Decisions, Decisions

Curtis and I met with representatives of 2 hospice providers in Hawai'i; Hospice Hawai'i and Islands Hospice. They said essentially the same thing: hospice services are covered 100% and this is no matter where you live in the US. They will cover the hospital bed, oxygen, oxygen concentrator,  hospital tray, wheelchair, walker, and pain killers, for example. We were amazed to find out that since we have met with them, we can just call them to start the service and have equipment delivered within 3 to 4 hours. They also have registered nurses on call so that if there is an emergency a nurse comes to the house rather than us taking Mom to the ER. They can provide aides to help with bathing and a doctor comes once a week to do a check up. However, hospice will not cover transfusions since they are considered a treatment and not a part of comfort care. Nor will they provide physical therapy.


Home Health through Kaiser will provide physical therapy and Mom can continue transfusions, which gives her energy to do little things she enjoys like playing mahjong. Dr. Thalody said she will discharge Mom tomorrow about lunch time, so we will discuss the following options with Mom & Dad later in the day. (Mom wants Dad involved in the decision.)
Option 1 - Continue with transfusions & get physical therapy for weakness in legs, but when she has another major ER episode, start hospice service.
Option 2 - Go directly to in-home hospice care.
Option 3 - Go directly to hospice care in a facility.

One thing we discovered while talking to one of the hospice representatives was that it is likely Mom will need to go home with an oxygen tank. If so, the hospice service would provide the portable tank as well as the concentrator to be used at home. I talked with Ken, the Kaiser care coordinator assigned to Mom. Ken had Nurse Kimmy test Mom to see if she needed oxygen, she does. Ken said Kaiser will provide both to Mom for a 20% co-pay (which appears to be $6.88 for the portable tank, which was delivered this evening). When she transitions to hospice care it will be covered 100%; there does not need to be a change of equipment, just a change in paperwork. Ken made all the arrangements; the portable tank is already here, the concentrator will be delivered to the house tomorrow afternoon.

Oxygen meter reading at the start of the test; it went down to 89 within 5 minutes out of a 30 minute test period.

Curtis & I ate lunch at the Sunrise Cafe. Curtis had the Quesadilla with Shrimp and I had the Goan Chicken with Curried Cauliflower. Both were very good and we would order them again.

L to R: Goan Chicken with Curried Cauliflower & Quesadilla with Shrimp.

As we left the Sunrise Cafe I went over to the walkway window to look at the construction project that we were watching from Mom's other room a couple of weeks ago. We think that they removed the tree and built the concrete pad so that delivery trucks and other vendors can drive down the driveway then back up at the end to get to the delivery area. Previously they had to back down about 100 feet to get to the delivery area.

New concrete pad where one of the rainbow eucalyptus trees used to be.

If Mom's current room was on the other side of the Ewa wing, she would have a great view of the golf course. This is the view of the golf course from one of the windows at the end of the corridor.


Mom was hungrier tonight than she has been recently so I helped her order dinner. She had shoyu chicken with mashed potatoes & gravy, with apple crisp & strawberry gelatin for dessert and green tea. She ate about half of it. Here she is having dinner with her Mobile Warming heated vest on. (She says it is too tight when it is zipped up. It seems to help keep her warm most of the time even when it is open.)


I dropped by the ATC on my way up to Mom's room. I printed up the photos of the cats to see if any of them were the ones Kim & Rowena feed. Unfortunately both of them were off today. I will stop by again tomorrow.
   

Justine's birthday is a few days before David's birthday. While he was here, David was brainstorming ideas for making dessert sushi that looked like regular nigiri sushi. They had their belated birthday celebration on Saturday. He & Randi made the sushi with sweet rice, papaya, and mango. He also made cornbread cupcakes with salmon.

Randi adding the myofascia lines on the faux sashimi. (Photo by David)

The faux nigiri sushi. (Photo by David)

Two types of salmon cupcakes. (Photo by David)

Mom had a couple of surprise visitors this evening. Suzanne & Manu flew in this afternoon from the East coast! Manu is the kumu hula for Halau Ho'omau I ka Wai Ola O Hawai'i. Mom was very happy and very surprised to see them! (We knew they were coming. I told Mom a couple of weeks ago but did not tell her tonight when we got the text from them when they were on their way to the hospital.)

Happy Birthday to Eddie & Rachel!