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!