This Is Harder Than I Thought It Would Be

Jim is in such a state of confusion, I feel like I am dealing with someone with Alzheimers.

It has to be his ammonia level, combined with the change in situation. (Jim got terribly confused the first few days out of the hospital to Shipley.) I feel like he's had a week's setback. Jim had blood drawn on Friday, and I'll try to get the results of his ammonia level from Shipley today. I suspect they cut his lactulose back too far. If his ammonia is back up, I'll call his GP to see whether and how much I should increase it.

The nature of Jim's confusion--pretty much everything. He tries to use the TV remote to call people (even though he doesn't have their numbers) and the phone to change the TV channel. Therefore, my intent to use the phone as an intercom (which it does) will not work because who knows what TV channel Jim will end up with me if he tries to buzz me.

He's also became pretty belligerent yesterday. Kept calling me a bitch (with different adjectives in front) because I would not place his walker within his reach whem I was out of the room. He spent an hour sorting through the money in his wallet, putting the bills in different order, and seeming to count it. Then later he told me he had to go to the ATM because he has no cash. I offered and he accepted an Ativan for his anxiety. Unfortunately, that really knocked him down and he didn't want much dinner (I had made a roasted pork tenderloin with fresh fetticine with pesto).

I keep hoping this is all an anxiety thing that will clear itself up in a few days. Luckily, I found a message on Jim's voicemail that one of the GI specialists had scheduled an appointment for him this Wednesday, and Jim wants to go then. Maybe she can shed some light/hope on this dementia he's experiencing.

A visiting nurse group started its home health care evaluations today. A nurse did the evaluations for skilled nursing care and a home health aid. Jim will see a nurse ~3 times a week, and she will take his vital signs, check his breathing, and check him for signs of recurring liver disease (such as belly bloating and swollen legs). She also will draw the blood for the required lab work.

The home health aid will come in 3 times a week to help with personal needs, such as a shower, shaving, toothbrushing, and do his laundry and feed him a meal as needed.

Tomorrow we will get the evaluation from the physical therapist. There also is supposed to be an occupational therapy evaluation somewhere.

After a hospital stay, Medicare pays 100% for these home health services for up to 9 weeks is deemed medically necessary by the service provider.

Would I do this again? Probably, but I 100% wouldn't want to. Taking care of Jim right now is a 24-hour operation that is thankless when he starts calling me a bitch, and stressful/guilt-inducing for me when (in an outside voice) I have to set rules or correct him about how he is mobilizing. But I'll discuss that with him after he gets better, which I expect him to do. We'll have a plan in place in case this happens again, whether it's him or me that gets into this nasty place he is in right now.

My apologies to Betty, who called yesterday while Jim was in the middle of an episode. I understand, Betty, how you first thought Jim was teasing about me being a bitch. We had bantered in front of you when you saw him in the hospital. Now is indeed different. He is having dementia espisodes that I am completely untrained to handle.

For example, he woke me tonight yelling and ranting about 8 women in 4 planes that were crashing. We were up more than 2 hours with that in his mind. Now he's been down in the basement sleeping for 2 hours while I've been on the Internat checking the FDMB and writing this. I better head off to sleep; I can't let him get too far ahead of me in the sleep department.