so I figured they must already be inside. Something "checked" in my spirit and it made me pause, and I wondered who they were there for, and prayed that God would be with them and help them. Little did I know at the time that I was praying for my step mom.

When I got home, I still had not checked the voice mail. It wasn't until about an hour later that I remembered to check it. I could not believe what I was hearing. I called them back immediately and spoke with one of the nurses to get more details, then asked what time it had happened. It was then that I realized I was THERE when it was happening and was kicking myself swiftly in the rear. I found out what hospital they had taken her to and since my husband was about to get home, I waited for him and we all went to the emergency room. They didn't know yet what was wrong with her and were running tests. After finding out it was a brain hemorrhage and that it could go either way--get much worse, or stop bleeding--we prayed hard that it would stop, and were so thankful and relieved when the second CAT scan showed that the hemorrhage had stayed the same size and had not grown. She was transferred to another hospital, where she stayed for several days, and was then moved to a Rehab Center. Her recovery has been painstakingly slow... she is still having double vision and feels dizzy if she tries to sit up for too long... but we are continuing to pray and hoping for the best.

Sunday, August 12, 2012

Swollen hands and feet

Today when we went to visit my dad in the nursing home, I noticed that his hands and feet were really swollen. I talked to the nurse on duty (very nice, by the way), and she said they're doing some testing. They think he's having some circulation issues.

We arrived when he was eating dinner and the table was full with other residents, so we waited in the "living room" area. When he was done, he started "walking" while in his wheelchair with his feet, and was getting around pretty good. Except there are no wheels on the sides, so he couldn't steer, so we had to help him with that. He "walked" out of that area and into another area that led to a big hallway and stopped there. There was no-one around there, so I have to wonder if he purposely did that so he could have some time alone with his family. My daughter ran up and down the hallway, and every once in a while, he would look up slightly to look at her, but then put his head back down again.

He seems to have a cold, too, and was hunched over, so I'm guessing he's not feeling too great. He was only slightly responsive to us, and seemed to have trouble making eye contact. After only a few minutes, we looked over at him and suddenly realized he had fallen asleep, so we went and got the nurse, and she came and took him back.

Oh, and the nurse said he had been getting up out of his wheelchair and slowly walking, holding on to the wall railing, and they were following behind him making sure he didn't fall. I'm so thankful that he is still able to walk, even if only for short distances.

Forgive me for the non-interesting, rambling post tonight. It's late and I'm tired, but I wanted to give an update. I appreciate the continued prayers of anyone out there who's been following this. It is only by God's grace that I am able to handle seeing my Dad suffering the way he has been.

Monday, July 23, 2012

Visited my Dad at the new place and... Wow!

I'm impressed. VERY impressed. I had heard it was a nice place, but didn't want to get my hopes up like I did for the first place he was in, so I didn't set my expectations too high. I was pleasantly surprised! Comparing this new place to the place he was in before would be like comparing a brand new Cadillac to... umm... maybe the old rusty Malibu station wagon I owned many years ago that started itself back up after I turned the engine off? (Not to mention the clouds of smoke that billowed out the tail pipe.) ;-)

I wish I could exclaim how thrilled I was that someone else out there had the same dream as me to build a Cadillac-like Alzheimer's Facility/Nursing Home for the elderly who so deserve it, but... I'm afraid it is because this particular nursing home is for veterans. Still, I am thrilled for the veterans who are able to live in (or temporarily stay in) such a nice facility and also so deserve it.

We visited him on Sunday afternoon and as soon as we walked in the front doors, I had a very good feeling. After we signed in and walked further, I was liking it more and more. Very clean, no pungent smells, nice furnishings. Definitely not your typical nursing home.

We got to the section where my dad was after almost getting lost in the vast expanse of hallway surrounding an outdoor courtyard area so large you could barely see the other end of it, were let in by a very nice man (a doctor, maybe?) who punched in the code for us that opened the doors automatically (unlike the other place where we had to press a doorbell and wait for someone to come open the door for us).

As we approached the area where his room was, I spotted him in the communal "living room" area. And it really was like a living room, complete with a big flat screen TV and fireplace to use in the cooler months, with a "porch" area leading off of that. The chairs... oh my... EVERY chair was an easy chair and no ordinary easy chair at that. VERY comfortable. My dad was in a special kind of chair. Like an easy chair but different. It had two foot rests, and no handle on the side so that he couldn't put his feet down and try to get up when the nurses weren't looking. He could, however, be adjusted to where he could sit in a more upright position, but his feet were still up far enough to where he couldn't put them down on the floor. Plus (and I had to kind of laugh at this), on the back of his shirt there was a little clip with a line running to an alarm, so if he did figure out a way to get out of the chair, the alarm would go off (and it actually did at one point when he was adjusting his pillows and he accidentally knocked the clip off, so we know the alarm works very well). Genius.

I talked to a nurse while there and found out that he is receiving daily therapy now during the week! Once a day on weekdays, a physical therapist comes and gets him up and takes him for a walk (and has him do other exercises, too, I'm sure). I was so happy and relieved to hear that.

My daughter was so precious with him, and he responded well to her (and to us). He seemed in good spirits and overall doing pretty good. He drank some water while we were there, and ate pudding as well, all with no help at all (my daughter figured out that he was saying he was hungry, when neither my husband nor I could understand him, and she went and told the nurse and brought him the pudding, and then later the cup of water). We were talking with the nurse and I happened to mention that my daughter wanted to be a doctor, so the nurse showed her how to use the stethoscope to listen to my dad's heartbeat and stomach sounds. It was one of those rare times my daughter got very quiet. Her reaction was priceless.

My dad did say some words a few times that we could understand clearly, and responded appropriately to a couple of questions the nurse asked. The nurse said he was free of all infections now and was no longer on antibiotics. More good news.

I didn't even think to see what his room or the dining room looked like while we were there, we were so busy visiting with him in the "living room" area. I will have to make it a point to do that next time.

Thursday, July 19, 2012

Moved to a Nursing Home

Sorry it's been so long since I updated. Life has been busy, in a good way. I started a business, which is actually a fulfillment of one of my New Year's Resolutions/Goals, which was to--by the end of the year--come up with a plan to allow me to eventually make an income large enough to help me reach another ultimate goal of mine: To build one of the best Alzheimer's facilities in the world, and to have several around the country, God willing. I haven't worked out all the details of what I want the facilities to be like, but it is going to be really, really nice. I will not be interested in making a profit from it, only have it sustain itself, so prices for families will be very affordable and the employees will be paid well (and you better believe I will have high standards for the type of employees that work there). :-)

Then of course there are the more immediate financial needs of my daughter's upcoming school tuition and building her college fund, as she has aspirations to be a doctor, which may or may not hold when she gets older, but it doesn't hurt to be prepared just in case. On a side note, I asked her one day what her reason was for wanting to be a doctor (testing to see if it was a real desire, to be honest) and her response was: "Because I want to help sick people. And because God tells me to." Hey that's good enough for me.

Anyway, on to my dad's move. To make a long story short, he recovered well from the UTI, then got sick again and had to return to the E.R.; this time it was a stomach/intestinal infection, and he was put on another round of antibiotics, and began recovering from that. Somewhere in there he fell again/went to E.R./no concussion but had a nasty black eye/returned to ALH and recovered from that. My step mom determined at some point that enough was enough and my dad needed to be in a facility where he could have closer supervision and better care than what an ALH can provide, and began looking into Nursing Home facilities. She found a nice one, and though the cost is even more, she is cutting costs to bare bones in order to be able to do it. Bless her heart! Another reason for me to start a business. Once it gets off the ground, I will make sure she is well taken care of and doesn't lack for anything! She has sacrificed so much.

Back to my dad. He was moved to the new facility on Monday. Another plus: it's closer to where I live! So I will be able to see him more often. Not so good for my step mom, as it's much further from her, but she feels so good about the new facility and how well taken care of it seems he will be, that she is comfortable visiting him less often than when he was only five minutes away. There are nurses and doctors on staff there, and the nurses can see my dad in his room at all times from the nurses station.

The newest change in his medications seemed to do the trick this time. Since returning from his last hospital stay, he has been more lively, chatters away (though most of the time you can't understand what he's talking about), and can get up out of his wheelchair or bed and "tries" to walk. Oh and he is also able to use his arms and hands better now. He looks a lot less pale, too (though I'm afraid the paleness I was seeing before was because he was silently suffering from a UTI for at least four months!).

I haven't visited him in the nursing home yet, but have driven by there and it looks nice. I plan to try and visit him today while out delivering customer orders and running errands.

Sunday, June 24, 2012

A rough few days

My dad is back at the Assisted Living Home now and--after a rough few days--is doing better today. The first antibiotic they used for my dad's bladder infection while he was still in the hospital didn't help and the infection only got worse. Then they discovered that the bacteria that was causing it was E. Coli, and had to put him on a very strong, special-ordered antibiotic. They said they believe he had the infection for at least four months before it was detected. At least. Wow. I am amazed that it didn't get worse than it did and also that it didn't go into his kidneys.

Today my step mom told me on the phone that he was sitting up in a wheelchair today, chattering away, and once again, trying to get up out of his wheelchair. We have stayed away as a precaution since hearing about the E. Coli and the fact that the hospital had moved him to a private room and had a note on the door about wearing a mask, scrubs, and gloves upon entering his room. I didn't want to chance exposing my daughter to it, but I think the danger has passed now since he has been on the new antibiotic greater than 24 hours, so I'm planning to take my daughter to see him sometime tomorrow or Tuesday.

I give praise and thanks to such a wonderful Heavenly Father who has watched over my dad and held him in the palm of His hand.