Monday, May 30, 2016

Sleep and Blood

I have been neglecting the blog and there is a fair amount to catch up on.

The last four weeks have gone past in a bit of a blur. In a good way, mostly.

Rosemarie was doing quite well and has settled down to a more regular food and fluid intake with occasional bad days. It took me a while to get rid of the haunting feeling that this was all going to crash and burn suddenly. But we had three weeks and there is cause for cheerfulness.

A few weekends ago our friend Celia was down and we persuaded the care home to dress Rosemarie and put her in the comfortable chair we have on extended loan. We were able to take her into the garden and sit her in the shade looking around in the bright sunshine. 

Saturday she was a bit sleepy but Sunday she was alert and 'chatting', laughing and generally interacting. Monday was more sleepy again, and this alternation developed into a pattern.

We found out she has a UTI again, and the general consensus is that this can account for the sleepiness.

I have another theory.

We have pretty much established the principle that her food and fluid intake notes are kept in her room where I can keep an eye on them. Recently they have made interesting reading. There is a night staff care worker who is filling in notes about giving Rosemarie fluid during the night. I don't know if this is a widespread practice and nobody else is filling it in or it is just her. So the fluid intake chart says she was given 200ml thickened water (yuck) at 2 a.m. This would have required her to be pretty awake or it would have taken a long time. Let's check the sleep chart and see what it says for 2 a.m.

Asleep.

So the sleep chart is meaningless. I strongly suspect she is having restless nights and not sleeping well. The days are boring and she is tired so she dozes. When she is up and dressed and in the chair she may doze for a while but when she wakes up she is available to be stimulated. In bed during the day, she wakes from a doze, looks blankly into the unstimulating distance, and closes her eyes. This translates as her 'sleeping most of the time'.

We steadily worked on establishing the routine that she is dressed and put in the chair mid morning (if they don't do it then, it seems difficult to find the time later) even if she is 'sleepy'. She can then be fed her lunch in the chair (easier and safer) and can have a doze after lunch if she wants.

All seemed to be going well until Saturday morning. I got a call from Good Nurse saying that Rosemarie had eaten breakfast and had 200 ml thickened tea (yuck) and 200 ml of juice, and been dressed and hoisted into her chair, but some time after 11 a.m. she had vomited everything up and the vomit had included a noticeable amount of blood.

Rather worrying. I had to exercise great self control not to Google 'vomiting blood'. The doctor had been called and had recommended keeping an eye on her (!) and saying if she vomited blood again she would need to go to hospital. 

By the time I arrived she was cleaned up and back in bed and on a regime of only thickened water (yuck). No food, no treats, just yuck. 

She was sleepy (genuinely I think) but not particularly distressed and seemed brighter and more alert by the time I left in the evening.

Sunday she was back on normal meals and thickened juice, and happily ate a chocolate trifle. She seemed alert and chatty, and kept her eyes open most of the time I was there. Even when she did close her eyes she was not usually asleep and would respond to sounds or food.

Worrying about the blood though. 

1 Comments:

Blogger Unknown said...

Kind of good then... except for the blood, but maybe that was just a one-off. She is so lucky to have you caring for her.
Massive hugs
Mxx

5:07 pm  

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