Easier said than done…I’ve got concerns.
Judene and I have picked up our visiting schedule. Sam still feels that Katie requires two person assist—not only for transfers with the Hoyer lift, but also for repositioning and changing diapers and clothes. So we’ve been helping out when he goes to work.
And indeed, Katie is a handful when providing personal care.
Gloria gets frustrated when Katie cries out because of course she doesn’t want to hurt her. But really, it’s impossible not to. I stressed to Katie that she has made good strides (because she cries out much less often) but that she needs to continue to work on it. I stressed to Gloria that she needs to try to disregard the “OW OW OW’s.” She is, after all, doing the best she can do.
I asked Gloria if Katie was the most physically challenging client she has ever worked with. She replied that she had worked with another individual with like-disabilities, but that there was always someone in the home to help her with the heavy lifting. As I said previously, Sam needs the freedom to come and go without having to constantly make arrangements, and that the success of this plan rests on the caregiver’s ability to work independently. So at this point, I continue to:
It would be unrealistic to expect a move of such gargantuan portions to occur without challenges—and even chaos. “It’s really hard,” Sam stated when Judene and I visited again today. And yet, we observed real progress in the midst of the confusion.
First of all, Katie’s living area is in the middle of renovation—new laminate is being installed to facilitate use of the Hoyer lift and wheelchair. The bathroom has been gutted in preparation for converting the entire space into a shower room that includes a commode and pedestal sink. Also, ramps are being built outside to improve wheelchair accessibility. So it’s noisy and busy with the workers coming and going, but the end product will definitely enhance Sam and Gloria’s ability to provide Katie with the best of care.
Secondly, two weeks ago, Sam stated, “I can’t see Gloria being able to transfer Katie alone; it is a two-person job.” He has been arranging for neighbors to help on the evenings that he works. Today Sam was much more optimistic, and said that he would try transferring Katie solo tonight, and if that works, Gloria will try next. Of course they will be there to spot each other and make sure that Katie is safe.
Thirdly, Katie has a home health company that provides visits from a nurse, physical therapist, and occupational therapist. Those services will end soon because it has been determined that Katie does not have the potential to make significant strides toward being able to transfer (let alone walk). However, they have shown Sam and Gloria how to do stretching exercises with Katie to keep her extremities less locked. The exercises will be a part of her regular routine of care, especially since Gloria reports that Katie now cries out much less often.
Most significantly, Katie’s mental and emotional state has improved dramatically in a very short period of time—literally overnight. Through the act of bringing Katie home she has gained some sense of having control in her life. The result: Katie has dubbed herself “Captain Commando.” How great she feels to be at the wheel of her own ship.
- “There are always bumps in the transition road–we expect them,” the Provider said. “Give this about a week and Gloria, Sam and Katie will start to get into a routine.”
- First bump: In short, the home health agency did not show up on Tuesday, and will be unable to come until Sunday. This occurred because the nursing home did not send the orders until the day of Katie’s release; orders were incomplete; the staff was uncooperative in rectifying the problem.
- Second bump: The environmental modifications could not be provided until after Katie’s discharge. Katie’s living area is carpeted, which makes it very difficult to move the Hoyer lift and wheel chair. In addition, since Katie is dead weight in the bed, it takes two people to move and transfer Katie. The laminate floor will not be installed until after the New Year.
- Third bump: Sam is having difficulty visualizing that Gloria will be able to handle the heavy aspects of Katie’s care without assist. He points out that this has always been his biggest concern. The success of the plan rests on the caregiver’s ability to work independently. In the meantime, Sam will have to pitch in to help Gloria, or make arrangements to have the neighbors help.
Sam is embroiled in the middle of a very difficult situation. It’s hard for him to see the positives.
- First positive: The Provider is monitoring Gloria’s ability to handle Katie. They will make adjustments where needed and are confident that it will all work out.
- Second positive: The Provider reports—“ I cannot believe how alert and oriented Katie is—it blows me away. She is reminding Sam to do things! Sam went up to get some tape and came down and said, ‘I can’t remember what I went upstairs for.’ Katie replied, ‘Honey you went for tape.’ After Sam leaves the room, Katie says to me, ‘I think Sam needs to do some of my brain teaser exercises to stimulate his brain.’ Gloria, Katie and I cracked up. She laughs, she smiles—she is funny and right on point.”
- Third positive: Katie’s new mantra–