New Week, New Directions

Today Dad has been home for two weeks, and his third week begins.  Yesterday after the difficulties with his dialysis shunt bleeding, we decided to stop dialysis and call in hospice.  At some point, I asked Dad what he thought about dialysis — he said he was tired of it and didn’t want to go back.  Decision clinched.

The home health nurse came; we initiated the shift to hospice.  She did her usual visit as well as make the appropriate phone calls.

Kay went to Natchitoches for the day by midmorning — she needed to do some paperwork and make sure a file was ready at her office.  By 6 p.m. or so, she was back here in Egan.

Just after 1 p.m., the hospice nurse came for the evaluation.  She was here for over three hours, and she and I had much to talk about.  BY the time she left, I had a much shorter medication list.  I also had Ativan gel, morphine to give under the tongue, and medicine for nausea should that be needed.  I had signed who knows how many pieces of paper.  I had a new folder, with new papers and a new pamphlet to read. I had a new medicine schedule and new things to watch for.  Hospice is about palliative care, and medicine is a tool to achieve that.

Dad rested well last night with the morphine.  Kay and I were less rested — we kept popping in to check on him.  I slept a few hours.

This morning was busy — I called Dad’s primary physician, the dialysis clinic social worker, and the ambulance company regarding the changes, and then I went to Crowley to run a couple of errands.  When I got back, the house was filled with lots of new hospice people — a social worker, an aide, a nurse, and the volunteer coordinator.

Dad had more trouble with pain and with restlessness.  After his bath and the dressing change, everyone left.  Kay and our friend Billie left to go to Lake Charles to take care of some errands.  I stayed here.  Within an hour and a half, it was clear that the pain wasn’t diminishing, that the meds weren’t working.  I called hospice and within minutes had a new routine:  more morphine, more often, then more morphine at a slightly longer interval, then that same larger dose of morphine with the Ativan gel.  Moving the morphine to every 30 minutes and then every hour, then adding the Ativan gel with one dose of the morphine — that was the routine.  One dose of morphine after the combined dose and finally he was resting well.  Now I’m shifting to two hours between morphine, with the Ativan added at 4 hour intervals.  Fingers crossed that this works tonight.

Tomorrow is another day, as Scarlett O’Hara reminds me every time I think of one of Mother’s favorite films.

Now he is resting.  I’ve made a few necessary phone calls, talking to family.  More to come.   Business to take care of tomorrow.  Photos to select and scan.  Arrangements to make — though we’ve talked through and know what we’re going to do.

Tonight, after I finish my grilled cheese sandwich and milk (thank you, little sister), I will shower and pull on new pajamas and crawl into bed.

Shakespeare’s right in Hamlet: sleep does knit the raveled sleeve of care — and so I hope to find soon, that my raveled sleeve of care is eased with some quiet time, some reading, and some sleep.



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