Sunday, January 27, 2008

Memorial Service Plans

Tom and I met with the funeral director this morning and we agreed to have a memorial service on Thursday evening. We'll plan to gather at 6:00 PM with a service to be held at 7:00 PM at Grandstrand Funeral Home in Lindstrom. After the service everyone is invited to gather at our home in Center City. We'll have some food and an opportunity to visit further.

Sunday, January 28, 2008

Mother passed on last night about 9:00 PM. For the last two days she had been sleeping almost constantly. On Friday if you spoke to her, her eyes would open and there seemed to be recognition. On Saturday, not so much. We had family with her almost constantly. Tom and Sandy were with her when she passed. They said her breathing became more shallow and then it just stopped. She didn't seem to have been uncomfortable at any time in the last couple of days. She didn't have much pain medication on Saturday at all. It seemed to be a peaceful time. We spoke to her and expected that at some level she knew we were there. We held her hand and tried to assure she wasn't alone.

Arrangements have not been made, of course, but we expect to have a memorial service at Grandstrand Funeral Home in Lindstrom later this week. We'll be posting the details as soon as we've met with the funeral director. We're expecting a small gathering with a short service followed by a gathering at our home.

Thanks to all of you for your thoughts and prayers!

Thursday, January 24, 2008

Thursday 24th 10:30pm

This is Tom from Alaska Sandy & I got to Minnesota about 2 pm this afternoon and got to Parmely where Mom is about 4:30. They had just medicated her and I am not sure she knew who I was. Before too long she complained quite clearly that her feet hurt and her socks were cutting off her circulation to her feet. They tried to get her to eat a few bites of ice cream which she did and took a few sips of water at around 6pm. We left for a little while to move our stuff to Butch's house and then went back out and stayed till about 10pm. The nurse felt Mom was NOT comfortable around 9 pm, I agreed and she called the Hospice and got permission to increase her pain medication to the next level and to give her something for anxiety if it becomes needed. Her legs look good and her pulse was around 55 and body temp was normal. Blood oxygen levels were a little low but not too bad. When she sleeps she takes about 12 breathes a minute which seems slow and can be a little unerving when you watch her close. She hears everything and I presume understands most of what she hears. She has trouble verbalizing very much which is aggravated by mostly breathing through her mouth. She has fought a valient battle to live independently and can still sense her fight to keep going. Won't be weeks......... Days at best. More tomorrow. TOM

Wednesday, January 23, 2008

Wednesday, January 23, 2008

Mother had a sleepy day today. I was there from 6:00 to 7:30 hoping to see her wake up but she was tucked all snug in her bed and she slept straight through. They might have gotten her up and dressed her to go in to breakfast but I asked them to let her rest. Matt stopped out not long after I left and she slept through his visit, too.

At 1:00 PM I had an appointment with Fairview Hospice to get mother signed into Hospice. I’m not sure how much difference this will make but Hospice costs are all paid under Part A of Medicare which is better than payment under Medicare Part D. She’ll have an extra hospice nurse visiting her twice a week. After taking care of the paper work I stopped over to see how mom was doing. She had been up for lunch but by 1:30 she was sound asleep. I spoke to her and she woke up but clearly she wanted to get back to sleep. After work I stopped out again and found her in her wheelchair sitting in the dining room with a glass of milk in front of her. Her aid told me she had said she’d like a bratwurst and they were cooking one for her. I didn’t wait around to see how that went as I had to get home for supper. After supper Sue and I went out and by 7:00 they had her in pajamas and tucked in. She opened her eyes when I spoke to her and she recognized me right away. I asked her if she was thirsty and she drank a third of a cup of water or so. She seemed to go back to sleep the minute she closed her eyes so we sat on the couch opposite her bed and watched her sleep for about an hour.

Mother’s voice seemed shaky but she responded appropriately. It will be interesting to see if she’s more awake tomorrow, particularly because we expect Tom and Sandy to come in tomorrow afternoon.

Tuesday, January 22, 2008

Tueday, January 23, 2008

Last night after bedtime we got a call that Mom had tried to get out of bed on her own. She fell and they decided to move her to a recliner near the nurses station to sleep. I went out this morning at 6 AM and found her sleeping in a recliner in the day room next to the main nurse's station. She seemed very comfortable and soundly asleep. About a quarter to 7 there were a lot of folks in wheelchairs coming from their rooms and to the day room and watching TV. She woke up fairly alert. Gracie Carlson, an old acquaintance of mom and mine, came over in her wheelchair and they actually had a little conversation. I met her aid for the morning and they moved her to her wheel chair and went back to her room to get cleaned up and dressed for the day.

I stopped back about 1:00 pm and Mom was back in her bed sleeping soundly. They had a mattress on the floor beside her bed so that if she fell out she wouldn't hurt herself. We talked a little bit and she told me about the two guys from Milltown and their motorcycle. I suggested she might want to go back to sleep and see if she'd get a ride on that motorcycle.

The social worker at Parmly was supposed to call me when they were ready to sit down and get her signed into Hospice. The placed the call to my home phone so we got the message after they went home for the day. I'll call them first thing tomorrow.

Sue stopped out after work a little before 5 PM. She found mom's aid getting her ready to get in her wheel chair and go out to have supper in the dining room. Sue felt mother was very positive and mother actually commented that she thought this might work out. She also learned that mother had beem moved to a room right next to the nurses station so it will be easier for them to keep an eye on her.

I had a meeting tonight at church so Sue went back to be with Mom after supper. I was able to give Chrissie back to the folks who originally sold her to Tom as a gift for mother. before I left mom's house I turned down the heat and shut off the lights.

Sue came home after 9 having spent some time with Grandma and the Chaplain who had spent some time with her today. She was experiencing some back pain and had a pain pill before she went to bed. She said she was really tired and looking forward to sleep.

Monday, January 21, 2008

Monday, January 21, 2008

Mother had a pretty rocky night and morning. Angie and Jessie stayed over night and said she was awake off and on all night and started to get out of bed several times. When I got there, it wasn't long before she complained of an upset stomache. We had those symptoms through most of the morning. About 11 AM we got word from the hospital social worker that Parmly had a single room available for her and they would transport her there about 1:30PM.

She got moved without any hitches and she is now in Room 146 at the Parmly complex in Chisago City. I'll get more particulars and put it in my next blog.

I had hardly been in the office at all last week. Susan was off with MLK Day so she is sitting with Grandma and I'm at the office catching up on messages and Email. Mother seemed very tired and was sleeping when I left. We hope she'll adjust to the change well.

Sunday, January 20, 2008

Sunday, January 20th, 2008

Mother had a good day today. Jessica and Angie stayed with her overnight and I went out at 6:00 AM to relieve them. I guess she pretty much slept through the night but she woke up about 3 AM for 45 minutes or so and was very lucid. When I got there she was awake and when breakfast came she had about three bites of french toast and a third of a cup of coffee. She had some discomfort with her stomach again this morning but the nurses gave her a hot pad to put on her stomach and that did the trick. She rested comfortably the rest of the morning. She slept through lunch but woke up about 1:00 PM.

We heard that Brent and Lydia planned to come and visit so she had the nurses get her up into her chair. She spent the rest of the afternoon in her chair. There was plenty of company. Besides Lydia and Brent, Erik, Angie and Jessie, Susan came and Cyndi Weston stopped by. It was a lot for her and I know she’ll sleep well tonight.

With the MLK holiday tomorrow Angie and Jessie decided to spend the night with Grandma again. Erik has a class all week in Roseville so he caught a ride with Brent to the Hotel where the course is being held. Susan stayed with grandma while Jessie and Angie went out for some supper and I came home after a long day. Now I’ll watch the Packer Giants on my TV.

Tomorrow, we’ll find out when we’ll be transferring Mom and where she’ll be going.

Tom let us know that he’ll be flying down to get here the afternoon of Thursday the 24th.

Saturday, January 19, 2008

Saturday Afternoon

Ethel slept through lunch and all afternoon. Erik and I sat with our laptops while she slept peacefully. Apparently she had a pretty rough night with her upset stomach. About 5:30 the nurses came in and got her up out of bed and helped her sit in a chair to eat her supper. Erik and I decided to get our supper then, too. When we got back the nurse had gotten her to eat a little, but she was sure that she couldn't eat another mouthful. Winona's granddaughter Danielle and her son stopped by in the afternoon to visit. It was nice to see them but Ethel slept right through their visit.

Angie and Jessie got back from the girls trip to help Lydia look at wedding dressew while we were there saying good night. They had decided to spend the night with Grandma so she'll have somone with her overnight tonight.

Saturday Morning January 19th, 2008

At 7:00 AM this morning Mom was awake and uncomfortable. Her stomache was upset and she seemed to have stomach cramps. The nurses tried several things and finally they put a heated blanket on her stomach and she was able to sleep. When she woke up in an hour or so it was back to the same problem. finally about 10 they gave her a shot of morphene and she settled down and slept.

Now it's noon and her Doctor was just in to look her over. She reported that her kidney function improved again but that was dependent on continuing the IV. Longer term if she doesn't start taking food and liquids orally, the IV fluids will start accumulating in her tissues and she doesn't feel we should continue the IV beyond tomorrow.

I didn't hear from the Social Worker yesterday as to whether they had been able to get her a room at Parmly I'm sure she's off today. There are other facilities in St. Croix Falls, Forest Lake and North Branch but Parmly is the closest and probably the best. I'm pretty sure they will keep her here until we can find a bed but they probably won't wait for Parmly if all that is available is one of the others. We'll see Monday on that, I guess.

Erik, Angie and Jessica arrived late last night and they are here with me at the hospital. Erik was able to help me get on the hospitals guest wi-fi so I'm updating from mother's hospital room.
We're not much company for her since she's sound asleep but I feel that by being here in her room, we can alert the nurses if there's any change and see that she gets a drink or a treat if she wants anything.

She just woke up thirsty and we got her some cranberry juice. Now Jessi suggested that ERik and I could go get lunch and they'd stay. So I'll post this and do more later.

Friday, January 18, 2008

Friday, January 17, 2008

Today I went over to the hospital early. It seems like Mom has been getting up early and getting into trouble early the last couple of mornings so I thought I'd get there early. When I got there a little before 7 AM she was sleeping and the room was dark. I had hopes that the extra oxygen might help her confusion and difficulty in speaking but she really wasn't much better. She knew me right away and seemed to understand questions I asked but she didn't know where she was or why she was there. She was having some discomfort so I asked the nurse and she gave her a pain medication in her IV. They are administering a course of antibiotics and fluids by IV. She continues to get oxygen to ease her breathing. Her circulation seemed to be better but she wanted to stay bundled up in blankets. She gets cold really easy. The tell me that they've ordered a heated air mattress that will help keep her warm and cut down on any breakdown of her skin.

I sat with her all day. Helped her have a little oatmeal at breakfast and some chicken and mashed potatoes at lunch. She had about a half dozen Hershey's Kisses, her favorite as snacks, and took sips of water, juice and milk from time to time.

Her oncologist stopped in and basically gave us the same report we'd heard from the ER Doctor on Wednesday. The cancer had not advanced in her lung and liver. He did say that it is possible that it may have metasticised into her brain but he felt that was un likely. Given her declining health he didn't recommend continuing the medication that she'd been on and didn't feel a head CT would really serve any purpose.

Late in the afternoon her internist stopped by to discuss her condition. She did say that her kidney function had not eroded further but there was a concern that they couldn't continue the IV drip more than another day or so because that will start to contribute to her adema. There was a concern that her very limited oral intake of both food and liquids will stress her kidneys and consequently her heart.

I tried to get an idea how long Mom has but there's really no way to know. It seems pretty certain that if her oral intake doesn't increase she'd need a feeding tube and IV to keep her going and we don't plan to do that.

It sounds like she'll be spending the rest of the weekend in the hospital and we're hoping for a spot and Parmly on Monday. At that point she will be designated for Hospice and the hospice nurses will see that she has the medications necessary to keep her comfortable.

Late in the day her nurses got her a recliner and helped her move into the chair to sit for a while. She was pretty tired by that time, but she liked the chance to sit up and have a little supper. Mom is definitely best early in the day. About 5 PM I drove home. I stopped at mothers and checked on Chrissie. We're going to have to figure out what to do with her. She's got the house to herself right now. I picked Sue up and we went back to Wyoming and got some supper before stopping back to see how mom was doing. When we got there they had just gotten her out of her chair and tucked her into her bed for the night. She was so tired. We just wished her a good night and we went home to update her blog.

Erik, Angie and Jessie are coming down from Grand Forks tonight so they'll be here to see Mom tomorrow.

Mother's Condition - Thursday evening 1/17/08

Mother's condition has been deteriorating at a faster pace ever since Christmas. Most recently, in the last week she has reduced the amount she eats and drinks to almost nothing. She's been less able to walk un-aided. She's been confused and has gotten out of bed at night and got into trouble when she was by herself. After we found her half way down the cellar steps one morning we felt we needed to stay with her around the clock.
Wednesday, she was scheduled for a CT Scan to check the status of her cancer. We had to arrange for wheel chair transportation as she really didn't seem capable of getting in and out of a car. I had discussed the situation with her Home Care Nurse and she encouraged me to take Mom to see her Internist or to Urgent Care while I was there to have her looked at by a doctor for her overall condition. Her Doctor wasn't in so they took her to Urgent Care. They ran a battery of tests and reviewed the CT Scan. They found a broken rib (that had probably taken place in a fall just before Christmas) and a large new lung lesion that could have been pneumonia, some other type of infection, or a new malignancy. Her blood oxygen level was low and her adema (sp), swelling and fluid accumulation in her feet and lower legs, was bad. The Doctor told me that he would be admitting her to the hospital. I stayed with her until they got her situated in a regular hospital room. As I had been with her since 10 PM the previous night, at that point I went home got some supper and went to bed.
On Thursday I had appointments in the morning so I went in to work but I called and left a message for the admitting Doctor's nurse asking her to call me as soon as they had decided on a course of treatment. I didn't know if they might want to discharge her that day and I had to let home health care people know whether they needed to show up on Friday or not. When I hadn't heard anything at 3:00 PM, I drove up to the hospital.
When I got to her room, she had just returned from an ultrasound and they had a nurse sitting with her. She told me that mother had been very confused and had tried to get out of bed and pulled on her IV, etc. I had hoped that since they were giving her oxygen, her mind might have been clearer. Instead, shemom told me that they had been trying to murder her, and she wasn't kidding. It seemed to settle her down to have me there, she recognized me right away and when I explained the tubes and stuff was what I wanted and it was to make her feel better she seemed more comfotable.
Her doctor came in and basically told me that she certainly wouldn't be going home and would likely not live long enough to have to worry about moving to skilled care. Her circulation to her extremities was failing and her kidneys were shutting down. Her mind was definitely affected and we were talking days or hours, not weeks or months. I asked to see a social worker because I still felt I should be thinking about a nursing home option. (I know how tough mom is and figured they might underestimate her will to hang on.) They are talking to Parmly about a spot and she might be moved before the end of the weekend. I authorized them to move her to Hospice care. That would mean that the focus of care would switch to keeping her comfortable and it would reduce the hospitals normal poking and proding to get vitals every 3 hours, taking blood, etc.
After everybody left us alone I asked mom if there was anything I could get for her. She said "Chocolate" Her favorite for the last week or so has been Hershey's Kisses. She'll eat 3 or 4 one right after the other. I promised her I would go out and bring her some chocolate. I ran to the grocery store and brought her a couple of bags of candy then went home for supper.
Sue and I discussed the idea of mounting a vigil. Of course, we want family to be there when she passes and they say there's a chance of a lucid time before that happens. I plan to try to be with her as much as possible over the weekend. I went back last night and sat with her until 9:30 PM. The color in her face is good, she can speak and laugh a little but the words won't come to express what she wants to say. I feel like I can understand what she wants to say most of the time. She asks where she is, what will happen next, why is she there. She's not distressed and she dozes a lot.
I have no idea how long this may go on. She's not taking much nourishment and hasn't for several days. They are giving intravenous liquids and antibiotics. She has an oxygen tube under her nose. She can have visitors any time. She's in room 2209 and Fairview Lakes at Wyoming. The general Hospital number is 982-7000 if you want to check on her condition.

If you can, forward this to someone who should know, please do so.
Butch