There really wasn't much discussed, to be honest. The same things that are good, are good and the same things that are bad, are bad. Nursing staff says she remains more alert than when she first arrived with some really good communicative days and fewer days without any communication at all. Because she had several very good weeks lately and now has quit talking again I did ask that they get permission from the doctor to do another urine culture just to make sure she is not suffering from an undiagnosed UTI which often leads her to become lethargic and non-verbal.
She is still scratching herself and they are trying to keep her nails short so she cannot break the skin but her skin is very fragile and it's not always possible. They cannot, by law, restrain her with any sort of hand split not ordered for PT so they are trying to get new splints from Physical Therapy and an order from the doctor to leave them on for a portion of the day. They had been doing this before but apparently it can no longer be done without a more current order.
Her oral care remains problematic. She does not cooperate with tooth cleaning or mouth swabbing at all. They do the best they can but they cannot risk having her break a tooth or bite herself (or anyone else) in the process.
The new feeding tube is not working any better than the old feeding tube, unfortunately. It is still leaking and the site remains open and inflamed. Some weeks it looks better than others but it never heals entirely. The nutritionist is becoming concerned that she is leaking more of her feeding than being reported since her weight is fluctuating without any other apparent cause. Personally, I'm not too concerned. She weighed 142 in March when she arrived here from The Manor. In June, she weighed 154 and they talked about cutting back on the amount of calories being given. (Unfortunately no one seems to know if they did or did not do so and the nutrition chart was not available. I seem to remember that they did - but that nutritionist no longer works here so I'm on my own.) She went down to 140 in September and is currently back up to 143 - which is a decent weight for a woman of her height and age. They did do a blood work up in Sept. to make sure the weight loss didn't have a physical cause and found nothing. That was when the last feeding tube was leaking really badly, so it's possible that she was not getting enough calories before the tube was replaced on the 13th.
The Activity Director said that once or twice a week Gary, the guitar player, either went to her room and played for her personally or they took her out to the commmon room when he entertained the entire floor. She seems to enjoy it although Gary reports that she does not speak to him or acknowledge his presence.
I visited with Estelle both before and after the meeting but she spoke to me neither time. She did open her eyes and look at me but she shut them again and that was that. There were letters and cards there to be read to her but she did not seem at all interested and so I tucked them in the drawer for next time.
She looks very good. There is color in her face and her hair was fixed attractively. It's getting quite long and we're trying to arrange for hair cut but until then the nurses have figured out how to pull it up into a high pony-tail and it really looks very good on her.
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