Sunday, April 5, 2015

SunHaven Trips and Overnight

DRT 

How to Get Ready for Sunhaven - Lists and Guidance

Essentials List:

1. __Erica or Tobii
2. __Ambu bag
3. __Sponge Bob blanket from the guest room
4. __Black box and stool.
5. __Fully charged lithium battery.
6. __Shower chair with bucket.
7. __One white circuit for backup
8. __3 Diapers

Overnight Vacation Checklist:

From Bedroom:

  • __ 7 Blue Washcloths (Bedtime, Morning, and extra for Peg Tube.)
  • __2 White Towels
  • __ Socks and/or Ted Hose
  • __ Preparation H
  • __ Colloidal Silver
  • __ Large Q-Tips (Do not bring any small q-tips, and skip anything that uses them)
  • __Water Syringe for Trach
  • __ 3 Condoms
  • __ 5 Alkare wipes for condom
  • __ Alcohol Wipes (A lot... more than 10)
  • __ Any Blankets or sheets that Don wants
  • __ Razor ** and charger **
  • __ Calmoseptine
  • __ Eye drops
  • __ Nose Sucky Machine
  • __ Paper cups and Trach. Solution 

From Bathroom:

  • __Pink Sponges
  • __ Mouthwash
  • __ Wet Wipes
  • __ 2 Gauze Packets
  • __ Tissues
  • __ FULL roll of paper towels
  • __ Toothbrush ** and charger **
  • __ Toothpaste
  • __ Mouthwash
  • __ Orange Bucket
  • __ Body Wash to clean Trach.
  • __ Numbing Gel
  • __ Deodorant
  • __ Spit Bucket and Cup
  • __ Duo Derm, little scissors, adhesive removal wipes
  • __ 6 extra feeding tube

Optional:

  1. Big Bertha
  2. Extra blue circuit for backup
  3. Extra water bag
  4. Camera with film from my bedroom closet

Saturday, April 4, 2015

Shopping Instructions (including bone broth)

Shopping goddess - Overview and Helpful Hints: 

Basic Overview: shopping every other week takes about 2 hours (give or take). Keep an eye on the shopping list and inventory to determine when to go shopping. When something gets circled on the list, we still have one of whatever left. That way, you can let the list build up a little bit to make the trip worth it.
During PA shift check the shopping list and inventory because sometimes things don’t get circled and you’ll get an idea of when you need to go. 
Before you Go: before you leave check the list and inventory again just to make sure everything you need to get is circled. More often than not, people forget to circle things so ALWAYS double check inventory and shopping list. Also ask Don about credit card limit. Remember to bring reusable grocery bags. When you return from shopping read the totals from the receipts to Don and put them in “Kate’s Box” (the horizontal file holder on Kate’s desk).
Sprouts: depending on how much frozen food we have, buy 3 bunches of kale (or whatever greens you pick, kale is the easiest to cook and is usually on sale) for 1 package of chicken. We usually go through greens quicker so that’s just a general guideline to use so sometimes you might have to adjust it. There should technically always be four containers of frozen greens and protein, its okay if there’s less, but just make sure we don’t run out.  Typically buy 3 bushels of parsley, if there’s still a whole one in the fridge get 2. Buy fennel bulb based on bone broth; if we have bones and can start a batch, get a fennel bulb. Overall, just use your judgment.
Vitamin Cottage: there are a few things we get from here that we go through quickly so buy multiple:
Burts Bees Honey chapstick (3)
Rosemary (4)
Plant enzymes (2)
Dish soap (2)
Water: good way to determine when to go shopping. If three or more of the 5 gallon jugs are empty check the shopping list/inventory, use your judgment. It is easiest to bring 2 of the jugs in, get everything else on the list, check-out and tell the cashier how much water you have/will be getting and make two trips if necessary. Also, they will help you load the water into your car if you want, sometimes they offer but you might have to ask.
Rewards: sign up online so you can use your phone number. Go to naturalgrocers.com and in the upper right-hand corner click Npower sign up/log in.
Sam’s Club: the most important thing we get at Sam’s is paper towels so buy 2 depending on how much we have. Also there’s a few things you can get here or wherever is most convenient:
-organic extra virgin olive oil (EVOO)
-hydrogen peroxide
Online Shopping: the billing address is  my home address in Collierville, TN 38017. Also the phone number for the billing address is my wife's cell  phone (all of this information is on the paper above the phone in the kitchen). When you order from Herbal Healers when you check out click “order with credit card on file” and then scroll down and enter the “HHA Member Number” which is DB1048. You’ll still have to put in the credit card info even though it says it’s on file. For Super II, order 3; Reishi Mushroom, ½ pound ground; and Colloidal Silver, 2oz with dropper BUT check with Don before you buy anything.
Other: there are some things that you can obviously get at multiple different stores (such as EVOO, hydrogen peroxide, Burts bees chapstick, etc.) to save time and gas, get it where it’s convenient. For example if we need EVOO but nothing else from Sam’s Club get it at Sprouts or Vitamin Cottage. Also, generally speaking, get the bigger quantity of things if it is available (ex., T gel shampoo, hand lotion, coconut oil, etc.).
As the shopping goddess, you’re also in charge of running other errands for Don unless he asks someone else. The most common would be sending his mail. If Don asks you to mail something go to Leonard’s Mail Store (off Magnolia and Howes). Kate and Ken have an account there so when it’s time to pay say he/Kate has an account.
Also, when you return from shopping don’t hesitate to ask the PA to help you unload water and groceries.
IMPORTANT: the shopping goddess is in charge of getting cash for Don’s haircuts ($15) and staff meetings (usually about $100). You can get cash back and Wal-Mart and King Soopers in amounts of $60 so try to plan ahead as much as you can by looking at the calendar to see when haircuts and staff meetings occur. Sometimes you’ll just have to go to either King Soopers or Wal-Mart and get something we use but it’s not circled on the list (ex. Hydrogen peroxide, dryer sheets, etc. use your judgment). Also Wal-Mart doesn’t have 10 dollar bills so get change at King Soopers or a bank. As a last resort it is possible to get checks from Kate so if it comes down to it, text her to see if she or Ken will be in town, but again, this is a last resort situation.
Bones: we usually go through Meadow Maid Foods at farmers markets. Email Cindy Ridenour (cindyr@meadowmaidfood.com) to see if/when she will be in Fort Collins and to place an order. 20 lbs lasts about 4-5 months. She only takes cash or check. If you can’t get cash text Kate to see if you can get a check. If that doesn’t work out you can buy organic bone broth at Sprouts/Vitamin Cottage. Try getting on Google and searching for organic grass-fed beef bones. They don’t have to be beef, but they do have to be organic. If that doesn’t work consult Kate.

Additional liquid bone broth options. There is a big difference between beef broth and bone broth! In terms of vitamins, minerals and nutritional content. Bone broth must be organic and can be found premade in those square boxes they put soup in nowadays at Vitamin Cottage (now called Natural Grocers) and Whole Foods. Check for some at Sprouts. Buy organic beef bones from Vitamin Cottage or Whole Foods but of course they cost more. Get knuckle bones and or marrow bones.
Lastly, don’t hesitate to ask questions about anything you aren’t sure about. Don and Barb are both good resources. You can also call stores to see if they have what we need or to price check. 


Monday, March 2, 2015

Morning CNA Visit

DRT 
  • Call in with Assuricare (only if are in their system) 
  • Read Reports and White Board
  • Turn on ERICA and move her by the blue chair so Don can see it. 
  • Wash hands
  • Set Up Supplies for visit on Table at foot of bed
    • Water syringe for  trach
    • Condom cath and Allkare
    • Lotion
    • Trach solution
    • Tissue
  • Set up Supplies for cart by door
    • 2 Gauze packages 
    • 3 Q-tips
  • Water Management and Mouth Suction
    • Remove and place in cart by door: 
      • Right hand, yellow finger foam 
      • Hand Blue Bird Pillows, Hand Towels and Arm purple pillows
      • Foam pillow behind head
    • Move sheet to the left side of the bed 
    • Remove blue roll under knees and place on dining room table
    • Drain Condom Catheter hose - but first raise head up first and then feet down
      • Disconnect Tube from Bag and remove condom
      • Strap on Cart by door
    • Grab 2 Blue Washcloths and place on bathroom counter
    • Grab 2 more Blue Washcloths for face and belly and place on towel bar
    • Drain Cath Bag in Bathroom
      • At the same time- fill Orange Bucket with HOT water
      • Put both washcloths in tub
      • Take out 2nd washcloth and dab with soap
    • Place Orange tub on Shower Chair in bedroom
      • Cath Bag on cart by door
    • Legs up for Butterfly
      • Wash stomach, then groin area,  with soapy washcloth
      • Rinse with other washcloth
      • Then dry with Towel on back of Shower Chair (towel stays on bed foot board)
      • Fold sheet
ROM- Both Legs
  • Butterfly x3
    • Remove foot foam and place in corner at headboard
  • Leg straight then heel to butt x3
  • Stretch foot back once
  • Pull toes
  • Remove bandanna - put it in laundry, foam pad (helpful hint:  use bandanna if foam just needs to be wiped clean otherwise wash if gross), and Wet Trach with water in syringe
    • Keep 1 tissue for catching mucus under trach
  • Lotion on Lower Legs and Foot (not between toes)
  • Keep Right leg bent up
ROM- Left Arm 3x
  • Thumb out, fingers in, then Thumb in, fingers stretched x3
  • Arm up- sideways, bend arm x3
  • Remove gauze and clean trach with 3 long wet Q-tips
    • Use Colloidal Silver, A&D ointment
    • Wad tissue and place under trach
  • Put Condom on
    • Apply Allkare- fan then apply condom
  • Put on TED hose
  • Important, put both feet beside the box (in place for lung suction - not on box) 
  • Put things on Cart by door
  • Return orange tub to bathroom
    • Save washcloths to use on upper body
    • Wet 2 Q-tips
ROM- Right Arm x3
  • Same as LEFT
  • Remove feeding tube and take peg out of shirt
Clean PEG tube
  • Remove gauze on belly
  • Get belly wash cloth from bathroom- dot of soap on one corner
  • Clean PEG with soapy corner then rinse- 2 drops Colloidal Silver
  • Nose Suction- use Sucky Machine, then 2 wet Q-tips then dry end, tissue (save tissue)
  • Clean Sucky machine then grab face cloth
  • Wash Face with HOT washcloth- eyes first, forehead, cheeks, chin, nose, mouth
    • Turn over washcloth and wash ears
    • Dry neck with tissue - save tissue for spit while dressing
  • Mouth Suction
  • Shave
  • Lift chin up to shave Adams apple and neck
  • Chin, cheeks and mustache
  • Wipe hairs off lips after mustache 
  • Last Q-tip- Calmoseptine, put on PEG tube
  • Gauze- PEG tube and Trach
  •  Important! Always put the balloon little tube over the gauze as shown: 

    When you put it under it hurts and causes a red mark as shown: 
  • Lung suction- Bullet ALWAYS:
  • Between first and second - get brace, unhook roll pillow
ROM- Neck Exercises
  • Remove roll pillow and place in corner at headboard and put white pillow to the right of head
  • Turn Neck- Up and Around- look up, turn right and back, turn left and back, side to side – 90  degrees
  • Down and Around- look down
  • Head to the side- massage sternoclaidomastoid
  • Brace On
  • Water Management
Transfer to Shower Chair - left hand on thigh, right hand off bed 
  • Have your pa help swing my feet around, put shoes on and put feet on disk. 
  • Move disk so legs are vertical 
  • Your pa helps lift Don's hips
  • Have your pa push the shower chair to Don's legs. 
When Don is sitting down: 
  • Raise tubes on vent arm 
  • Feet on Foot stool
  • Paper Towel between legs
Remove Shirt
  • Left arm out first, then Right arm
    • Hand under shirt and brace
    • Lift head up
  • Remove Brace
  • Reconnect trach under shirt
  • Remove Shirt over head, put in laundry, check if shirt has food spots to be sprayed
  • Important, the extra tissue goes under Don's chin 
  • Make sure shoulders are straight 
 Important! On Saturday skip washing upper body.  Skip to putting shirt on below.  
  • Get Diaper and cut
  • Set up Mouth supplies in bathroom
    • Toothbrush, tub, cup, pink sponge with mouth rinse
Upper Body Bath- in Shower Chair
  • Hot Water in Orange Tub- hot, soapy washcloth
  • Wash Chest, Arms, Back (don't hold head)
  • Rinse Chest, Arms, and Back
  • Dry Back and Lotion entire Back, pain cream on back? Ask Don where? Usually upper  spine or upper right. 
  • Dry rest of body
  • Need deodorant?
Put New Shirt On- Head, Right arm, Left Arm, Trach 
  • Lean Forward, Straighten Shirt down Back
  • Diaper on, Shorts on
  • Connect Bag to leg
  • Wait to connect to condom
  • Lotion on Knuckles/Fingers and Psoriasis spot on Left Arm if necessary
  • Ring Management
  • Return Lotion and Orange Tub to Bathroom
  • Grab mouth supplies already set up in bathroom, move to bedroom, get 5 double paper towels and put numbing gel on q-tip
Mouth Care
  • Wipe out Mouth with paper towel
  • Brush teeth
    • Outside- up and down
    • Inside
    • Outside- up and down
    • Inside
    • Roof of Mouth and Tongue
  • Wipe out Mouth with paper towel
  • Lean forward, tub on lap, right hand over left 
  • Mouth Rinse 2x
  • Wipe teeth with pink sponge
  • Wipe out Mouth with paper towel
  • Numbing Gel on front teeth top and 
  • Belly Rub
    • Up on Right, across, down on Left x2
  • Lean forward
    • Place Batman pillow behind
    • Hands on knees
    • Butt lift on both sides, fold pillow down
    • Fix feet
    • Paper towel on hands to catch spit - make sure clips don't stab hands and the yellow tube on bertha is up
  • During Wait
    • Clean up Mouth supplies
    • Set up Nighttime supplies- gauze, water syringe, 3 Q-tips, 2 washcloths, alcohol swab, and 2 tissues
    • Make bed and empty suction bucket
  • Shower chair back one notch
  • Remove batman pillow when finished 
  • Brace on
  • Connect Condom Cath tube to bag 
    • Use alcohol wipe on cath tube
    • 2 Tissues on blue tab (if it falls off - this is optional) 
    • Pull up diaper and shorts over knees
  • Lay on Floor to Wipe Bottom
    • Check Duo Derm if on bottom, Prep H
  • Mouth Suction
  • Move to Living-room
Transfer to Wheelchair
  • Use Black Box to Transfer
  • Push condom on 
  • Sandwich legs
  • PA guide hips back as far as possible
  • Push knees to get Don as far back as possible
Wheelchair Comfort
  • Pull down and Straighten out the back of his shirt
  • Feet on pedals
  • Put bag in WC holding bag
  • Check and straighten condom, cath bag and tissues around blue tab position
  • Roll under trach
  • Left butt lift
  • Seatbelt (make sure shorts are under the strap)
  • Cross arms and lean wheelchair all the way back
  • Push HARD 2 times with hands just below kneecap & ask if it’s okay
  • THE SHOULDER TWIST
    • Right arm up, side lateral around – don’t push!
    • Shoulder Twist- the lateral should click after this move
  • Move wheelchair back into place
  • place blue roll pillow by left thigh
  • Lung Suction
  • After lung suction – Burp tube while still leaning back
  •  Head 19, Feet down until foot pedals extend
  • Shoes off
  • Adjust Neck Brace (Chin lift to tighten) /use the same bib
  • Move Wheelchair to big wheel in blue floor tape
    • AM- Place black blind behind chair to stop glare on computer screen, feet facing front door
    • PM- Spin Don to face TV (hold power cord/ big wheels in line with blue tape)
Set Up ERICA
  • ERICA should be horizontal with silver bar, twist Erica sideways if necessary
  • Move Erica up/down by grabbing the edges of the screen. Move side to side by using bar. Don will help guide you to the correct positioning.
  • Important. When Don says UP it means tilt Erica down so his eye goes up!
FINAL-
  • Mouth suction
  • Chapstick
  • Set up Black Hand Bell
  

Tuesday, February 24, 2015

Bedtime CNA visit

READ REPORTS AND WHITE BOARD

In bedroom preparation:
  • Get mouth supplies
  • New diaper
  • 5 paper towels
  • Trach solution
In living-room: 

Take blue roll and rice off of belly
Water Management
Lung Suction
  • Disconnect Urine Bag, hang in bathroom
  • Plug condom
  • Tissues in Shower Chair
  • Remove burp tube
  • Trach roll on hospital table
Transfer to Shower Chair
  • Unplug Big Bertha
  • Remove diaper, shorts, and shoes 
  • Move to bedroom
  • Lock Shower Chair
  • Feet on Step stool
  • New Diaper at ankles 
  • Paper towel between legs
  • Diaper at knees 
Mouth Care
  • Remove Brace- life chin and hold head
  • Wipe lips
  • Put hands on knees- space for bucket
  • Rinse mouth- twice
  • Brush teeth with pink sponge
  • Wipe mouth with paper towel
  • New bib
  • Replace Brace
PEG Care
  • Roll shirt up and under
  • Remover gauze, fold old gauze opposite way and wipe off pink stuff
  • 2 wash cloths- one with soap, one without soap
    • Wash belly- use Q-tip
    • Rinse belly
  • Colloidal Silver- 2 drops
  • New gauze- 1 tape across bottom
Rub Belly- Colon Massage
  • Start at Don's right, massage up, then down on left
  • Lean forward- Batman pillow, chair forward, fold hands- ring on top
  • Butt spread
  • Paper towel on knees for spit
  • Feet straight on stool
  • Clips not stabbing arms
  • Condom in bucket- unplugged
WHILE GOING
  • Clean up mouth/teeth stuff
  • Clean suction machine in Livingroom
  • Drain and rinse urine bag- put in bedroom
  • 3 baby wipes, scissors, Prep H
When done using commode
  • Remove Batman pillow, wipe mouth, sit back
  • Wipe bottom, Duoderm, Prep H
  • Push condom on all the way
  • Pull up scrotum, tuck diaper, hands in diaper
Water Management/Mouth Suction

Transfer to Bed
  • Unlock Shower Chair
  • Put shoes on
  • Smooth shirt
  • Lift up in Bed- make sure pillow is under head
  • Lift tubes, make sure to LEFT of PEG tube
  • Remove Brace
  • Place Trach Roll with clips
Eye drops, tissue
Remove socks (need washed?)
Place foot foam, get wedgie, flatten diaper

LEG ROM
  • Butterflys- 3x
    • Get wedgie
    • PeriCare- wipe out groin area, lower feet alittle
  • Legs up, then bend,- 3x
  • Pull feet back- 3x
  •  Pull toes
Connect Urine tube to Right leg
Wrap short side
Blue roll under knees
Sheet sideways across legs and bed
Wet trach with water syringe

LEFT ARM ROM
  • Fist, backwards fingers- 3x
  • Arm up, sideways, bend elbow- 3x
Clean Trach
  • 3 Q-tips in solution
  • 1 Q-tip in Colloidal Silver
  • A&D or Neosporin
  • Clean up hospital table at foot of bed
RIGHT ARM ROM

Clean Nose
  1. Sucky Machine
  2. 2 wet Q-tips
  3. Tissue
Wash Face and Ears
Corellas Beeswax Cream on Knuckles and Nose
Put gauze on Trach

Bed rails up
  • Hang Catheter Bag on PUSH button
Place purple pillows and flower pillows, hand towels on bed
Ask PA for snack and meds

Smooth shirt under back and chuck and sheets
  • Place arm pillows, flower pillow and hand towel, yellow finger thing
  • Put head roll on bed (don't clip) 
Mouth Suction

Bedtime Snack- RED DROP, meds, food- clean up


Lung Suction with bullet ALWAYS:

  • Feet on box
Flip pillow, put small foam pillow under pillow, clips on roll

  • 3 tissues around neck collar, adjust pillows right arm
  • Connect Burp Tube to roll
  • Adjust foot foam
RIGHT Butt Spread

  • Connect condom (push condom on), washcloth horseshoe over urine tube, close to Don
LEFT Butt Spread

  • Fix Left arm pillows


Rice Pack (1 1/2 min)
Test Door Bell (lower head, move legs/feet)
Hair Management, place pillow behind head, tuck chin
Water Management, hoses up with cardboard
"Did we forget anything/"
Suction, Chapstick, Echinacia?
Lights Out, Goodnight

How to Lean Me Back in the Wheelchair

DRT 

How to lean Don back in his wheelchair

Before leaning back:

1. Ask Don if he wants to microwave his big Superman rice pack- not the small rice on his belly
2. Clamp burp
3. Lower feet until Don gives you the eye (His bottom has less pressure when his feet are down).
4. Water management
6. Move the black blind out of the way
           a. If Don is facing the TV, make sure the cart is out of the way
7. Sponge Bob blanket?
8. Mouth Suction

Leaning back:  (only AFTER he sets up Tobii on Track Status!) 

1. Hold and watch tubes as you lean Don back. Lean all the way until it stops
2. Blue FedEx blanket? If so, fold it in half and place blanket across chest and tuck it around elbows
3. Big rectangular Superman rice pack?
             If so, put it vertically across chest as low as possible covering hands.
             (This can be found to the right of the microwave).
4. To find out how long to lean for:
           a. Let Don know what time it is
           b. Start at 30 minutes - Go down in intervals of 5
                    until Don says you’ve reached the appropriate time in minutes.
5. Move the joystick out of the way only if Don is watching TV:

6. Look his way occasionally to make sure he’s doing okay
 Important - if Don starts coughing out of control ask if lung suction is needed! 

After leaning back:

1. Lean forward - Look at Tobii and tilt forward until you see the white arrow is slightly above the green area to the right of the two white dots (eyes).
2. Take big rice off? Take FedEx blanket off?
3. Unclamp burp tube.
4. Put feet up until Don gives you the eye.
5. Mouth suction
6. Replace black blind if necessary.

Saturday, February 21, 2015

Directions to ALS Support Group Meeting

DRT 

ALS Support Group

is at 1 pm -  2:30 the fourth Tuesday of every month at the

The Medical Center of the Rockies 

The meetings are at The Medical Center of the Rockies, located at  2500 Rocky Mountain Ave in Loveland on west side of I-25 just north of hwy 34.   G. P. S. the hospital address before we leave Fort Collins. 
We will be meeting in the Horsetooth Rooms. Go to the main entrance and then take the elevator down to the basement. Look for signs posts telling what room. It may vary depending on how many people.  

1. From Don’s house go south on Shields Street.

2. Shields Street changes name to Taft Avenue in Loveland. Continue on Taft Ave.

3. Follow your G. P. S.

*Special Sauce tips:

  • The meeting starts at 1:00 p.m. and lasts until about 2:30 p.m. Leave Don’s house no later than 12:30, and bring 2:30 meds. 

Tuesday, February 17, 2015

Afternoon CNA Break

DRT 
 Composed by Marianna

  • Wash hands
  • Check to see if there are tissues in SC bucket and bring out SC and stool
  • Water management / take out blue hot dog pillow/rice in microwave
  • Prep 3 double paper towels and alcohol swab- put on dinner table
  • Move blind and take Tobii away
Here's how you should position Tobii:
  • Pull Don forward to about where the dinner table begins
  • Mouth suction
  • Lung Suction
  • After LS…
    • Open burp tube
    • Lean Don forward
    • Fix arms
    • Lower feet 
    • Put shoe strap around heels
  • Take off seat-belt and loosen the left strap of seat-belt enough to drape over the arm of the WC
  • Take out catheter bag (pull tube out from under legs so it’s sitting in between legs when draining) 
    • Put tissues from tube on Bertha to reuse
    • Hang leg strap on SC
    • Put urine bag in bathroom
    • Rip a small square off a paper towel in bathroome
  • Use square from paper towel to plug condom
  • Tuck condom into diaper
  • Take off burp tube (put in sink & rinse with water) and take off trach roll
  • Mouth suction

TRANSFER

  • Put Don's feet on your shoulders
  • Put strap on foot pedals and lower them all the way
  • Have PA hold forehead
  • Lean forward all the way- feet down so toes touch ground (may have to pull a little)
  • Sandwich legs with yours
  • Take off right arm lateral
  • Transfer to Shower Chair

IN SHOWER CHAIR

  • Hands in lap/shoes off/ lift feet and slide stool from behind legs/ diaper and shorts below knees
  • Pull plug out of condom, do not take the condom off
  • Check for “spot” in diaper
  • Put double paper towel over junk into bucket
  • Pull diaper and shorts over hands
  • Belly rub over large intestine; with force. Watch video below 
  • Batman pillow/ pull chair forward one notch/ lean Don forward
  • Cross hands (ring hand on top)/ put hands over knees/tuck double paper towel into hand (tuck by thumb, should hang forward)
  • Butt lift both sides
  • Fold Batman pillow
  • Check everything! (condom, push pillow down, socks over toes, toes not over stools, no clips stabbing, blue trach tube to the right of the white one & yellow tube up)

While Waiting

  • Empty suction bowl and fill jar
  • Get burp tube ready
  • Empty catheter bag
  • get prep H, baby wipes 

Complete Shower Chair

  • Remove pillow/ wipe lips with paper towel from hand/ lean back
  • Get catheter strap
  • Connect catheter bag/ push condom on ALL the way
  • Diaper and shorts up to hold hands
  • Wipe away until baby wipe is totally clean
  • Shoes on
  • Mouth suction
  • Get black box for transfer/ push condom all the way on one more time

Transfer!

  • Use Black Box to Transfer
  • Sandwich legs
  • PA guide hips back as far as possible
  • Push knees to get Don as far back as possible

Wheelchair Comfort

  • Pull down and Straighten out the back of his shirt
  • Lean back a little
  • Feet on pedals
  • Check and straighten condom, cath bag and tissues around blue tab position
  • Roll under trach
  • Straighten condom
  • Left butt lift
  • Seatbelt (make sure shorts are under the strap)
  • Cross arms and lean all the way back
  • Push HARD 2 times with hands just below kneecap & ask if it’s okay

THE SHOULDER TWIST 

  • Put both of your hands on Don's shoulders 
  • Put his left shoulder back while pushing right shoulder forward
  • Lift up Don's right hand and push right lateral in.
    Push the right elbow rest in position. 
  • Place blue roll pillow by left thigh
  • Lung Suction
    • Close burp tube
    • Feet almost all the way up. Tilt head back until you can reach him, your decision. 
  • Shoes off, blanket?
  • Adjust Neck Brace (Chin lift to tighten) /NEW bib
  • Move Wheelchair to big wheel in blue floor tape
    • AM- Place black blind behind chair to stop glare on computer screen
    • PM- Spin Don to face TV (hold power cord/ big wheels in line with blue tap)
Set Up Tobii
FINAL-
  • Mouth suction
  • Chapstick

Duties of the Care Manager

DRT Care Manager Position Job Description Keep track of Medicine/VA order, tell Don when VA order needs to be ordered Don’s med...