Melissa thursday-friday

I arrived at 3pm , John was due to come (at 3 pm).He is usually on time , Ruth called him before she left , and left him a message he called back shortly there after and said that he was running late.When he arrived Jean informed him that she was not sure if she should work out due to her cold and he agreed with her.She did not want to get him sick , she also had me reschedule charlea from Friday to Sunday.John would like to be called Sunday afternoon to see how jeans doing and if he should plan on coming in on Monday or not.I made a note of this on the calender.

Bill has a little to no appetite , he does not feel that well.I took his temperature on Thursday , he did not have a fever , it was 98.2. he called every 5-10 minutes after 8pm, until 1130 pm,one time he called and said to me ahh are my feet covered they don't feel covered ,i told him they are and to look at them then he said well that because i just covered them. he has been very lackadaisical in doing any thing for himself ,ANYTHING, even turning his head to look and see if a light is turned on for example.Instead he will call to ask,without even looking.

On Friday Susan stopped by to have Bill and jean sign a paper stating that she missed a week of work due to a car accident she got in last year when she was still working here.She left a copy (for skip and Joan)in the entrance way on the draws below the mirror.That is the highlights of my shift.

Weekend Jennifer

Arrived Friday, Bill and Jean both still hanging on to their colds. Jean had me give a shower I made it really steamy and she sat in there and took deep breaths, she seemed to be better after. Bill sounds really 'wet" I listened to his lung sounds this morning, and they are clear at the bases, but his upper lobes of his lungs are crackling, very gurgle around his bronchi, good news is that they clear out when he gives a few good coughs. I think its residual mucous from their colds. I have noticed Bill hasn't had an appetite, so if we could really watch this, as we may need to adjust his diabetes medication, since hes not been eating as much. Melissa gave him a variety of choices, then she would make the one he picked, and he didn't eat it. Same with my experience, he ate a lot of yogurt this weekend though. I want him to go to the doctor, if anyone can call during the week and make a Farooqui appt, I want to discuss with Farooqui:

Lung sounds (wet)
Decreased Appetite
Increased shakiness, he motor control is terrible, maybe he needs to increase his sinemet.

also has anyone ordered Jean more Briefs? thanks

Jean has been pretty good all weekend, she tore out about 10 pages from a magazine (evil creatures lol) with pictures of how she wants to re model her kitchen and paint new cabinets, I gave her a gentle reminder about the change in living situation. She then wanted to bring all these 'i want it" ad's shopping after lunch with Cookie, I hid them away in a folder, maybe she will forget, Its all the same exact creams/lotions/potions that she has or had.

Bill has been in a new routine, around 930 bed time, he will call you every 15 to 30 minutes on the nose, I don't know if he fears we are gonna leave or what, I reassure him that Im right downstairs, and I can hear him and come right away. He doesn't really want anything when I get up there, in fact he kinda looks around as to why did I call her? So I try to fill in the mental blanks " did you need water? are you cold/hot? change pillows? etc. But inevitably he will still call about various reasons. I just remind him that I will be here and its okay for him to call, for assistance. It usually peters out around 1am he settles in and is okay. Reminder, please when you go in the room, just remind Bill to change positions, he is getting some redness and soreness on his sacral area, the area lowest on his back and above his rectum. Its from sitting in one place, but it can turn to an open wound fast!. and with his poor circulation, age and diabetes it would be detrimental. So even if he just uses the lever on the side to lay back in the chair or move a little to one hip it will encourage blood flow to that area.

House all cleaned, linens changed, all garbage's emptied, refilled, TP / paper towels, briefs, juices, picked up any mags and flyer's left around etc. aired out the house really good.

That's it
Have a great week!

JENNIFER TO RUTH

Ruth if you read this please call me at work, cookie called Lunch is on Wednesday NOT tuesday, and you have a hair appt in QC on Wednesday, please get back to me asap, Cookie is waiting to inform Cis. I left ya a message on ur cell phone.

Thanks

Overtime/Double Time Policy

Hi Ladies...thanks for all the blogs. This really keeps us current.

In our effort to cut back on some costs, we are going to prohibit any double coverage hours that are not absolutely necessary. Please contact me PRIOR to double coverage hours for approval. We have talked to Bill and Jean and told them that there will be double coverage only in case of Emergency.

Thanks for your cooperation....Joanie

Thursday 27th Ruth

Pretty good week, came in on Tuesday and got the update from Wedad about what happened over the weekend. I guess Jean was pretty sick and it is going around. Wedad said Bill has been asking for cough syrup and cough drops continually. Bill told me that his ribs were sore from his falls, when I asked him what happened he told me he ran into a wall, which is the exact opposite of what Wedad had told me. I asked him if he actually fell back in his chair and he said "yeah I think that's what happened instead, but I also ran into a wall too."

Dinner went well and the house was quite until bed time, at which point Bill could not get comfortable and need assistance to the restroom every 30 minutes or so. After 12am he slept through the night and was up bright and early. Made breakfast and then got Jean in the shower, Cookie showed up at 11:30am and took Jean to the tailor and Arcadia Farms for lunch. I got Bill in the shower and we left the house around 1:45pm, we had lunch at the Quilted Bear, since it is easy for Bill to get in and out of, not because the food is great or because it is my favorite place, as Jean suggested. Bill and I had a nice lunch and then came home. Cookie and Jean were waiting for us.

Cookie has made a suggestion about a new chair for Bill. One of those chairs that rises with a remote. She claims that Medicare covers them and all we would need to do is get prescription from Farooqui. She left all the information for me to make the appropriate phone calls, but I am going to wait on those calls.

Cookie made a lunch date with Cis, herself and Bill and Jean next Tuesday. I will be in early to help get them ready to go and will take them to the lunch.

A couple of months ago, I was out getting my nails done. A few blocks from my neighborhood a new shopping center opened up and I was walking around the plaza looking at the new shops and getting my nails done. I had heard that Jean's hairdresser Liz- opened her own tanning salon, on a whim I walked into this tanning salon to see if it was the one that Liz owned. I spoke with the young man sitting in the front of the store and it was her tanning salon. He told me that she was working at the salon 5 doors down. I got really excited and came into work the next week and told Jean that I had found Liz and that the new place was fab, in comparison to the "garage" Jean had been going to. Long story short--- I made an appointment for Wed. the 2nd to go out to the new salon. This is the same Liz that Jean found at Mane Attraction in Scottsdale, followed her out into ghetto in PHX and now will see her in QC. Liz and Jean are very excited, and we may do a nail appointment in Tempe if Bill is up to it.

John will be here today at 3pm
Bill and Jean have a lunch date tomorrow at 12:30pm with Skip, Joan, and Chris at Tomaso's if Bill is feeling up to it.

Bill is a little congested today, with a sore throat. We had to cancel the lunch for today and make it for tomorrow, because he wasn't feeling up to it. I already called Charlae to reschedule for 2pm.

Jean inquired about the cost of Charlae, she is thinking of discontinuing her services in light of the cost and Jean's new mission to save. Jean also would like to discuss with Skip and Joan the necessity of John and his fees. I told her to mention it to them at lunch tomorrow.

Have a nice weekend

Jennifer Weekend

Sorry all for the delay!!! Very busy week, last semester before graduation. Weekend went well, both Bill and Jean were sick all weekend. Jean sounded worse than she said she felt. She had a little temp 99 on Saturday, I gave her 2 Tylenol. She sounded so stuffy, I gave her a warm steamy shower, and let her sit in the steam, then she had me cover her chest in Vick's. Bill was more c/o stomach virus. I gave him antidiarrhea medication, but not until I let it run through a little, sometimes its not good to stop it, the body is trying to get rid of it for a reason. I pushed fluids on him, and Gatorade. He mostly ate eggs and yogurt, crackers with pb. He wanted pot roast and fried shrimp Saturday night, he said it was the only thing he wanted, Jean looked and ordered it and herself some pot roast too. They ate it ALL.

Jean talked with Amanda on Saturday, she wanted to call her and decline the invite for Sunday, as she didn't feel up to it or Bill and was worried the kids would catch it. Note: Jean told me Amanda said she has called several times and no one answers and or she has left several messages, and no one told Jean. This is second hand from Jean so don't quote me. Jean also said Cookie has complained of not getting through to Jean and missed messages. Jean was understandably upset, I showed Jean the phone and I scrolled through the Caller ID for her, there was calls all the way back to February but only one from Amanda on the 19th of March. I also told Jean we do check the messages as the phone will repeatedly beep when you pick it up. Cookie I know we all avoid her call but I couldn't tell Jean that, and when Cookie does call I write down Jeans schedule nice and big and extra 'busy' and put it in front of Jean with her glasses in case Cookie makes plans with Jean. I really don't know why Cookie makes plans with Jean and doesn't call us back at least to inform us, just pops over. Anyway, I told Jean we would double check the messages at any time, and she can pick up her phone in her bedroom, if she hears the beep beep beep remind us to check them. I also told her we would call Amanda once a week so she can talk, as she was kinda implying that us not picking up has stopped Amanda from bringing the girls over, that was the main reason she was upset. "Amanda said for weeks shes been trying to bring the girls here, and no one answers or calls her back." So I assured her that we will stay in contact better.

Bill, was unstable all weekend, I think he has orthostatic hypotension(low b/p when you get up fast) I reminded I'm to CALL and to get up SLOOOOOOW. and use jeans bathroom. I took Bill to Dr. Khalid appt on Monday, I was coming to pick up my books i left, and heard Jean saying she didnt feel well, I felt bad for Wedad she was in a quandry, as Jean insisted she can stay alone! I made childcare arrangements and took Bill and we headed out. On the way there, he was very funny and talkative, he told me about his large wager with Ruth $1 ( I can spot ya Ruth) regarding "Baraama the Negro and McLain" I was laughing inside, then at Khalids in the waiting room Bill said "well I don't want a Negro or a Skirt running my country!" loooooool all the other patients were older than moses so I don't think they heard.

Mary did INR it was 1.7 perfect, we will keep him on 5mg of coumadin. Soon we may be able to go only twice a month. On the way home, I got Bill inside, he was very winded, I insisted he stop and rest he insisted that he is fine, he walked into the door jamb, then a hanging picture, I got him to his chair, he turned around, and fell so fast into his chair it tipped OVER. completely upside down. Thank God Wedad was right in the kitchen, and came running to help me lift Bill and Chair up. He is fine, but its NOT fine that he keeps falling, I did tell Khalid, and wrote him a note, and called the office and left a message with Deb his RN. He isn't on Coreg. I told Bill on the way to Khalids, we need to talk to Khalid about falling, but Bill was kinda, rationalizing it, long story short, he felt that admitting he is falling will be an instant one way ticket to a nursing home. I told him Bill that's NOT true. it may be a medical reason, we have to be honest and you have to be honest with us. And the best way to prevent falls is to Call us to assist him. I re assured him that one has nothing to do with the other, and they are NOT going to a 'nursing home'.

I washed all the blankets in the house in hot water, boiled the toothbrushes, all dishes in dishwasher, lysoled every light switch, door knob, chair, remote etc. Germophobs are good to have in Post Cold/Flu clean up!

That's it for now.

OHHHHH
Briefs for Jean from One point patient care, the Walgreen's ones are cheap, if anyone has time to order them.


'7

Sat. March 22 - Chris

This is the first time I've actually successfully gotten on the blog to reply:)
This is great and Jennifer, your suggestions for money saving steps are perfect. I agree with all of them.
Just want you all to know what a great job you are doing with the folks. These last few weeks have been difficult for Skip, Joan and me, but we will come to an agreeable solution for all (we hope). You all are really on top of matters. Thank you for your really great blog. I love reading this. Chris

Skip

I wanted to take a few minutes to communicate with you regarding Mom and Dad and the current plans we have been discussing with them. Before I go into what we have been planning, I need to bring to everyone’s attention a situation that we have to get under control immediately. Mom has been writing checks for caregiver hours and other items which should be paid either by Joan through the folk’s household account or by me through their caregiver account. Please do not go to either Mom or Dad for checks for these items. With respect to any caregiver hours, those hours have to be reported to Tara each week and I must issue all checks for caregiver services. As you are all aware, we have to get Jean’s spending under control. To do this, I have worked with Mom and will be reviewing her checking account with her each month. I will make sure she has a certain amount of money in that account each month which she is to use only for her personal items. She is not to pay household bills, massages, caregiver hours, meds, etc. Those items are all to be paid by Joan through their household account or by me through the caregiver account.

With respect the plans we have been discussing with the folks, we are trying to accomplish three things. The first is to come up with a long term plan for their care which takes into account what might happen if one of them should suffer another serious medical problem which would necessitate more intense daily care. We want to make sure that should that happen, they are not separated due to the type of care facility available to them. It surprises us, but the skilled-care procedures in most of the care facilities we visited (and we visited about all of them in this area) result in many cases in people being separated once a certain care level is required for one of them. This is something we just will not allow to happen to our parents.

The second goal is to provide an environment where the folks can engage in other activities and meet other people without being dependent on others to drive them somewhere or to arrange for people to somehow get to them. We visited many care facilities which have in-house activities, concerts, movies, classes, and a whole host of other events which Mom and Dad can take advantage of just by walking down to the lobby or other meetings areas, the on-site restaurants and cafes, and other in-house facilities. We also want the facility to have its own vans and other means of transportation providing daily trips for shopping, theatres, museums, and other activities. The right environment would allow Mom to be more active and give her more opportunities to do things without being totally dependent on others and without having to worry about Dad if he does not want to participate. The right environment might also allow Dad to be more active and engage in more activities.

The third goal is to provide for their continued care at a cost they can reasonably afford. We want them to enjoy their lives for many more years and to be as active during those years as possible. I think all of you are aware that while it has been worth every penny we have spent, we simply cannot continue to afford the costs of the coverage they now have. While their current coverage is the best, it doesn’t provide a plan for what we will have to do if one of them requires additional care in the future. In addition, their house has become a major expense and will require major upgrading and renovation in the near future.

We are recommending Sunrise to Mom and Dad as the care facility they should move to. It is located practically across the street from Dr. Farooqui’s office – in fact, Dr. Farooqui’s partner spends days at Sunrise providing on-site medical care for the residents who want it. Because the apartments at Sunrise are small (we all immediately started laughing when we saw the closets), we have arranged to combine two units together. While this will not provide Mom with the closet space she wants (of course, ASU Stadium wouldn’t do that either), it will provide them with a very nice environment. Mom can even do some decorating. Sunrise has the on-site facilities and activities we have been looking for, and the transportation we also wanted. More importantly, Sunrise is set up so that as residents require more intensive care, it can be provided without moving then to other facilities. They can stay together and receive the increased care needed in their current apartment unless they choose to make some sort of change. This was the most important factor in making our selection.

Assuming the folks agree to make this move (they have seen the facilities and have initially agreed to this – but the final decision remains with them), it will probably take place over the next 45 days. And as always, we will need your help. We obviously want to transition them over very carefully. We will continue to need your services after they have moved. On what days and for how many hours, we don’t know. What we would like to do is meet with all of you to hear your thoughts on all of this and to help us come up with a plan for the transition. Chris and Joan will speak with you to arrange a time so we can do so.

As always, thank you all for your dedication and hard work. Please let us know any questions you have or any suggestions you may have. In the meantime, we will set up a time so we can get together and discuss the transition.

Per Joan , from Jennifer/Melissa

Joan per our conversation today, Melissa left me a list of ideas she had on money savings and here are mine too, I'm sure the other girls will add, some of ours are similar so here they are;

1. minimize appts and try to make them back to back so that one day is used for appts (ie Dr.Campbell is done at 1210 and 1220 for Jean)

2. Limiting Charlae to twice a month for full massages on both Bill and Jean

3. Cut John down he really can just show us and we do it with her to continue therapy. He comes 8 times a month maybe make it 4 or 6

4. Cut pool guy back, we think he comes, four times a month, but nobody uses the pool, buy us a net and we would be glad to get some fresh air skimming the pool, and have him come once a month for the chemicals and filters.

5. Jay doesn't need to be here period, but if he has to be the one, he doesn't need to come every week, I have a lawn and my 45 dollars a month does my landscaping fine.

6. The car, several times Jean and Bill have commented on how much they love Cookies PT cruiser, and how easy it is to get in and out, and the big space in the back, we think that the Cadillac is a gas guzzler, and they don't need such a big vehicle, they really do like Cookies Mom's PT cruiser and Jean tells her all the time.

7. Dry cleaning!, way way overpriced, I was doing the dollar cleaners but I got too busy, maybe we can rotate one girl a week to dry clean at the 1.50 cleaners, drop off and pick up, this would cut down on a lot and the burden wouldn't be on one person.

8. Jeans Hair/nails, I think Once every 6 weeks is good, she goes every four weeks to these over priced salons, I found a women, on craigslist, that travels to elderly homes, and does hair, she has been doing hair for 15 years, she mostly does senior homes that don't have a salon built in, she knows the short, white hair cut well, and will do Bills too, with traveling its 6o for jean haircut and whitening, and 18 for Bill hair cut, it will save traveling, and prevent over lapping of hours when Bill decides he doesn't want to sit in a ladies salon for 2 hours.

9. Limit ordering out, now we need Jean and Bill on board for this, as they will often say, lets order Mexican or lets order Marie calenders, despite a full fridge, they want a particular item, maybe we can limit ordering to twice a month.

10. The newspaper, they don't read it! I have been here for almost 6 years, they don't read it, occasionally very rarely she will ask for it or Bill, they don't even ask for it so I usually forget it even comes. And when I do give it to them Bill says " i cant read anymore, I'm blind in my left eye, just throw it out." I think the weekend edition or even just the Sunday paper would be fine.

11. Garbage cans, I don't know how PV works, but in my area more cans = more money per month, maybe in their younger busier days they needed 6 garbage cans, but now we don't need anymore than 2, they do come twice a week, and if the problem in suggestion 5 (aka Jay has a problem with that he should haul away debris like every other landscaper does).

12. Cable, we have about 500 channels, maybe its a bundle package, but honestly I can only vouch for Melissa and me, but I'm sure the other girls would agree, we don't need 500 channels, Bill and Jean watch the same few channels and none of them are passed CNN 209.

13. Indiscriminate spending Jean out =Jean spending, as you all know Jean could spend anywhere, even if its a gift shop at a hospital she will spend, we need supplies from Target, Walgreen's, Walmart etc, but the problem is she gets it there and wants to spend spend spend, lets not even mention when Cookie takes her. I think a small account for just household spending with debit card and a small limit say 500 per month should be the max, and any forgotten supplies should be bought using only that. One debit card left in a place we can all find it, and its used for only small quick things, would budget instead of dragging Jean with us to these stores and she does the shopping Olympics, also this would eliminate, writing of checks back for items bought out of our pockets.

14. We think buying in bulk is a great idea, for some items, ie: toilet paper, paper towels, laundry detergent, decaf coffee, softener, OJ, cereal, Kleenex, hand soaps, things that we go through really fast, just an example, in one weekend Bill and Jean used 4 rolls of toilet paper and 3 boxes of tissues and they were not sick. Maybe the "debit card with a limit" can be used for this once a month shopping. Then any adjunct online food ordering can be just for produce/meats/dessert/perishable items, this would cut that bill back significantly as its cheaper to buy in bulk then to buy online.

15. Stop the catalogs/beauty magazines/gossip magazines/fashion magazines, cancel the subscriptions, sign up on an OPT out list for junk mail, all these do, albeit keep Jean busy for hours, is rile her up to start tearing out pictures, and want to buy products/clothes/shoes/changes rooms and decorate/re arrange. And they make sooooooo much clutter, and Jean tears out tons of pages and wants to save them for later shopping dates. I suggest getting her large print Readers' Digest or National Geographic. The ART and Architecture magazines are just coffee table dust collectors too.

16. Put a fraud alert on her credit report and Bills, so that when Jean goes shopping and they offer her a store credit card, she stops applying for them, Cookie unusually is there to feed Jean her info, as in her social and address with the fraud alert, they cant use that second party information JEAN herself needs to be able to say it, and trust me they will deny her a card. Which is not what has happened, hence she has Chico's, coldwatercreek, Talbot's and sears cards now.

17. Maybe we can have a consignment shop come and have Jean go through items that she has and consign them and Bills too, he goes to that rip off 250.00 for pants for Bill, that are nothing more than big and large that he can easily get at Dillard's, he is all about comfort he doesn't care if its Cutter and Buck , but maybe Jean would agree to consignment. We also talked about a professional organizer to come and clean Jeans closets, maybe if she sees that 85% or her shoes and clothes and purses have tags she would feel like she has new clothes all the time. We have all done the complete 12 hour closet make over, but inevitably it reverts back to a massive menagerie, Jean says she wants this there and then this over there, maybe if a pro that charges 25 and hour to do it, she will keep it tidy.

These are just some small changes that we feel will add up to helping save money, in the bigger picture, speaking for Melissa and myself, Jean and Bill's house depletes a lot of their money, its inefficient, and requires more and more costly up keep, for all this unused space, we saw beautiful condos, one story, handicap accessible, in Paradise Valley that went for 1100- 1300 per month. This would decrease: electricity, fall risks, water bills, landscaping, pool, garbage collection. etc.

Bills Dr. Khalid Appt. Jennifer 3/14/08

Picked up Bill, he apparently had a hard time getting ready, Melissa was in the bedroom, dressing him after she had showered him. I called Khalids office and explained we would be about 10 min late and they said fine, as he was 45 minutes behind.

1115, arrived at Khalids, we waited, in the office for about 45 min, so much for being behind, then we waited in the exam room, which Bill accurately described as the "secondary waiting room" for about 30 min, Dr. Khalid came in, Cathy his assistant, took his INR, which is 1.7 perfect! I will give him 7.5 mg of coumadin tonight, and continue on the 5mg of coumadin. Bills weight is 224# he still needs to lose more weight, and keep down the salt and sugar. Dr. Khalid was extra chatty and spent about 30 minutes with Bill, he said his lungs are dry(a good thing) and that his CHF is inactive, which I personally never heard a MD say that. So that was also a good thing. Bill also has no edema on his legs, he said his heart sounds really great, and that he is impressed with the "Cadillac" Bill has in the bifurcated, ICD he has.

I did talk to him, regarding his small hemorrhages behind his eyes, this was pointed out and faxed to him, back when I took him to dr. Viareall, he said it wasn't the priority now, but he wants Bill, to get a Caratoid artery Scan, he was at 45% occlusion before, and thinks its about time to check again. I have an appt set for the 21st at 11:00 its at SMILE on 92nd and Shea, for the scan . Also they want Bill to go to Dr. Ruggio, for his pacer to be increased on both sides of the heart, in order to give maximum squeeze from the heart. He has an appt, on 4/25 I am going to ask that someone call and see if he can do it on the 25th of April, its called a V to V conversion. He wants him to be seen in 3 months as with Jean so they will send out blood work sheets together, and I asked if we could bang it out in two appts, back to back in one day.

Bill and I put gas in the car, has anyone smelled the gas smell in the car? especially when it is running, maybe that's why it eats up gas? or the 8cylinders. Bill and I earned a free car wash the drive through one, Bill actually enjoyed. I'm glad we re washed it, as Jean has bday girls and the car will be nice and clean for her.

Regarding Jeans bday, I got all the gifts for her that she had been picking out over the last few weeks, they are wrapped, bows and tagged, 3 of them, and the girls giant Easter baskets, which are filled with hours and hours of hyper sugary goodness. ( Sorry Amanda :)