I think I'm finally beginning to get it.
    Although my Ancient One, my mother is back home, and according to most appearances she seems to be "back", as well," she's back in a somewhat altered manner, a manner that probably began to take hold of her some months previous to her legs collapsing on the evening of 5/14/08. She wasn't coughing before, except during her cold, but, after the interview today with the Hospice Nurse who is substituting for the Hospice Nurse who has been assigned to us who is on vacation at the moment, pertinent aspects of her condition, now, and what I am convinced can legitimately be labeled her "decline" are apparent to me.
    She wasn't coughing before her hospital admission because she wasn't being provoked to cough. She is, now, with the breathing treatments, and she coughs a lot every day, especially after the breathing treatments. It's good, full phlegmy coughing...and, I realized, today, it isn't going to go away. Her lungs are not going to dry out, nor are they going to become stronger. Chances are, from what I'm understanding, if she'd had the breathing treatments before she may not have developed pneumonia. Then again...
    Anyway, what lead to my consideration of this was that the Hospice Nurse listened to her lungs today and mentioned, later when she and I were discussing Mom's coughing schedule, that, even though Mom had partaken of a breathing treatment about two and a half hours prior to the nurse listening to her lungs, Mom's lungs were fairly well blocked. There were other details, too, that dropped into place, like a discovery I've made over the last year which the nurse mentioned without me prompting her, that I usually dial up the oxygen when she sleeps to the same point it's at when she's moving around the house. I start her out at 3/lpm, then, about an hour or so later, when I'm sure she's asleep, I check in on her and something about her breathing always causes me to dial her up to 4/lpm. The nurse pretty much described what I've been observing and to what I've been responding.
    So, Mom's coughing will be a part of our life, now. This is definitely a decline...but, at least she's coughing, which is good.
    Mom took significant part in the interview. In some cases she described things I didn't think she'd noticed: The color of her sputum (when she doesn't swallow it); she also knew when she'd had her last bowel movement (yesterday). Today she wasn't sure where we lived, so the nurse prompted her. I mentioned that we spend a lot of time in Iowa, but I guess Mom wasn't even sure we were there, today.
    I learned that I can give my mother the Ipratroprium part of her breathing treatment three times a day, if necessary. I didn't know I had a choice...I'd just been doing it, anyway. I can also give her the Albuterol part for times a day if her breathing appears to be unusually labored. I learned, as well, that I don't need to give her the zinc, anymore. I wasn't sure why the rehab facility was giving it to her and never remembered to ask. It seems it is given to promote general "healing", but there isn't evidence for or against it's utility, so I'm not restarting it.
    I think I'll restart the Mom's Daily Tests & Meds area, although without as much of the explanation as I used to include. I think this is a good time to record her stats, again, as this may also help me describe decline, or lack thereof, to Hospice and keep me aware of what's going on with Mom, as well. I probably won't include what she eats unless it is significant in some way or explains stats I'm recording. I'll also be including her temperature, which I take regularly in the morning, now, before we head into the bathroom for bathing.
    Today, when I asked Mom is there was anything in particular she wanted to do, she immediately mentioned, "I haven't seen any good movies for a long time. I've missed that." This isn't completely true, as we've attempted to watch a few movies but I'm adjusting to her new movie viewing schedule, which doesn't seem to include her "mornings" anymore. So, today, we managed a full movie and it looks like we'll be doing that for awhile. I'm having a little trouble, at the moment, getting her outside, as I'd planned, because the weather isn't cooperating with her up times, but as soon as the monsoon is over (to which I, personally, am not looking forward), I'm sure we'll be getting outside, more. She is no longer hesitant to use assists, including the wheelchair, in public, which is a nice change. That, I suppose, could also be indicative of "decline", but I prefer to think of it as a necessary, long needed and very welcome adjustment.
    Think I'll head over to the Movement Journal. Nothing spectacular, just the detail, to report. Then, I've got to get to bed. I've got a couple of errands I need to run before Mom arises tomorrow, so I guess it'll be an alarm clock day.
    Later.
- posted by Gail Rae @ 01:45   email  this post