Hospice Hawai'i Assessment

This morning we met with Joey, the Hospice Hawai'i Registered Nurse, assigned to Mom. She was accompanied by Linda, the Hospice Hawai'i Social Worker, assigned to Mom. As we started the assessment, Mom called me to help her go to the bathroom. After I got her back to the bed she was having problems breathing, I asked Joey to come in. Joey showed us how to arrange the bed so that Mom could breathe easier and not slide down. Joey also had us set up a fan in the room and suggested to Mom that she needed to use the bedside commode rather than walking to the bathroom. Earlier on the phone I had a long discussion with Joey regarding things we were told by Lucy about the physical therapy & transfusions that could be available to Mom, if she qualified for it. Joey was very negative about both. As it turned out, Mom is much weaker today than she was on Friday; she would not be able to handle physical therapy. She was also much more dehydrated, so transfusions would be much more difficult and probably not have the desired result. Before she left, Joey told us about the stages of dying; she also gave us the booklet "Gone From My Sight." She said, in terms of timing, the rule of thumb is, if changes are taking place on the order of weeks, then the end is in weeks. If changes are on the order of days, then the end is in days. If the changes are on the order of minutes, then the end is in minutes. But she also said everyone is different.


Joey also went through all the medications that were delivered late Saturday night. It is what Hospice Hawai'i calls the 'comfort kit'. It contains 7 medications for pain, fever, secretions, nausea & vomiting, shortness of breath, anxiety, constipation, and terminal agitation. Three of them are suppositories so that they can be administered even if the patient cannot swallow or keep anything down; the rest are sublingual. The medications are acephen suppository, bisacodyl suppository, haloperidol, hyoscyamine, lorazepam, morphine sulfate, and perchlorperazine suppository. (The suppositories are kept in the refrigerator so that they don't melt in the Hawai'i heat and become unusable.)

The Comfort Kit

Xander likes the new bed; it makes a nice dip for his okole as well as Mom's okole. In fact, the bed configuration that Joey told us about is seen below. Mom can relax and breath comfortably and she is not constantly sliding down because there is a puka for her okole.


Later in the evening cousins Baron and Mona came by to visit. They are Dad's sister's children.

L to R: Mom, Mona, & Baron.

Baron and Mona also brought chili and mini-cinnamon rolls that Baron had made that day. The chili was made with chorizo. Guess what we had for dinner!

The missing cinnamon roll is for Mom.

Happy Coconut Torte Day, Earmuff Day, Good Samaritan Day, Jewel Day, K9 Veterans Day, Open an Umbrella Indoors Day, and Napping Day.