Friday, February 3, 2017

Fall Number Six

The sound of CNN from across the hall faded out as I woke up. A faint rustle came from Maggie’s mattress. I sat up to go to the bathroom. Today would be her next expected fall. I did not want to miss this every-other-day event for the past two weeks. I had seen two of them already; nothing broken so far.

There she was on the floor looking at me some six feet away. It is a shiny clean foot-square always-looks-dirty hospital tile floor from over 20 years age. At night the half-opened bathroom door reflects a soft light throughout the room.

She had that “Well, here it goes again”, expression on her face. No bumps or bruises. She cannot get up by herself. I trip the room alarm and the bathroom alarm. Two days ago a Provision Living caregiver arrived in less than a minute at midnight. The aids here know that the lights come on and off during the day as I reset them after Maggie pulls the lines out of the wall sockets from time to time.

Three minutes. I walked into the hall. Both alarm lights were on. A person at the desk saw me and turned to my right to talk to someone I could not see. It was a PVL caregiver posting notes on the other four refugees. She had just left our room on her hourly check on Maggie at 6:00. I woke up at that time. Maggie slid out of bed shortly after the sound of CNN was muted by the room door closing.

The usual threesome arrived to pick Maggie up to standing. When she falls during the day, her shoes grip the floor. This is very helpful in standing her up. Our crew socks are slippery. A set of gripper socks arrived; then the standing up. I am advised to get gripper socks for both of us. PVL memory care has a hard weave carpet floor that minimizes slipping.

8:00. Maggie is sitting on her bed ready to put her pants on. Her shoes need to come off first. On got the pants, but it took her three tries to stand up. She is fully aware of her loose grip on the floor. To my surprise, in this never ending string of surprises, there is no grip under the heals!!

Yesterday we took the heart monitor back in the morning. Maggie had taken it off and put it in the middle bathroom chest drawer. It stayed on all night. The PVL crew were happy to get her up and dressed earlier in the morning. She fell about two hours after going to bed. Or did she slide out of bed?

The records now show six non-injury falls. She does do free falls as well as slides. I have seen two of them. Her body relaxes; she slumps a bit and then goes down in a turn to the right. Her expression is one of relaxed bewilderment: “Now what?” There is no sign of fear, of falling or of trying to catch herself, On contact she rolls back. Her right leg seems to give way; allowing her to, basically, just swat down. There are no bruises except from what she hits when rolling back; they are on her back and the backside of her arms.

I understand the roll back from PVL exercise classes. Just swat down as far as you can. Then lean back. Unless you have done this a few times (and avoid going straight over), the result is a bang on the back of your head. My feet flew directly above me toward the ceiling, the first time. The trick is to roll back on ONE hip. This is what I see Maggie do with the exception of her first fall, the month after we arrived at PVL, that sent us to the hospital for stitches.

The heart doctor prescribed to slow heart muscle that could cause fibrillation to occur; a pulse not below 50. The neurologist prescribed to slow the rate of dementia decline using a patch to avoid digestive tract problems. He also used a daily low dose of long term calming drug and a second short term dose as needed drug.

Two weeks ago the house doctor at South Hampton Place changed the short term drug from “as needed” to daily am and pm and double the dose for night. The PVL people and I were not informed of this. The PVL caregivers do not have ready access to SHP records.

Maggie went into a calm dazed state for a couple of days that concerned everyone. She has slowly returned to a “near normal” state now; with the exception of falling, a slower wobbly gate, difficulty standing up, and so weak that I have to put her right foot into the car.

She is not In pain. She is back to teasing her memory care refuges. She enjoyed the sing along of old time favorites yesterday to the point she did not want to leave the dining hall.

We now have three doctors and half a dozen workers at two residential care facilities trying to sort out what is happening. Fortunately, for me, Maggie’s three month checkup with our PCP Is at 11:00 Monday. [Written Friday at 10:10 am]

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