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June Berg's Care Conference 3 September 2008


June’s quarterly care conference was held at the Alzheimer’s “Villa” of the Benedictine Health Care Center on the afternoon of Wednesday September 3rd, 2008.


This conference is usually attended by the duty Villa Nurse, the dietician, the social worker, the activities coordinator and the family member or members representing the resident. Because of staff absences, only the Duty Nurse and the Dietician were available to meet with me and provide information on June. (The activities coordinator had contacted me earlier to discuss any items that I might have questions in regard to. The social worker also contacted me following the Care Conference meeting in the event I had any items to discuss with her.)


Discussed a recent non-eating or drinking episode. June had a recent episode of 24 hours on Monday August 25th, 2008 in which she would not accept food or liquids at any of the meals. Food placed in her mouth would remain there without June chewing or swallowing it. At first it was thought that June was shutting down and this was her end times. Checking of June’s vital signs at the time indicated a slightly lower oxygen level than the required minimum of 90. Her blood pressure was normal. The nursing staff felt that perhaps June was not feeling well and had some chest congestion. While June did not appear congested to me, the duty nurse was of the opinion that there was some indication of minor congestion. The x-rays that were taken were inconclusive. June was treated with Nebulizer therapy for congestion and placed on oxygen. The oxygen was removed after 24 hours but the Nebulizer treatments were continued for the balance of the week. June was also on antibiotics. June improved quickly and with in two days appeared to be back to her pre-incident condition. She was accepting food by chewing and swallowing it. At the time of the care conference the only treatment June continued to have for this condition was to exhaust the remainder of a 10 day supply of antibiotics that had been originally started. Because June cannot communicate and is largely non-responsive, it is always difficult to determine when she is in sick, in discomfort or trouble. It is normal for June to sit with her eyes closed most of the time. Refusing to eat or drink was June’s way of indicating a health and comfort condition.


I discussed a few items with the Duty Nurse in regard to June’s daily care.


 I indicated that I desired for June to have music at her nap time and at her bed time. I have provided a CD player for this purpose. June enjoys music of the 40s and 50s as well as gospel music. I keep a CD in the player and all the NA has to do is push a button to start the player before leaving the room. Because of June’s present condition, her life is almost void of quality. I feel this is a way to put a little quality into her life by a soothing atmosphere. I have preset the volume at a low level and expressed my desire that the music be played in a low quiet mode.


I also discussed the need for the staff to turn off any overhead lights at nap and bed times so as to remove any distractions and to provide the most comfortable atmosphere. Also to partially close the door to help screen out any disturbing noises. The need to be check to be sure that June’s blanket is in position to provide the warmth needed and not left in a turned down position on one side. These are things that on occasion are overlooked,


We also discussed the use of the bed side guard rails. I had noted that the rails were being pulled in an upward position during nap time. I suggested that since June cannot move about on her own, there is no danger of June falling from the bed. I was concerned because of June’s advanced Alzheimer’s condition, that if she looked at either side of her bed and saw the blocking rails looking like bars she might become afraid or fearful. The nurse agreed that the guard rails need not be up and would see that this was corrected,


We also discussed the bed and the Geri-chair back and head elevations, settings and proper position.


The Dietician indicated that June appeared to be maintaining her weight. The most recent recorded weight was 132.4 lbs.


The Nursing Assistant staff that cares for June is dedicated and caring and I am confident that my concerns will be taken care of.

Comments (1)
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1Thursday, 11 September 2008 04:14
Mary M Thelen

I am happy that I finally found someone in tune with me! I finished reading most of your story.. and felt your essay on "A Caregivers Guilt" hit home.. I need to write my own, it will be much like yours. Your poem An Alzheimer's Heart is more than one can it is so true. I have a treatment plan conference coming up also. I question why you allowed your caregivers to administer antibiotics.. My husband and I both have health directives and in them we put "only keep me comfortable". This disease is so devestating.. and Jim is also in the final stage.. he too uses a nebulizer for his asthma.. I sometimes question it..I miss him terribly, but do not want him to go on any longer than necessary in his condition. I pray that God (and sometimes I question God's will also)may help me with any decision I have to make. We have 4 loving children who cannot bear to see their Dad as he is either. We have so many great memories ..remembering him this way is hard to take.

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