Today Mike arrived home and got out of the car.He got dizzy and began to stagger.Ivan recognized what was happening and positioned the car so Dad could lean on it.Dad still fell, but apparently not an outright collapse.He bruised his knuckles.
I spoke with him later and he seemed to be okay.Ivan got in touch with us immediately to let us know.Unfortunately, Ivan thought Dad might have some hand pain and he gave Dad an aspirin.I have since informed Ivan that Dad can NEVER have aspirin – because he takes blood thinners.Ivan cannot give Dad anything that even vaguely is medicine without direct instructions.I had him tell Maria, and she thinks that he is fine.We will be having a further and definitive conversation with Ivan about this.
Upon arriving home and learning of this Mom called me.Fairly agitated and very concerned she wanted a doctor called immediately because “he fell and he is forgetting everything.”I “talked Mom down” and explained the reality – that Dr Rappaport told us that dizziness was part of Dad’s disease.That there would be moments of this.That his increasing forgetfulness is what his disease is all about.We talked about the fact that Dad’s disease is a one way street…that he wasn’t suddenly going to get better.That it wasn’t suddenly going to stop.That he seemed to have limited periods where he appears to have plateaued but in short order he takes another step down.I reminded Mom that we have people all around them.That we are aware, engaged, and watching.She accepted all of that.But I suspect it must be just awful for Mom to watch this.As I have said before, we will all need to be sensitive to the fact that Mom is on the front lines of this battle 24/7.We take breaks from Dad.But she spends more time with him than anyone.It must be very hard for her.
Jan 4
Mike wound up in the ER. Some of this after-the-fact recap takes into consideration things that we learned and summised.
After breakfast and a brief stay at his desk he got up and went to the bathroom. On his way back apparently his heart rate dropped out, and he passed out. On his way to the floow he hit his head, face and chest on the coffee tablehad brkfst went into study. He doesn't remember passing out or even falling. Emt read 40 heart rate and transported to er. Said it shot ip to 120 for a few seconds but then back to 40. Said mike was very lethargic.
He cut his head requiring stitches above his eyebrow, and cut up his face. Big black eye. And broke a rib.
Er doc is Loffredo
12-11-09
Tonight he went home was was very "disturbed." Issues and thoughts tumbling out. Only semi-connected. Only partially formed. Burdened. Comments like, "very troubling," "can't disregard it," "it's there," "I need to reconstruct my existence."
11-11-09
I spoke with Dad this morning and he did not sound well and said he didn't feel well. When asked what was wrong he said he didn't know. I suggested that he go back to bed, which he did. After he woke up he felt better. Not 100% but better.
Later in the day he once again wasn't feeling well, and once again laid down. Again after he awoke he indicated he felt much better.
I spoke with Dr Bush today. He will be going out of town but wants us to know that the entire office will cover him and we do not need to be concerned about that. he did say that often with Alzheimer's patients they begin having family appointments. Not only so that we can hear what he has to say (and not rely on Dad's memory after the appointment) but also so that he can hear what we have observed and are aware of.
As to Dad's diarrhea, if it continues he wants Dad on a five day course of Imodium 3x daily. He wasn't fully familiar yet with Dad's gastro history. He asked who his GI was, and I told him there had probably been several. He indicated that he knew this was Dad's m.o. but it wasn't going to work with him...he intends to outlast Dad on that score.
He said that if the diarrhea does continue thereafter that he should go to the last guy (Jim Sherman.) He mentioned that he really likes Ed Feldman, but said that it is always better to see one doctor twice than two doctors once.
11-10-09
After lunch (that included spinach and coffee) Dad had an urgent and explosive bout of diarrhea. He then went home not feeling well. There are notes in the message forum on this.
11-8-09
This is an update including several different elements from the last few days. The significant item seems to be an increasing number of incidents of dizziness/light-headedness. He informed Dr Stein of it, and then today while with Sharon and I, had several (3-4) incidents where he either had to sit down, stand against a wall, or just stop moving. We had previously heard from Dr Rapaport about this being symptomatic. I am forwarding all of the infor to Dr Rapaport.
11-1-09
We've had a medicine problem. Despite having taken medicine control away from Dad, he woke up in the middle of the night, didn't remember that he had taken his night time medicine, went into the kitchen cabinet where there dispenser is in a cabinet, and helped himself to tonight's medicines.
So he had double dosage of his nightime medicines. Marcella recognized it this morning when she saw both last night and tonight's pills were gone. When questioned Dad told her he had helped himself in the middle of the night.
When she took him to Rehab he became light headed as he was walking in and started to fall down. She held him up (in some fashion.) A stranger appeared and offered a hand, but when the place rolled out a wheel chair he refused it, and used Marcella as a cane. They walked into Mom's room and Marcella called in immediately.
The following things happened thereafter: Mitch faxed all of Mike's doctors who were responsible for the meds, told them what happened and asked them to comment and advise. (Later we heard that most of this stuff didn't cause great risk - but that the Cumodin was problematic.) He was ordered to skip tonight's meds.
Mitch and I ran over to Rehab and had a direct discussion with Dad, in front of Mom about these matters. Firstly, we made it clear to him that he we knew because Marcella had called us about it - and that was exactly what she was supposed to do. That he would have no cause to be even upset with her in any way - that if she HADN'T reported what she was seeing THEN she should be in trouble! He whole-heartedly agreed. (In fact, he likes her a lot.)
We used this opportunity to remind Dad of all the grousing and tummuling he does about being in control of his things ...like his meds....and how that just isn't a good idea in a lot of cases. He got it. I think he scared himself today. And then we told him the meds were going to be locked away. He accepted that (even if he may not recall that acceptance later.)
10-22-09
I met with Mom and Dad and Dr Rapaport this morning. The purpose was to inform Mom and Dad that all of us are in agreement that they are totally understaffed, and that their continual insistence at being in the middle of the staffing process is only making things much more difficult.
As might be expected, Dad began in a very obstinate and semi-defiant mode. He repeated often how he suffers from having been totally in charge of his own life, and based on yada yada he has obviously done a good job. And he has difficulty allowing things to be done for him.
Mom was having a drugged time of it since she had Vicodin around midnight for pain, and when that didn't work they added morphine at 2:00 am. The combo has her whacked out. She periodically would open her eyes and blurt out things like: "he doesn't like left over meat loaf...there isn't anything wrong with it...." This was not in context of any food discussion. Just utterly random.
Among the things that came out (not necessarily in order:
Dad demanded to know what the proof was that they need separate help. Dr Rapaports response: Millie is back in the hospital for the second time in less than two weeks. That seemed to register with Dad.
Rapaport went back to the 30 day period that they just have to agree to let us work without their interference. Dad was irritated saying it already started, and when it was pointed out to him that every time we started he jumped right up and interfered. We got into examples, etc.
At some point Dad went back, quite seriously, to the notion that they should both just be in a home. It wasn't some idle threat - he really was feeling that would be best. Rapaport disuaded him and told him they were not at that point, and that proper staffing would make life far easier and hopefully happier for them at home.
Mike insisted that he was capable, but when reminded that he hired three (its actually four) different drivers he recognized that he had screwed that up.
Rapaport talked about the various groups that are available, and I noted that we already had a system that we were trying to put together.
Mom and Dad agreed that they would both stay out of it and let us put people in place and they would just have to live with it for the 30 day trial period. Rapaport told us to put their agreement in writing for them to sign so that there is a handy "proof" for them to look at and be reminded of what we all said and agreed to. I have done that and will have Mom and Dad sign it later.
No sooner was that done then Dad decided that he was unwilling to have anyone paid as much as $150 per day. I told him it was none of his business. "Oh, is that so..." I told him if he had gone into a "home" they wouldn't discuss with him what they paid their help - he would just receive a monthly bill. And for the next 30 days (at least) that was how things were going to operate. He managed to accept this. I did tell him that we would leave his Hillcrest drivers in place (at least for now.)
Mom periodically chimed in (at appropriate moments) and she acknowledged that she too was going to have to go along with this. She'll be signing the agreement along with Dad, since she too is not processing information. In fact, Rapaport had previously mentioned to us that she too was no longer capable of complex decision making.
We are moving forward on immediate staffing since Marta is leaving sooner than we were originally told. Some people have already been hired, and as soon as we get it all in place we'll get the details up as well.
