Nursing Care

I do not want to admit it but I think we have moved closer to the "Nursing Care" phase. Not so much medical needs but more daily, detailed support. Since associations continue to disappear, words loose meaning, even one direction at a time doesn't work so I have to "do it for him." Sometimes that means "Do it to him."

Laying out his clothes has become necessary and even then the pile of suggested clothes does not work and he goes off in another direction. I have had to help him on with his shirts, make sure he remembered his underwear, and comb his hair for him. Often he will be full dressed but his pants and wonder what's next. Sometimes he will attempt to put on two pair of pants when he was really in the closet looking for a pair of shoes.

I have been more alert to his personal hygiene needs like suggesting he shower, making sure he remembers how to shower, putting lotion on his face for him, making sure he wipes (-: Too much information :-) Today I will trim his toe nails and groom his feet. He comes to me with "dry patches" and asks what to do. When he is in pain, he is no longer able to describe it so I enter into a guessing game, sometimes guessing with him and sometimes playing by myself.

Recently he seems to have disassociated from "place." He complained about a pain in his knee (at least I think so because while he wasn't able to use words I relied on body gestures) and when I asked him to describe it, his hand hovered in the air some six or eight inches away from his knee, "Here," he said. I touched his knee and said, "Touch where it hurts." He continued hovering.

When I asked him after shaving if his face was irritated, he pointed to the lamp on his desk and said, "This always takes care of it." What I think he was doing was pointing in the direction of the medicine cabinet where the lotion is kept as if he was standing in front of the cabinet and not sitting at his desk. I replied, "Oh, OK."

A while back at meal times I started adding the condiments, salting and peppering his steak, buttering his veggies. I continue to point to his fork or knife when he hesitates and out of frustration he is using his fingers more and more. Now and then I have found that I need to cut up his food. Try doing that and helping him keep his dignity!

When we go out into the cold I make sure he has his gloves, scarf, ear muffs, and the right coat. When we arrive somewhere I put his gloves in his coat pocket as that is not a skill he still has. If I say "Put your gloves in your pocket," he will attempt to put them in his pants pocket or just look confused. When we leave I must be on the alert to make sure he has gathered all of his belongings. You can imagine that as I spend so much attention keeping him together I have begun to leave my things behind.

I am afraid to let him go to the bathroom by himself in a public place so I go along. I try to be unobtrusive (especially when others are in the bathroom) but sometimes I have to help him with his pants. Once or twice had to explain how to use a urinal as he was about to pee through his underwear. Sometimes I'll just go into a booth with him, onlookers be damned.

And, as I have often ended these rants, some days he has no troubles with any of these skills so when I intervene it then confuses him or he waves me away. "Roles and rules are subject to change on a moment's notice and sometimes not even that." M.Horvich 2012.