Living with Bob and "Al"

The beginning of the end Chapter 7

After the catheter fiasco they tried yet a third dose of "calming medicine" there was about a 45 minute wait for the next test, they were hoping the medicine would take affect since "the boys would have to be very still for the next round of tests. "Al's" adrenaline was high and his jerking and grabbing was uncontrollable. The only thing Sheri could think of doing was to start singing and see if that would calm "them" down. She started singing "Zipity Do Da", and after a few verses Bob started to relax slightly and he began to try and sing, Sheri was glad he was relaxing his grip a little, because "Al" had Bob's huge hand tangled in Sheri's hair and was pulling hard.

Living with Bob and "Al"

The beginning of the end Chapter 6

Sheri waited patiently ( "the boy's" impatiently) for the doctor to come in and evaluate Bob's condition. About a half hour to 45 minutes in, a female doctor came in and read the chart and then turned to Sheri and asked why we were here what types of changes the facility had seen. Sheri took a deep breath and tried to explain what she knew. The doctor said they need to run a battery of tests and listed off a chest x-ray (Bob was coughing), blood work, a urine sample, and head CT scan. The doctor did her best to explain to Sheri why the tests needed to be done, Sheri said she felt that this was just a progression of the disease after all they were 10 years plus in this monster called Alzheimer's. The problem with that assumption apparently, was that the facility needed to know what was happening, because the 2 person assist was a change. They scheduled the tests and the first one, the urine test, was not attainable with out a catheter. The calming medicine they gave "the boys" was not working, they gave a second dose but to no avail. Sheri spent the next five minutes or so assisting the 2 nurses by laying across 6'4,strong as an ox Bob's chest holding "them" down while the nurses inserted the catheter. Bob and "Al" cried out in pain, Sheri went into her familiar survival mode (at least on the outside) on inside she was weeping uncontrollably.

Living with Bob and "Al"

The beginning of the end chapter 5

The nurse said they needed to start an IV, "the boys" were restless. In the previous week or so Bob's eyes were closed most of the time, whether sitting or laying or being fed ,but he was also doing very jerky movements with his arms, reaching and grabbing at the air and any thing in reach. Needless to say getting the IV in was a challenge. The ER was busy that late afternoon and there was no one available to help Sheri keep Bob in the bed as she waited for the doctor to assess "the boys". Sheri was frustrated because she was not even clear why they were in this ER battle. The nurse already had an order for some  "calming medicine". Sheri prayed it would kick in soon, because "Al" was already getting his grasping hands tangled in the IV line , Sheri knew it would only be a matter of time before "Al" pulled the IV right out of his arm.

Living with Bob and "Al"

The beginning of the end chapter 4

Amidst Sheri's frustration and anger, she asked the male nurse to please come in and help her get Bobs leg out of the railing. He said he would be right there, in the mean time Sheri had to dodge what was quickly becoming a very agitated "Al's" grabbing anything he could, hands. When the nurse came he started telling Bob in his not so pleased stern nurse voice, that he needed to lie down and rest, and he was going to start an IV. Sheri tried to explain the degree of his disease, and that he does not understand what you are telling him... just so he would know why "the  boys" were not following his s"rest" instruction, but the nurse snapped at her and said "Yes, but we still talk to them like people."
 Sheri's heart hurt.

Living with Bob and "Al"

 The beginning of the end Chapter 3


Finally after Sheri's continual persistence , they let her go back to the room. The curtain was drawn and when she drew it back, there was "Al" by himself with Bobs' eyes closed and jaw clenched tight ... and one leg stuck through the railing trying desperately to get out of the tangled mess of the hospital bed.
Sheri had to hold her tongue.

Living with Bob and "Al"

Sheri is has spoken to 3 people at Bob's new home. All three of them indicated that it was the  hospitals responsibility to provide any needed care to "the boys" such has staying with him for that emergency room visit, they told the ambulance driver he" came out of memory care." They all indicate the emergency room nurses shroud be capable of handling this. Sheri thinks there is way more to do around this subject.

Living with Bob and "Al"

Emergency Room Visit final thoughts

Sheri knows that nurses and doctors are amazing people to do what they do everyday. Every person at the hospital was caring and friendly. She knows that in emergency circumstances the physical well being of the patient is first and for most, and she knows that even with the best of education these things would still happen. What she thinks might be able to change is to make sure if some one comes out of a locked Alzheimer's ward where they require 24 hour supervision that there is some kind of coding system, maybe a red , yellow, or green dot, that represents this persons cognitive ability such as red means total assist and so forth. This info would be on whatever they sent to the hospital with him or pinned to his shirt or something like that. Then the same color dot goes up on the board with their name. I mean a large dot easily recognizable to all that enter the room.

This is just what has come to mind since this experience. One might think that "well this person was handed over to a medical facility, 24 hours hour supervision is their whole purpose." As you can see from the long recount of this experience a person with these types of impairment, 24 hour supervision means something very different. Sheri know many doctors and nurses and she loves and respects them all. This is just an area that needs more education and with the expected increase in these diseases, it needs to be soon.

 

Living with Bob and "Al"

Emergency room visit part 8
They tested Bob's swallowing and things looked good. They said we were okay leave after we signed the forms. Sheri got "Al" dressed and they opened the curtain to leave. One the nurses at the desk smiled and gave direction for how to get out of the maze of doors. Bob was obviously feeling better as "Al" began his marching steps whistling away, when the nurses heard him whistling they looked at him and smiled. In return "Al" gave each of the familiar salute, and nod of his head he has become known for now at his new home. As they walked through the exit door she heard the nurses say how cute and sweet he was, that... he is, he is a fragile vulnerable adult.
Sheri needs to pause, praise and pray.

Living with Bob and "Al"

Emergency room visit part 7:
Sheri worked on distracting "Al" because his eyes were still fixed on the heart attack sign. The doctor popped his head in and told them the ex-ray was clear of blockage Bob did not appear to have any broken ribs from the Heimlich maneuver which was good.  The doctor disappeared behind the curtain. A few minutes later the nurse appeared, and very quickly pushed the curtain way back making that pushing high screech noise. At the same time she was pushing the curtain back she began talking to Bob very quickly, rattling off instructions and explaining  they were going to have him eat and drink something to make sure the swallowing would go smoothly, since choking was the reason he was here ending with a list of drink choices for Bob to choose from. "Al" sat staring with a confused smile on his face, but said nothing. Sheri said I am sorry that was way to fast..... Sheri said " Bob,  she  going to get you some apple juice." To which"Al" replied great!"
Sheri can't help but think about all the dementia patients that have no one to come to their side while in the hospital.

Living with Bob and "Al"

Emergency Room visit part 6:
Sheri helped Bob do what he needed to do in the bathroom, and walked him back to the room with the curtain. She had Bob sit on the end of the bed while they waited for the nurse to return. Bob was eyeballing the room, now from a different angle then laying on his back. "Al" came across a plastic coated sign on the wall that Bob began to read out loud. "FIRST LEVEL HEART ATTACK" panic set in quickly for "the boys" as "Al" began to clutch Bob's chest. Sheri quickly and calmly explained to him that this was an instruction sheet and that was not happening to him now.
This is the person they left alone behind the curtain with all kinds of wires, devices and medical stuff. Please remember that Sheri believes this is about education, not blame.

Living with Bob and "Al"

Emergency Room visit Part 5:
The nurse disappeared behind the curtain and Sheri went back to her happy face for "the boys". "Al" began fidgeting and from experience she knew he needed to use the bathroom. She confirmed that with Bob, and told him she would find a bathroom. Sheri peered out the curtain and let nurse know that he needed to use the bathroom. The nurse said "oh okay I will show him where it is." Sheri said "a... I think I will come with you." In seconds they were at a bathroom. The nurse in a very rushed but cheerful tone said " Okay, here you go pull the string if you need anything". Bob in his polite manner said "thank you"... as "Al" began to relief himself in the garbage can.  

Living with Bob and "Al"

Emergency room visit part 4:
Sheri sat with Bob and tried to have light conversation as she tried to evaluate the situation. She looked for any sign that someone coming into the room would quickly know how cognitively impaired he is, but there was none. There was one of those boards that should have had his name and so forth on it that still blank, may be it could have been there when they had time. When a nurse came in she asked Bob if he was feeling better to which "Al" replied, "yes.", (of course he is... he has no recollection of the event or where he is). So as the nurse was walking out she said " well we are waiting on the chest ex-ray and then the doctor will be in. She was a very friendly gal so Sheri said, "can I ask you  a question?" She replied "sure!" "does it say anywhere in his file that he has advanced Alzheimer's and highly cognitively impaired"  The nurse replied " I don't know let me look". The nurse went to the computer clicked into many screens scrolled way..... down and said "yep it is in here." Sheri paused a minute and said "Oh good...because that is really important for everyone working with him to know right away."
Heavy sigh...

Living with Bob and "Al"

Emergency room visit Part 3:

Sheri was upset to see "the boys" in such distress but she took a deep breath and passed through the curtain. Drawing on her years of experience, knowing  "Al" would mimic her mood, she entered the room with a big smile on her face.  "Well hello there!" she chirped. Bob shook himself out of "Al's" blank but grimacing stare and looked up at her. "Al" paused for a very long moment and then a cautious smile crossed Bob's thin lips and "Al" said "well, howdy!" Sheri could tell  "the boys" knew she was at least a familiar face, and at that moment, that was enough.

Living with Bob and "Al"

Part 2 of last weeks emergency room visit:

Sheri waited patiently for the nurse to answer her question, she was busy typing in information so Sheri repeated, "Is someone back there with him? He has Alzheimer's and can not self assess or answer questions." The nurse replied "I just need a few signatures and we can get you back there asap." Sheri's head was imagining all kinds of things going on back there. When she finally got back there and moved the curtain back "Al" was in the bed with those sticky things all over Bob's chest. Bob was alone behind the print curtain."Al's" face was distraught with a blank yet confused expression on his face. All Sheri could think about was that she had spent the last 9 years of he life making sure Bob and "Al" were never left alone, and here he was alone and scared. :(