Adapting
03.23.06 (9:19 am) [edit]  I went up to the lounge last night to see how Francis was doing, in adapting to the new Liquid Oxygen system that we got for him. Using the regular larger oxygen tanks is cumbersome, since they have to be replaced every four hours or so, and have to ordered almost everyday in order to keep Francis supplied. He has been spending more time up and about, when he cannot use the concentrator; though I have noticed him getting weaker over the last couple of weeks, but he does like to push himself a bit. As usual we just wait to see what must be done, or simply when to move in and help. The agency representative came up yesterday and taught us how to refill the tanks, which also have to be filled often, also every four hours when being used, but they can be done on site. Also the contents will evaporate when not being used; it takes about ten hours per tank to empty in that way. We did make one change for him, when he is in the lounge, and not going out, we will bring up his concentrator, and put his new tank on when he is going out. Or at least that was the plan. When I arrived I was surprised to see him not doing very well. The LPN on duty explained to me that he did not react well to the new system. Francis told her that he did not feel he was breathing right when using the liquid oxygen; also that it made him nauseous, so she took him off, and put him on his concentrator. I am not sure if his nausea is connected to the liquid oxygen, but the RN will deal with in the morning. Frances has slowly been getting weaker, getting very tired when in his chair, and tonight he looked exhausted, and gasping for air. When asked if he wanted to go to his room, he said no. I think he was nervous about being alone, even if we would check up on him often. We have an electric recliner in the lounge so I put him in that, and put up his legs, and reclined his head a bit, this seemed to help. After that I sat with him for a short while and we just talked. Since I did not know which way this would go, I decided to explain to him what I needed to know; if he wanted to go to the ER, if things proceeded to get worse. At first he told me that yes he wanted to go to the ER, always choose life he told me. I said fine, and notified the LPN about his decision, and ask Francis to repeat it in her presence. About twenty minutes later, when I was leaving, and making one last check up on him, he notified me that he changed his mind, that he did not want to go to the ER; if things got worse for him, he was not afraid, and was ready to go if it came to that. The LPN was there, and heard it all, so we knew what we would do if his started to die. Of course if severe pain came into the picture, which did not seem likely, we would call for help. When I checked up on him about 1:30 this morning he was in bed and seemed a little better until he tried to talk to me. He would gasp when speaking, though he did not seem to be in discomfort. The concentrator seems to work very well for him, and we only have in on 3 liters at this time. I explained to him that we may have to keep him in the unit if he was still having difficulty in the morning, he agreed. We will most likely take him off his wheel chair, and put him in a geriatric chair, that way we can get him up, and he can recline a little, which should help. It is not good for him to stay in bed all the time, since he also has congestive heart failure, which we keep in check with meds. I don’t know where this is going, he may rally for awhile, but rallies almost never bring someone his age up to the level they were before the set back. The plateaus that he reaches seemed to be short lived; of course he was in his nineties before he needed any real help. He only needed minimal assistance until about a year ago, when we moved him into his room, for those who needed full time care. While I am sure this is difficult for him, he as usual, is gracious about it, doing what we ask, and in his own way embracing life as he always did, accepting what is, in faith. He is probably one of the gentlest men I have ever taken care of. Even when he gets frustrated with me, he always uses humor to let me know that perhaps I am being a little too pushy. Sometimes I guess I can be, and a couple of times I have backed down, since it was about something that would not have harmed him either way. He is gentle and intelligent, a very good combination to have in late old age; makes things easier both for him, and his caregivers. |