Friday, March 31, 2017

Nearing Death Awareness

When they arrived, Aunty Florence & Tomiko gave Curtis & me a book called Final Gifts: Understanding the Special Awareness, Needs, & Communications of the Dying, by Maggie Callanan & Patricia Kelley. It's a book that they all read when Uncle Orv was in hospice care in 2015; it was very helpful for them so they shared it with us. I was reading a chapter each evening before bed, so I was not quite half way through reading it when Mom died; I finished reading it last night.

I knew some of what is in the book, other information was new to me. The authors call the events experienced by the loved one Nearing Death Awareness. I knew that people near death often see loved ones that have preceded them and frequently have conversations with them. I knew that often people near death hang on because they are afraid that the people they leave behind won't be able to handle things without them, sometimes they feel they have unfinished business. I also knew some of the signs that death is near, the labored breathing, the uneven pulse, the cooler limbs as the circulation changes, and the change in the urination pattern as the kidneys begin to shut down.

The most important thing I learned from the book was about how people near death communicate what they know about the timing of their coming death. For some people, it is really direct, for others it is more subtle, sometimes there is no indication; the book gives great examples to help you see what ways the message might be presented. If Mom gave us that information, we missed it.

In hind sight here's what we know. On Wednesday night, Mom peed every 20 to 25 minutes; her kidneys were beginning to shut down. By Friday night she was hardly producing any urine at all. On Wednesday night she recognized Kai and cooperated with him; the other nights she would not listen to him, she kept trying to get out of bed. Now I think she was trying to get out of bed to finish things she kept forgetting that she had taken care of. And I was not aware enough to brief Kai on what to say to her to calm her down. Which resulted in Kai waking me up in the middle of the night to talk to her; in my sleepy state I was still able to calm her down, but not thinking clearly enough to pass the info on to Kai for the next time. What I think was upsetting her was that she felt that she had not gotten all the house finances settled for Dad. I told her that she had "taken care of everything" and that Curtis & I would make sure Dad had nothing to worry about. When I reassured her that her investments were in the Trust and "everyone will be taken care of, everyone will be getting something,"  she calmed down & stopped trying to get out of bed.

On Thursday morning Mom was very tired but wouldn't go to sleep; in hindsight she was developing terminal agitation but I was not able to identify it at the time. By noon, when I was still unable to get her to sleep, I coordinated with Joey, the hospice nurse, and gave Mom haloperidol. Two hours later she was still agitated so I gave her lorazepam, which calmed her down and she went to sleep about 20 minutes later. I was thinking she was only tired, so my plan was to keep her on the haloperidol and lorazepam for 24 hours so she could get some rest. Some of the ladies from Mom's mahjong group were coming to visit Mom on Thursday morning. But she was so tired I called Sandy and asked her if they could postpone their visit until she was more rested. The next morning it became apparent that it was not fatigue but terminal agitation, so we decided to continue with the haloperidol and lorazepam to provide comfort for her.

The nice thing about the level of haloperidol and lorazepam we were giving her (0.5 mg each) is that it controlled the terminal agitation and, after she had some sleep, she was still able to interact with visitors. She had a bed bath on Friday and had a really good time with Yumiko, the CNA who gave her the bath. She was also able to interact with us very well.

At 4 am on Saturday morning, when I saw the color of Mom's urine when the catheter was inserted, I knew her kidneys were failing. I didn't know how much longer it would be but I texted Curt and told him she was getting worse; I also sent an e-mail out to family and friends alerting them. The next morning I called Aunty Judy, she had talked to me earlier on Friday and said she was going to stay away until the following week because she had a cold, I told her to come any way. I also called cousin Jane who does not do e-mail.

Curtis & Lori came to visit on Saturday morning after they were done meeting with their tax preparer. Aunty Judy also came to visit on Saturday morning; she & Mom had a great visit, talking about a lot of things. Curtis & Lori left right after lunch. Just before Aunty Judy left, Mom kept trying to tell us something. At first we thought she wanted to thank us for being there and what we have been doing for her. But after talking with Mom more, it turns out what she really wanted was for us to thank everyone that had done things for her; she made us promise to thank everyone that she had not been able to thank herself. After Aunty Judy left, I also told Mom that she didn't need to worry, everything was taken care of and it was OK for her to leave.

Later cousin Jane and her granddaughter DeeAnn came to visit. As usual, Mom and Jane had a lot of laughs! After they left, we let Mom take a nap while I got dinner ready. But she did not feel like eating, she just got up and talked with us when Curtis came back. While Curtis was here I took care of a bunch of household things, then took a shower. After my shower I went to relieve Curtis and sit with Mom; it was a little after 10 pm. Mom was sleeping quietly when I took over, Curtis said good bye, he would be back tomorrow morning, and left. I watched Mom for a little while, I checked her briefs and was going to change her but as I began to lower the head of the bed Mom's breathing began to change, her breathes becoming farther apart. I stopped and raised the bed back to the regular angle; her breathing got a little better. About 10 minutes later it changed significantly, becoming more labored; I asked Kai to call Curtis; it was 10:24 pm.

As I was holding her hand, I also checked for her carotid pulse but was having a difficult time due to the angle from where I was sitting, so I took her pulse at her wrist. Mom's breathing became even more labored, then stopped. Her pulse was very thready, then it also stopped. Kai was also unable to find a pulse.

As luck would have it, Lori had asked Curtis to pick up more of the Mepilex AG wound dressing at Longs for her mother who had fallen and skinned her knees the day before. He couldn't find it, so he was standing in the aisle trying to figure out what other thing he could get for her when Kai called. Curtis said he knew right away what the call was about. He got back immediately; if he hadn't needed to stop at Longs he would have been half way home and it would have taken him much longer to get back. But Mom still passed before he walked in the door. He couldn't find a pulse either.

Curtis then shared with us that while I was taking a shower, Mom looked over his shoulder and pointed at someone that she could see. She didn't say anything that he could understand. He felt that Mom waited until he left in order to die because she knew that I could handle being with her when she died better than he would be able to handle it. We all felt relief that she was no longer suffering.

Today I went to the Kapahulu Senior Center to let Cassandra, the director of the center, know about Mom and to thank her for all she had done for Mom. (Sandy from Mom's mahjong group had already told her.) I also dropped off some of Mom's magazines that we weren't going to keep. We had a great time sharing stories about Mom. Cassandra has been spreading the word at the senior center about Mom's service.

Over the last few days, besides calls, cards, & e-mails from friends & relatives, we also got calls of condolence from Joey the hospice RN, Yumiko the CNA who gave Mom the bed baths, Linda the social worker from Hospice Hawai'i, Diane one of the overnight caregivers from Ho'okele, and Mom's primary care physician Dr. Pham. I thanked all of them for her.

Today I found out that the leaky toilet is still leaking. But in a different place. It looks like I need to replace the incoming waterline. It's leaking a lot! At first I thought it was in the tank at the new piece I had just replaced but found that it is from the connection between the incoming line and the new piece. I think the kink in the line has put a bunch of stress on the connection and has caused the leak; it wasn't leaking when I first reattached it.

Happy Birthday to Steven & Peter!

Thursday, March 30, 2017

Honorable Discharge

I met with Ellen from Hosoi today. I took in the corrected obituary (they had Likelike instead of Liholiho), the signed Assignment of Preneed Funeral Plan for Mom to use the funeral plan, & Dad's discharge papers. I wasn't sure if I had found the right papers, but I did, so that was a relief. I also found a copy of an Honorable Discharge certificate.

I started cleaning up some of the area around Mom's chair in the family room. I forgot to take a real 'before' photo, the one below is an 'in progress' photo. It took me a little over an hour to sort through the pile of papers that Mom had on the little white table in the center foreground of this photo. The pile was about as large as the pile on the koa table behind the white table. One of Mom's parting messages on Saturday afternoon was to check all the pockets of her clothes and all envelopes and books before we got rid of them because she had money hidden in many of them. Auwe! It really slows down the process. I remember when Dad's father died, Mom was going through the towels in his room and $100 bills started falling out of them, she found several thousand dollars hidden in his room. Not sure how much Mom has stashed, but on one of the ER visits we found over $900 in her purse in 3 envelopes.

Late last night BJ e-mailed me a photo of a cat that looked like Momo. Unfortunately my phone was in the bedroom on the charger so I did not find out about it until a couple hours later. When I did check the phone the photo was so small I couldn't really tell if it really was Momo, but it looked close enough to him. I went to check tonight, it turns out it was Lefty the one-eyed cat, not Momo. (If you look closely at the photo you can see this cat has only a right eye. I met Lefty & his family back in January when I was handing out flyers about Momo.) I stopped in and talked to BJ and thanked her for continuing to look for Momo.
BJ with Lefty (photo by Kari).

Happy Birthday to Marisa & Delaney!

Wednesday, March 29, 2017

H & R Block

I took Dad to his appointment with Nancy from H & R Block today. It was originally scheduled for last Friday afternoon. Mom was too weak to go and Dad did not feel well enough to go; H & R Block rescheduled it to today. I let Nancy know that Mom had died on Saturday; she said I need to include a death certificate with the State return but not the Federal return. I guess the Feds will get their verification when Mom's social security number is retired. (Hosoi will be doing the paperwork for us for that.) Dad had to pay about $1660; Mom closed one of her accounts and had big capital gains to pay taxes on. I'm getting about $3400 back. I'm having my return electronically deposited, Nancy says that it will take about 3 weeks for my refund to show up in my account. Before I got home I had an e-mail saying that the IRS had accepted my return.

Dad appears to have dementia; he hasn't been officially diagnosed, but his behavior is that of a person with dementia. His dementia started about a year & a half ago but his rate of decline has been faster than Mom's rate of decline. Before Sarah & David came in February, and Kai just now, Dad said he didn't know who they were. I assured him that when he saw them he would know them; that's what we learned with Mom. If you just gave her a name she wouldn't know the person, but when she saw them she would know exactly who they were. Dad had no problem recognizing them once he saw them!

I have an appointment tomorrow with Ellen at Hosoi. She is the funeral director that we are working with on Mom's service. I think I found Dad's military paperwork that she needs to start the process to get Mom in to Punchbowl. I'll find out tomorrow if I got the right paperwork. If not, Dad & I will have to get in to the safe deposit box and check what is there.

Dad has said on numerous occasions that he is glad that Curtis and I are here to take care of things for him. He is relieved that we are taking care of the details for Mom's service, he said just let him know what he has to sign and when to show up. He has asked me to take care of going through all the mail and take care of whatever needs to be done. Unfortunately, neither Curtis nor I can sign checks on their account. We are looking in to starting another account with Dad's name and my name on the account. 

I am also starting on the photo collage for Mom's service. But first I had to copy all the photos on Mom's computer to a CD because Kai says it appears there is a virus on her computer. I've got a few more files to get off of her computer. Then I need to download the drivers for Mom's printer/scanner on to my laptop so that I can print from my laptop instead of having to use Mom's computer.

Happy Birthday to Ern Dog, Jim, & Leigh!

Tuesday, March 28, 2017

Signs of Change

Whenever I would take Mom to her transfusions or medical appointments or visiting friends or family, she would always ask if I left a note for Dad. So I made signs for the different things that we did. A lot of signs. Now I can retire some of them.
Signs to be retired.

I am keeping these signs and will probably be adding a couple others. I put the signs in a plastic page protector and leave them on the breakfast counter.
Current signs.

Since Kai is leaving tonight, Curtis took Kai and me to breakfast this morning. He has decided that he & I will go to breakfast every Tuesday morning so he can introduce me to the great breakfast places around the island. Dad rarely eats breakfast now, but I always make him a bowl of fruit & leave it in the refrigerator. If he gets up & thinks its morning he eats the fruit with his cottage cheese. If he's awake early enough on Tuesday we will take him to breakfast with us, if he wants to go; he rarely likes to leave the house any more. Today we went to the Highway Inn in Kaka'ako; the original one is in Waipahu.
Menu from Highway Inn in Kaka'ako.

Kai & I had the Smokn' Moco, a variation of the Loco Moco. It is made with meat smoked with lychee wood, bell peppers, onions, smoked aioli and eggs over rice. Kai had the full sized meal with fried rice; I had the mini size with brown rice. The moco comes with macaroni salad.
L: Smokin' Moco with fried rice; R: Mini Smokn' Moco with brown rice.

Today we were out of lettuce for salad so I harvested the biggest head of lettuce. Removing it will provide space for the remaining plants to grow. The lettuce plants in the planter to the right will be harvested next. Since these were from starts the plants are crowded together, I have been thinning them but they have not grown as fast as this direct-seeded lettuce. I plan on doing succession plantings of lettuce so that we have a continuous supply of homegrown lettuce.
The knife is 8 1/2" long.

Kai was having trouble with his charger. He asked to borrow one of mine, I gave him the Koppla charger that Suzanne brought as omiyage. It has 3 USB ports and worked well for him.

Happy Birthday to Lenny & Jon!

Monday, March 27, 2017

Some Things We Learned About Death & Dying

We have learned a lot about death & dying, but also about living. When Mom was initially given the diagnosis of acute myelocytic leukemia she chose not to do chemotherapy because she did not want to be sick from the treatment. She chose instead to only do transfusions of red blood cells & platelets as needed. The transfusions helped with her energy level so she could do the things she loved. Like going to Las Vegas. Twice!

Mom always said she wanted to die at home; she did not want to die in a hospital. So when Mom went in to hospice care, we set things up for her at home. One of the things that Hospice Hawai'i provided us with was a comfort kit; medications used specifically for palliative care. We were given instructions on how to use them, but also had a registered nurse assigned to Mom who would help with issues like this. We ended up using only 2 of the 7 medications that were provided.

Having Mom in hospice care at home made it easier for her to have visitors; they already knew where we lived and it was more comfortable for them at our house. (And usually the food is better!) I think she had more visitors at home than she would have had at the hospital.

A big thing for Mom was having the cats with her; she even asked me to sneak Xander in once when she saw a therapy dog making the rounds at the hospital. Although the hospice nurse preferred them out of her room, Mom refused to keep them out. Xander and Shiro were her nearly constant companions; Shiro would even stick around through part of Mom's bed bath! They gave her a lot of comfort.

This morning Curtis & I went to Hosoi Garden Mortuary to schedule Mom's service. Since both Mom & Dad have pre-purchased a plan it made it very easy for us. Almost everything is taken care of; our biggest decisions are which caterer to use and what kind of flowers to have. Hosoi will coordinate with Punchbowl for Mom's interment there. They will take care of closing her Social Security number. They will get the death certificates made for us. And they will coordinate both the lunch deliver as well as flower delivery.

Jane came by later in the day with food for us and any visitors that might drop in. She made things that would keep better getting moved in and out of the refrigerator.
L to R, from upper left corner: sweet rolls, fruit salad with li hing mui powder, chicken, noodles, broccoli salad, steak; center: rice.

Stat Medical came shortly after I got back and removed the hospital bed, over bed table, oxygen concentrator, bedside commode, suction device, big oxygen tank, 2 small oxygen tanks, & the walker. I vacuumed the floor again. And then steam mopped it. I was able to remove a bunch of dirt the accumulated at the edge of the old carpet (that we chucked).
Before steam mopping.
After steam mopping.

Happy Birthday to Christina & Andreas!

Sunday, March 26, 2017

The Cats Do Know!

Last night, as Mom was beginning to transition, Shiro was sleeping at her feet but Xander & Chibi were no where to be found. When Mom died, Shiro did nothing but sleep. So we thought there was nothing to the saying about animals knowing when people will die. About half an hour after the Hosoi Mortuary people took Mom out of the house, and just after I had gone in to my room to sleep, we heard Shiro calling for Mom. He was lying on the bed waiting for her; it's the same call that he uses when he is calling for Momo.

In hindsight, some of the things that we were seeing were signals that Mom was getting ready to transition. For example, the Wednesday night/Thursday morning period where Kai was helping Mom use the commode every 20 to 25 minutes was the sign that her kidneys were beginning to shut down. Then early Saturday morning, when the catheter was inserted the urine was a dark tea color, another sign of kidney failure. For the remainder of Saturday she produced hardly any urine and all that she did produce was dark colored.

I finally had time to fix the leaky toilet today. Twice. I did not do a good job the first time of making sure there was no debris under the base of the unit so it leaked. I took it apart again and cleaned it very well. It worked well the second time.

I picked up a Linda avocado from Kokua Market.  It starts out green and turns to purple as it ripens. The seed is not overly large either.

Now that Mom has passed,we have a really big job ahead of us. The last afternoon, Mom said not to throw any of her clothes out unless we have checked all the pockets (for money). Below is half of the closet space in my room. There are 5 more halves of closets that look similar to this photo.

Curtis, Lori, Brent, & Shaun brought dinner over tonight. Lori made meatloaf, pasta salad, and kalua pig with cabbage. Brent made fried rice and Shaun made pork larb. I made a tossed salad but forgot to take a photo.

Happy Birthday to Brian, Todd, & Jose!

Saturday, March 25, 2017

Mom Is at Peace

Mom passed away peacefully at 10:24 pm today.

Mom Is Declining

After Nurse Shawn left last night, Mom seemed to be doing okay, though she still would not listen to Kai. About midnight Kai had to ask me for help again as Mom wanted to leave the bed to use the commode. He even tried my strategies to keep her in bed to no avail. She kept insisting she needed to pee but was not able to. So I dipped her fingers into a cup of warm water and it worked! Unfortunately at 2 am it did not work. I called Hospice Hawai'i again and this time Dionne was on duty; he lives in Ewa Beach so it took a while for him to get here. By 4 am he had inserted a Foley catheter and drained about 200 ml of urine from Mom's bladder. It looked kind of dark to me, like the color of black tea.

The catheter helped relieve the strain on Mom's bladder but she still kept trying to remove it. Kai told her it was for "one of the machines" so she had to leave it in place. She became more feeble so trying to get out of bed or remove the catheter soon was not a problem.

In the early morning I called Curtis to let him know what was going on. He and Lori came over after they saw their tax preparer. Aunty Judy also came to visit; she had come down with a cold on Friday so was going to wait until Monday to visit, but we decided under the circumstances it was okay to visit with Mom today.

Later in the day Jane came to visit along with her granddaughter DeeAnn. When we were cleaning up after Jane had left on Wednesday, we found the 2 props for her "You Are My Sunshine" skit that she did for Mom. It was the sign saying 'Special' and a pair of lips.

Mom is experiencing terminal agitation. For her it has taken the form of pulling at her t-shirt, the briefs, the oxygen line, and the catheter line. We have decided to give her the haloperidol and lorazepam on a regular schedule to keep the agitation to a minimum.

Both Shiro and Xander have been spending a lot of time on the bed with Mom. Occasionally both take a break and lie in other places. One of Xander's places is under the cabinet in Mom's bedroom. I think it makes him feel safe when there is a lot of activity going on in the room.

In the middle of all this I got a pleasant surprise: a gift box from "work"! It surprised Curtis, who just retired, that my former co-workers were sending me a gift box since I left over a year ago. I explained to him that I send the Kona coffee that the Environmental Services Section uses for the annual March Against Hunger competition that the Snohomish County Public Works Department participates in to raise money for the local food bank. So far this year Java Junction has raised over $500. People line up for the Kona coffee!
I'm pretty sure the Samoas and most of the Trader Joe's items are from Stephanie! I wonder if the pens are from Doug?

Happy Birthday to Vivian, Glenn, and Jose!

Friday, March 24, 2017

Home-made Bed Alarm

Since Mom keeps trying to get out of bed, we decided we needed to get some sort of bed alarm like they have at the hospital. Because she was hooked up to all kinds of things while in the hospital, Mom's bed had an exit alarm. So if she started to leave the bed an alarm would go off, letting the nurses know they needed to come to her room as soon as possible to stop her. I decided to use one of Dad's fishing bells as a home-made bed alarm. I attached it to the bed rail that Mom uses to pull herself up on. The concept was great, the execution not so hot. The bell did not ring even when she had all her weight on the rail! I guess that's good, since that means it won't collapse under her massive 90 pound body!

Yumiko came by today to give Mom a bed bath. Mom really enjoys getting the bed baths now. Mom said she needed to use the commode so I got to watch Yumiko transfer Mom from the bed to the commode and back. I do a similar thing but since I am about the same height as Mom, I can't easily get her back up on the bed. Yumiko said this was probably the last time Mom would use the commode; she said Mom was not too stable sitting up on the commode.

We are not sure if Mom's instability while sitting was due to the haloperidol and lorazepam that I was giving Mom to get rid of her restlessness. But Mom was just about due for the next dose of both medications when Yumiko was here; she got them about 30 minutes after Yumiko left. We are tapering off so that she has none in her system by breakfast tomorrow; we'll see how rested she is and how much strength she has gained back after a good rest.

I asked Yumiko about the bed alarm. She passed the message on to Joey. Joey will arrange for a bed alarm for Mom, but delivery will be next week because I did not ask earlier in the week. Hopefully, the bed alarm will keep Mom in her bed!

Last night Kai stayed up to change Mom's briefs. But Mom would not listen to him, she kept trying to get out of bed and use the commode. So he would call me over the monitor so I could come and help him; I was very tired today. The first night Mom listened to Kai, she also recognized him as Kai. But last night she might have thought he was one of the Ho'okele caregivers, whom she does not like to listen to. Her reasoning is she is paying them, so they are supposed to do what she tells them to do. Tonight he will try starting each interaction with, "Hi, Grandma! It's Kai! Would you like your water?" (or whatever is going on).
Kai looking in on Mom to see if she needs help.

This evening Mom complained of being unable to urinate even though her bladder was full. With the briefs it was easy to see if she had gone. The answer was, No. Previously on the commode she would go and not know she had gone. This was new. I palpated her abdomen and found her bladder was full. For a whole hour she was unable to urinate so I called the Hospice Hawai'i on-call nurse line. Shawn showed up about an hour later; in the meanwhile, Mom had urinated but she also coughed up another chunk of very bloody phlegm. Shawn checked Mom out and found nothing wrong. He said the amount of urine she produced was good, her lungs had a little congestion, and if she started always coughing up very bloody phlegm that might be a problem. (Shawn is the RN that delivered the comfort kit when we first started Mom in hospice.)

David is coming on Sunday. He'll be here until Wednesday.

Happy Birthday to Ron!

Thursday, March 23, 2017

Props to Kai!

Last night Kai stayed up and watched Mom overnight, in place of one of the Ho'okele caregivers. He took the 9 pm to 7 am shift; I took a shower and went to sleep. (He agreed to do this while he is here since he stays up late anyway.) He said almost immediately after I went to bed Mom started getting up about every 20 to 25 minutes to use the bathroom; each time she peed in the commode so he was changing bags and relining the commode all night. Each time she would complain that she was unable to pee and her bladder was too full; each time there was at least a 1/2 cup of urine in the commode. Kai was exhausted by 6:45 am so he woke me up. He did an amazing job keeping up with Grandma!
The output from last night! The commode is lined with 2 bags and a couple sheets of newspaper to absorb urine.

Mom continued to use the commode every half hour or so after I took over. But each time she was weaker. The last time she was so weak she couldn't get back in to bed by herself and I had to lift her back in to bed. She kept saying how tired she was but refused to stop talking and close her eyes to get some rest. After about 2 hours of this I finally called Joey, the hospice nurse, to find out which of the comfort kit medications I could give her to get her to sleep. Joey said to give her a 0.5 mg haloperidol. I did, but 2 hours later Mom was still awake and saying she was tired. I called Joey again and gave Mom a 0.5 mg lorazepam; 20 minutes later she was sleeping peacefully.

I asked Joey about Mom being so weak she is unable to get to the bedside commode. Joey said to have Mom pee in her briefs. She had a couple suggestions on how to frame the conversation. It was a very frustrating conversation but I finally did get Mom to pee in the briefs, even though she kept complaining that she didn't pee. In fact, she also had a bowel movement in her briefs that she was unaware of.

While we were able to solve one problem by getting Mom to pee in the briefs, that created another problem, we only had 6 pairs of briefs. If she goes 3 times an hour tonight as she did last night, we would need 30 for Kai to make it through the night! I called Hospice Hawai'i and they sent hospice nurse Jackie over with more briefs; they said we could have her show us how to change the briefs.

It was enlightening. The first thing we learned from Jackie is that there is a "T" at both ends of the brief, the end with the sticky tabs is on the side that goes in the back. The gussets should be carefully straightened out. To turn Mom, we have to position her leg on the side we are going to roll her towards straight and move the other leg so her knee is bent; Mom's arms should be crossed over her chest. When she is on her side we slide the brief under her, positioning it so it will evenly cover her crotch. When she rolls on to her back, the front part is pulled up between her legs. She is then rolled to the other side and the back of the brief straightened out on that side. When she is on her back again the tabs can be attached, the lower tabs 1st, then the upper tabs; they should be at an angle to make them more form fitting. A helpful action we discovered is to raise the bed up to a comfortable height while we are working with her, rather than bending over to do all the positioning. Mahalo nui loa to Jackie!
Back of brief is at top of photo.

Tonight we will give Mom the 2nd dose of haloperidol around midnight so that she continues to rest well. We are hoping that the sleep will help recharge her so that she has more energy and strength and can stand and position herself on the commode without help. If she can do that we will return to the Depends which are much easier for her to pull up and down herself.

Aunty Florence and Tomiko left this morning about 10 am. Tomiko has a show to moderate this weekend in Arizona. Here's the photo Tomiko took last night of all of us in Mom's room. Kai is usually the tallest one in the group but he needed to scrunch down a little so that we could get more of Mom into the photo.
L to R, front row: Xander, Mom, Dad, & Tomiko; middle row: Aunty Florence, Lori, me, Brent; back row: Curtis, Kai. (Photo by Tomiko)

 Happy Birthday to Marian, Mike, & Sandy!

Wednesday, March 22, 2017

Another First

Tomiko helped Mom with more technology today. She linked Mom up to a Face Time call with Erica, Marc, & Mitchell. The screen was a lot smaller than the screen for yesterday's Skype call so she wasn't able to see as much. It was also a little harder to hear, so they went back to using the regular phone.
Mom talking with Erica, Mitchell, & Marc, while Tomiko assists and Xander watches

Jane brought lunch for everyone today. But Mom had stayed up too much yesterday so was very tired. We let her sleep a little longer but she was still too tired to join us for lunch. We were able to entice her to join us for dessert: blueberry pie made with fresh blueberries.
Clockwise from top left: rice, chicken, macaroni salad, shrimp wrapped in wonton, manju, steak, watermelon, watercress & tofu salad, rolls, spam musubi.
L to R: Jane Curtis, Kai, Tomiko, & Aunty Florence.
L to R: Mom, Aunty Florence, Tomiko with blueberry pie, Jane, & Kai.

Jane had also prepared a little song and skit for Mom, sung to the tune of "You Are My Sunshine."
Mom & Jane.

Joey, the RN from Hospice Hawai'i, came during lunch (which was later than normal) to check in on Mom. She took Mom's vital signs, checked out her left hand, and asked her a bunch of questions. She talked to me later. Joey was pleased that the swelling in Mom's left hand was gone. She said Mom's oxygen level has gone up to 94%. She asked about the Mepilex Ag wound dressings that I had used; I write the date on each one so I know how long it has been on her. She was glad that I was treating every wound judiciously so that infections were minimized even for small pin pricks.

Later Brent came over for dinner, we mainly cleaned up the leftovers from lunch. Of course, we had dessert again.
L to R: Dad, Aunty Florence, Kai, & Brent.

Tomiko showed us the handkerchief that Dacre made for a demonstration on screen printing.

Happy Birthday to Kirk!

Tuesday, March 21, 2017

Lots of Firsts Today

Mom learned how to skype today. Tomiko set it up for her to skype with Karen and the girls. At first she was touching the screen but later learned she didn't need to do that. She also learned where to look to see what they were seeing of her. Shiro got in to the act for a short look but was quickly bored and went to sleep.
L to R: Karen, Ursula, Justine, Shiro, & Mom.

Mom also got her first massage today. Albert from Hospice Hawai'i came by in the early afternoon. He started with her feet, then did calves (which used to cramp a lot), and also did her hands. She said she would like him to come back again, so he is now scheduled to see her every Tuesday around 12:30 pm.

With everything going on, we kept Mom up for a lot of the morning. In fact, she did not get to take a nap until about 4 pm and was back up at 6 pm for the Skype session, then dinner and dessert. She did not get back to her bed until Denise (the overnight caregiver from Ho'okele) showed up at 9 pm. It will be interesting to see if she sleeps better this evening.

I ran a bunch of errands in the morning. One of the things I wanted to do was find a better fan for Mom's room; one that had the controls on the front of the fan and that oscillated. Right now she has a box fan which has the controls on the back of the fan. I found a 12" desk fan at City Mill that met all the requirements and it was only $20! I will be getting 2 more, one for the guest room and one to replace the fan in my room that has issues. (You need to spin the blades to get it to start up, kind of like jump starting a car.)
Xander ponders how to assemble the fan without opposable thumbs.

We have been having a lot of problem with ants. It appears that they are coming in looking for water, especially since they ignored the tasty old pork rinds! The toilet by the guest room was running so I took the cover off to check out what the problem was and was confronted with a mass of ants; they looked like a herd of zebras at the watering hole! I went to check out the main bathroom and found a similar situation, though not quite as many ants.
Ants in the main bathroom, scurrying for cover.

Kai arrived tonight at about 11 pm. He will be helping to take care of Grandma on the night shift beginning tomorrow evening. Since he stays up most of the night anyway, we thought it was a good use of his energy.

When Aunty Florence arrived, she had brought a bag of Seattle's Best coffee. Unfortunately she brought a bag of whole beans and Mom does not have a coffee grinder. So I went to Kokua Market early yesterday morning to use their grinder at the bulk coffee area.
It was a good thing they had pictographs to tell me what grind to use!

I returned to find Aunty Florence and Tomiko talking story with Mom. They continued after breakfast, while sipping their coffee.
L to R: Mom, Sunty Florence, & Tomiko.

Last night one of the errands Tomiko did was to go to Longs Drugs and print some photos that she had taken at Mom's 90th birthday party in Las Vegas. I added captions of who was in the photos and put them in to plastic sleeves in a 3-ring binder for Mom. She really liked that.
Some of the photos before captions were added.

While they were out running errands, Aunty Florence and Tomiko decided to replace Mom's old dish rack, which was rusting away.

I ended up having to also scrub the calcium deposits off the sink. After I began cleaning things up around the dish rack I couldn't just leave the calcium build up.

Before she went to bed, Tomiko gave Mom a big good night hug. Those cats! Nothing seems to phase them!
Xander tolerates Tomiko's hugs.

I almost forgot to mention that I got an e-mail just before midnight on Sunday. Sara's brother saw an orange cat that they think is Momo at about 11:30 that night. I talked to Sara on Monday; she said about a month ago the cat hung around for about a week, mainly late at night. I told her to give me a call no matter what time they see the orange cat and I will come over and see if it is Momo. So far, no call.

Happy Birthday to Tom, Laura, Pedro, & Jeannine! Happy Belated Birthday to Heather! Happy Belated 18th Anniversary to Tom & Carrie!

Sunday, March 19, 2017

What's in the Garden?

I checked out the automatic timer I put on the back yard faucet. The timer was working well, but the faucet itself has a leak right at the handle. I looked it up on Google, it will take a bit of work to stop the leak; I might call someone to fix it, but I think I will test out all the other faucets before I do that. I want to set up an automatic system for the back yard since that is where the garden is. I want to make sure the lettuce and papayas, as well as the orange tree, get regular watering. The lettuce is looking really good.
Lettuce in the left hand planter are from seed, planted at different times; the right hand ones are from starts.

Brent & Shaun came by to visit with Mom about lunch time. I was really surprised that Mom remembered that Shaun is the one who washes her hair, especially since we have only been able to do it twice. We were also going to have him trim her hair but she was in the hospital the week that was supposed to have happened. Shaun must have made a good impression on Mom! Brent & Shaun will be making dinner for us next Sunday when Kai & David are here.

Aunty Florence and Tomiko arrived around 2 pm. They brought some food and were very hungry so we had an early dinner, about 4 pm, which was 7 pm for them. Mom actually ate more than she has been, which is good. As we were in the middle of dinner, Curtis, Lori, & Lori's parents dropped in. As always, Lori had presents for the visitors! (Plus one for Kai who will be arriving on Tuesday.)

Mom really enjoyed having all the visitors here. As I was wheeling her back to her room she asked me why I was doing that. I told her because she was in the way of cleaning everything up (which she was). I also told her I could tell that she was tired and needed a rest. As I was helping her in to the bed she agreed that she was tired but also said she would be back out later. Then she fell asleep. She was still sleeping an hour later when Aunty Florence & Tomiko went out to run a couple of errands. She asked me later why she was so tired; she keeps forgetting that she has leukemia.

There was just so much going on and so many people today, I forgot to take photos.

Happy Birthday to Melvin, Suzi, George, & Zach! Happy Certified Nurses Day, Chocolate Caramel Day, Let's Laugh Day, and Poultry Day!

Saturday, March 18, 2017

Garden Volunteer

While I was cleaning up after breakfast I found a little plant growing out of the scrubber that Mom has in a holder on the edge of the sink. It appears to be a volunteer tomato seedling. I carefully removed it from the scrubber and put it in a cup with a wet paper towel as a growing substrate.
The wayward seedling.
Temporary new home.

Curtis & Lori came by with Brent for lunch today. Their neighbor Anita met them here. It was great to have people come over to help eat the leftovers, though they did bring a little food; a couple Polish hotdogs, a slice of pizza, & a wrap. I forgot to take a photo so you'll have to take my word for it that they did not bring a lot of food. We wheeled Mom out to join everyone for lunch; she ate a little. After lunch Anita prayed with Mom.

After lunch I organized the bathroom closet where Mom keeps the towels. Since Mom seems to have resigned herself to getting a bed bath, I will have Yumiko come by 3 times a week to give her one. If the closet is organized she can help herself to towels whenever she is here. (As I write this I realize that Mom has towels in another closet. I will have to move those to the bathroom closet now that there is more room there.)

I also did laundry today, most of it was Mom's stuff. I used 3 of the Skubb boxes from Suzanne to help organize the shelf that I am keeping her clothes on for the caregivers. I think keeping her clothes on the open shelf in the room she is in will be easier than having them go in to the bedroom (where Dad is sleeping) to get things out of her dresser.
The TV was on this shelf before we moved it to the cart so we could reposition it so Mom could see it easily.

Tonight Mom had a couple of difficulties. At 7 pm, when she tried to go to the bathroom, her legs were very weak. She ended up using the bedside commode because she was unable to get her legs to move fast enough to get there in time. She stayed up and watched TV. Then at 8:30 pm, as she was on the way to the bathroom (walking better this time) she asked where she was, she thought she was somewhere else. When I told her she was at home she was surprised and said no wonder I was there and it looked like home! On the bright side, she did not see ants covering the wall last night. (We are not sure whether she was dreaming or hallucinating when she saw the ants. And, no, there were no real ants in her room. I am pretty vigilant about cleaning up after she eats.)

Those cats! They're so funny! Here's Xander looking like he got run over by the wheelchair.

And here's Shiro not caring that he gets covered up as I straighten the bed out for Mom and get it ready for her to easily get back in to it.

FYI - There are still no ants on the old pork rind. Perhaps I did too good a job disrupting their trails to the counter. Normally that would be a good thing, but now that I want to see what they think of stale pork rinds it makes it inconvenient to have to go and find a bunch of ants some where.

Happy Birthday to Patricia, Chris, Steve, & Kate! Happy Awkward Moments Day, Biodiesel Day, Lacy Oatmeal Cookie Day, Sloppy Joe Day, Supreme Sacrifice Day, Quilting Day, & Corn Dog Day!