Tuesday, March 20, 2018

The Go For Broke Spirit

Today Dad had his photo taken by Shane Sato, photographer behind The Go For Broke Spirit: Portraits of Courage. Shane probably took several hundred photos of Dad; I had almost 200 photos and I know I wasn't taking as many photos as he was. Shane is taking photos of more 442nd veterans to go into a second book, there is no guarantee that any of the photos that he took of Dad will be in the next book. One of Shane's challenges with Dad's photos will be to hide the wheelchair. We'll also be sending Shane some photos of Dad in the Army and some early family photos.
Getting Dad set up for the photo shoot; L to R: Shane, Susie, Dad, Jody, & Curtis.
Shane explains the process & his project to Dad.
Susie & Curtis putting the cap on Dad.
Shane starts the photo shoot; Dad with his Grumpy Cat look.
Shane setting Dad up for the next series of photos.
Susie helps Dad focus on where Shane wants him to be looking for the photo.

After the photo shoot.

The photos were taken in a conference room on the 1st floor; it appears that the 1st floor is the administration floor. This is the message board on the Human Resources door.

To get ready for the photos CNA Jose gave Dad a shave and dressed him in new clothes. He also moved Dad from the bed to the wheelchair; with the MaxiMove lift he can do it by himself.
CNA Jose giving Dad a shave.
CNA Jose hooking Dad up in the MaxiMove patient lift.
CNA Jose moving Dad to the wheelchair.

After the photo shoot with Shane, Dad had another PT session with Zhanna. Dad was stronger today than he was yesterday. He did more today and complained less about pain. After that he was very tired and dropped off to sleep without eating much of his lunch.
Physical Therapist Zhanna working with Dad to increase the strength in his legs.

Today is Tuesday! We went out to breakfast before going to get Dad ready for the photo shoot. Like at dinner, Big City Diner also has weekly breakfast specials; this is Week #3. Today both of us got Chef D's Breakfast Wrap with Homemade Salsa.Curtis had his with fruit instead of potatoes or rice; I had mine with Paniolo Potatoes.
Curtis' wrap.
My wrap with Paniolo Potatoes.

On the way in to Maunalani, we saw Popokilani! She was lying in the sun by the front door on the 3rd floor. She is very friendly and lets everyone pet her; I will have to keep cat treats in the bag I take to Maunalani.

Happy Birthday to Heather! Happy 19th Anniversary to Tom & Carrie! And Happy 15th Anniversary to Bev!

Monday, March 19, 2018

Dad's Physical Therapy

Curtis & I arrived at about the same time to give Dad moral support during his physical therapy today. Zhanna, whom we met on Friday evening, was his physical therapist again today; she spent a full hour with Dad today. He did better today than he has done on any of the other days!
Dad doing one of his PT exercises, reaching across with his left hand to his right knee.

We actually got there early enough to be there as lunch was being served. Nurse Gloria fed Dad as much as he wanted. Then she fed him a couple more spoonfuls; he still ate only about a tenth of what was served. It was a lot like feeding a picky toddler.
Nurse Gloria feeding Dad his Magic Cup.

I left Maunalani after PT was done since I was going to be back for dinner with Lynn after her ukulele session at 4. Shortly after I got back to Maunalani, Nurse Kriezl had another bunch of paperwork that I needed to fill out about Dad. Many of the questions were similar to previous questions that I had answered but asked for more detail; I'm not sure how someone with dementia would be able to answer these questions. By the time she was done I had missed all of Lynn's ukulele session. But Lynn, her friend Myra who was helping her, & I got together for dinner and had a great time eating with some of the World War II veterans; one of them is 100 years old!

During dinner, Nurse Kriezl came up and told me that Dad wanted to have his photo taken. Photographer Shane Sato is coming back to Maunalani tomorrow to take photos of more 442 veterans. He has taken photos of a few of the other residents who are 442 vets, two of them were incorporated in to his book, The Go For Broke Spirit: Portraits of Courage. Curtis & I will be going over early to deliver Dad's 442 shirt and Curtis will also give Dad a shave.

There's a cat that lives at Maunalani! She lives outside and is frequently seen on the 3rd floor lanai by the entrance; I actually saw her in the parking lot as I left. I am hoping to use her as an incentive to get Dad in to the wheelchair and outside. I will be keeping cat treats in the bag I take to Maunalani. (I am also going to see if I can take one of the cats to visit Dad. I have heard that other residents have had their small dogs come to visit them.)

Happy Birthday to George, Suzi, & Zach!

Sunday, March 18, 2018

Dad Is Settling In

When I arrived at Maunalani this morning Dad's bed was empty again. One of the CNAs said he was in the activity room. I think they must get everyone out of bed in the morning, which I think is good for Dad.

There was a Hawaiian music group performing in the Castle Living Room and about 45 or 50 residents watching them; nearly all in wheelchairs. I helped Dad get back to his room when it was done; his okole was getting sore and he also needed to use the bathroom. Dad decided to eat lunch in bed; which was probably a good plan since physical therapy was scheduled for right after lunch. Nurse Fred gave Dad his oxycodone and Tylenol about 30 minutes before his physical therapy was due to start.
CNA Sylvestre helping Dad with lunch.

After lunch physical therapist David came by and started Dad on his therapy for today. David started with having Dad sit up at the edge of the bed and try to keep himself upright in order to strengthen his core muscles. After that he had Dad do some exercises with his right leg, pushing against David's hands; the left leg will come later when the infection is more under control. Dad did much better with less complaints about pain than he has previously. When we have Dad in the wheelchair we will have him do a little exercise with his arms by rolling himself around a little. Currently Dad is scheduled for physical therapy every day except Saturday. We're not sure when his occupational therapy is scheduled for.
Dad and PT David working on the core strengthening exercises.

Today the nurse on day shift was Nurse Fred. Like Dad, Fred was born and raised on Kaua'i. Also like Dad, Fred likes fishing! They apparently had a great time this morning reminiscing about fishing on Kaua'i. Even though Nurse Fred is quite a bit younger than Dad, it's nice that he has someone he can talk to about things & places he knew in his childhood.

As I was leaving I noticed that some of the clouds passing by are below the facility. The others look like they are passing at rooftop level or just above. I'm guessing sometimes they have sunshine up at Maunalani when it's a little drizzly down in the valley.

Happy Birthday to Joe, Steve, & Kate!

Saturday, March 17, 2018

Dad's First Day

Last night Nurse Rio said it usually takes people 4 or 5 days to settle in to a move to a nursing home or rehab center. When we arrived today at Maunalani Nursing & Rehabilitation Center (MNRC or Maunalani) we walked in to Dad's room and found ... an empty bed! Which totally surprised us, we thought it would take forever to get him out of bed. It turns out, they changed Dad's regular mattress to a Prime-Aire air-filled mattress to make it more comfortable for him and minimize his chances of getting bedsores since he has been staying in bed so much over the last 2 weeks. In order to do so, they had to get him completely out of bed. They used a MaxiMove patient lift to get him out of bed and put him in sort of a wheeled bed; we found him in the Castle Living Room, which is basically the activities room. But he wasn't too happy about that. We convinced him to sit in the activities room and eat his lunch; Curtis & Brent sat with him while I went to another room with Nurse Daisy and answered more questions for Dad's treatment plans.
The controls for the air-filled therapy mattress.

After lunch, we explained to CNA Silvestre that the issue with Dad was if his legs were hanging it put a strain on his hips causing a lot of pain; he didn't need to be reclining all the time. We have found that if Dad's feet are supported there is less pain in his hips so he doesn't need to always be in a supine position. CNA Silveste and CNA Jose put Dad back in to a regular wheelchair for now; it put Dad in a lot of pain to do so. They are looking for a reclining wheelchair that has leg rests that can be raised and a back support that can be partially reclined.
Dad in the MaxiMove patient lift, being placed in a regular wheelchair.

Dad wanted to go from the wheeled bed straight back to the real bed. We convinced him to spend a little more time in the wheelchair so he could try the massage that would be starting in about 30 minutes. In the meanwhile, we sat outside on the lanai and enjoyed the view and the good weather.
L to R: Brent, Curtis, & Dad on the lanai, looking for a good photo op location.
Nice background! Bad portrait lighting.

It turns out the massage students from Kapi'olani Community College were only working on arms today; the announcement didn't say anything about that limitation. When I was in massage school they didn't send us out to work on the general public, especially medically fragile patients, until we had learned how to work with all the different body parts; I assumed this would be the same. Due to the PICC line in Dad's right arm and recent IV lines in his left arm it really wasn't a good idea for his arms to be massaged. I took Dad back to his room and CNA Silvestre & CNA Tawny moved him back to his bed. While Dad napped, I waited for Nurse Daisy to finalize the treatment plans for my signature.

I think Nurse Daisy and I covered everything we need for Dad's treatment plans at this time. We had to redo some of the paperwork that CNA Silvestre had filled out with Dad prior to our arrival yesterday; Dad's dementia prevented him from being able to appropriately respond to the questions. We covered pain management, daily medication schedules, personal hygiene, sleep management, nutrition & meal service, physical & occupational therapy, and activities. As Dad's ability to do things changes, we will adjust the treatment plans. One of the things that Maunalani helps with is making transportation arrangements when Dad needs to go to appointments. This afternoon Anna made all the arrangements for Dad to go to his follow-up appointment at Kaiser next week; I will be able to ride along in the transport van.

Happy Birthday to Walt, Dennis, Jed, Uncle Pat, Kerrie, Joani, Sally, & Ashton!

Friday, March 16, 2018

Dad Moves to Maunalani

This afternoon Dad left Kaiser Moanalua and went to Maunalani Nursing & Rehabilitation Center (MNRC or Maunalani). About an hour before he was due to be picked up, Nurse Christy gave Dad his oxycodone so that he would have less pain when he needed to be moved. Hospital Aide Emi cleaned Dad up and changed him out of his hospital gown and put him in his shorts & t-shirt.
Dad has been cleaned up and is watching TV while he waits for the transport van.

The hospital aides and Nurse Christy moved Dad to the gurney. And Aaron from ABC Transport Services loaded Dad up in to his van and took him to Maunalani. We followed and met Aaron at the 3rd floor entrance to MNRC.
Aaron loads Dad up on the transport van.

When we arrived at Maunalani, we signed in, got our ID badges, and headed to Dad's room that he is sharing with 2 other patients. Dad's room has a great view, unfortunately he doesn't have the window bed, though he is in the middle bed so he can see more of the view, than the fellow by the door.
Most of the windows look southerly towards Leahi, the other looks southwesterly towards Pearl Harbor.

After the aides and nurses got Dad settled in, I met with Kirsten from Admissions, gave her copies of the Provider Orders for Life-Sustaining Treatment (POLST), Advance Health-Care Directive, power of attorney paperwork, and signed all the admission paperwork. The previous night I had gotten on-line and looked at Maunalani's website; I found out they have a monthly newsletter and events calendar. The newsletter noted that there was a display of origami dolls throughout the month and a talk by the director of the State Office of Veterans' Services this afternoon so I went to look for those.
The display case the origami dolls are in was donated by the family of Dad's friend Walter & his wife Sally.
Ron speaks to the Veterans Club; Walter & Sally's daughter Lynn is at the far right.
Treats served at the Veterans Club meeting.

I spoke with Lynn after the meeting and told her we had moved Dad in about 3 hours earlier; she said she and her sister Lei had been wondering how Dad was doing. She went to his room a little later to visit with him; he remembered her! Lynn also comes to play ukulele for the residents on Mondays & Fridays; I'm going to try to get Dad out of bed for that. She also showed me around some of the facility on the 3rd floor. The dining room is on the 3rd floor; she showed me which table the 442nd veterans sit at, she said there is a space available for Dad. Lynn said to give her a call if we had any questions.
The view out the dining room windows; this looks out over Palolo Valley.

Later Anna came to take Dad's photo for their records. When anyone opens his electronic file, his photo pops up giving them another way to verify that they are treating the correct person.

After dinner Physical Therapist Zhanna came by to assess Dad's current physical ability. Because of the pain he is experienceing from the severe arthritis in his hip, she decided we need to have the nurses give Dad his pain medication about an hour before the physical therapy session to reduce his pain. He wasn't able to even get to the edge of the bed to sit up; she ended up just doing simple things, mainly passive range of motion and some active assisted range of motion while Dad lay in bed. The past 8 days of lying bed have really taken a toll on Dad's strength.
Zhanna doing assisted range of motion exercies with Dad.

I spoke with Nurse Rio about Dad's medications since I had not seen him getting any; she said for new patients that arrive in the afternoon, the medications arrive from the pharmacy about 8 pm. She said she would start the Ceftriaxone as soon as it arrived; she said the Oxycodone would also arrive at that time, in the meanwhile she is giving Dad Tylenol. Before I left she had me confirm all the other medications Dad is taking. On the way out I took a photo of Leahi from the patio area; they have great views from Maunalani! I hope Dad can get strong enough to get in to a wheelchair so that I can take him out to see the views.
#37 Leahi at twilight.

Happy Birthday to Kip!

Thursday, March 15, 2018

Happy Birthday, Chibi!

It's Chibi's 11th Birthday! In cat age conversion charts, Chibi is now about the equivalent of a 60-year old human; she goes to the vet next week for her twice yearly senior cat check-up. You can find other age conversion charts on the Internet, I prefer this one because it goes up to 25 years; two others that pop up on Google ended at 14 and 19 years, Shiro & Xander are already older than one of the charts and Shiro seems to be on track to live beyond the other. The chart linked above is for indoor cats, who live longer than outdoor cats. Living outdoors ages a cat more rapidly; for outdoor cats go to this chart.
Birthday Girl lounging in the cat run this evening.

When Physical Therapist Kevin came by today we did not give Dad a chance to say no; Nurse Christy had given him an oxycodone about half an hour earlier so his pain level would be under control. PT Kevin helped Dad get to the edge of the bed. Then he helped Dad get in to a chair next to the bed. PT Kevin asked me to keep Dad in the chair for an hour if he could handle it, then call Nurse Christy to have the Lift Team get him back in bed.
PT Kevin helping Dad get in to the chair.

Dad had been sitting in the chair for about 30 minutes when Occupational Therapist Rae-Ann came by. Since Dad was already sitting in the chair she worked with him, lifting his feet one at a time to put them in to a pair of practice shorts. He did very well even with the pain. OT Rae-Ann then worked with Dad to teach him how to get back in to bed; that was much more painful.
OT Rae-Ann helping Dad practice putting on shorts.

Before I left the hospital I got a return call from Nurse Charmaine who is the nurse for Dad's Tripler Army Medical Center doctor, Dr. Young. I explained Dad's situation and told her we needed to have VA approval for Dad to either go to an assisted living facility or to have in-home care if needed after he got out of rehab in order for the rehab center to allow him to enter the center. She said Dad needed to come in and see Dr. Young; I explained further that, even though we were so close by we could see Tripler right across the valley, Dad was unable to even get himself out of bed on his own to get to Tripler. She said she would talk to Dr. Young to figure out what to do. I told her I had heard it could take some time to get VA approval; she confirmed what I had been told. Auwe!

My travel cup is showing even more signs of a leak; there was tea seeping in to the space between the layers. When I got home I looked through the cabinets and found 3 other travel cups. One is a Jamba Juice cup, its got a closable lid and is insulated but is probably only good for cold drinks. One is insulated metal and while it has a lid it doesn't close completely, so it would spill if I knocked it over. The last is insulated plastic with a fully closable lid; this is the one I'll take with me tomorrow.

L to R: Jamba Juice cup, metal travel cup, & plastic travel cup with fully closable lid.

I did the morning shift with Dad since Curtis had a breakfast with his work buddies; after I left I got 2 calls from Kaiser. The first was from Nurse Jay from the Ambulatory Treatment Center (ATC; where Mom would go for her transfusions). I had actually talked to Nurse Jay yesterday when I ran in to her on one of my Fitbit walks around the floor; the ATC is on the same floor Dad is on. She was calling today to get my approval for them to insert a PIC line in Dad for the daily intravenous antibiotic treatments he will need for the next 6 weeks.

The 2nd call I got was from Home Health Coordinator Flo. She was able to get Dad a bed at Maunalani Nursing & Rehabilitation Center! (Not sure how she made this happen since I had not gotten VA approval today.) MNRC is the place that Dad asked me to check out a few years ago to see if he could get placed there. The plan is for Dad to be transported at 12:30 tomorrow from Kaiser to Maunalani. The short term plan is for Dad to stay there for the 6 weeks of IV antibiotic treatments as well as physical and occupational therapy. During that period they will make an assessment as to whether he can return home. The most important part of that will be how well he does in therapy.

This morning before I left for Kaiser, I checked on the flowers. Now I am sure the new shoot on Mom's last surviving orchid is a flower shoot. The flowers on Mom's last gift orchid are also still looking good.

There were so many photos yesterday, I held off on posting more Kaiser history photos. Now that Dad will be leaving, I am giving you the rest of the photos.

This is where Dad is right now. This is also where Mom got her transfusions.

I use this all the time to get Dad's lab results and e-mail his doctor; I did the same for Mom.

We really like this feature!
We really like this feature, too!

Happy Birthday also to Lisa! And Happy Ides of March!