Thursday, March 29, 2012

Bob's Last Full Day at Spaulding

Today was Bob's last full day at Spaulding. He had physical therapy, speech therapy and occupational therapy. It was the first time that Bob refused to attend a therapy session; he did not want to attend group occupational therapy. It was speculated that Bob didn't want to be the center of attention. Being his last day, they would have made a fuss about him graduating Spaulding.

Bob expressed that he is nervous about the move during speech therapy today. He circled the word as a response to a question about his move.

Dan helped my mom put Bob in their car to prepare for tomorrow's drive over to Kindred. Bob liked being in his car. This helped my mom feel good about her choice of which car to keep. She is going to sell the accord and they are keeping the CR-V.

Tomorrow Bob leaves Spaulding at ten in the morning. He is not scheduled for any therapy sessions. Thanks for reading and keep the positive thoughts and prayers coming.

Wednesday, March 28, 2012

The Answer to Last Night's Question

Bob will leave Spaulding on Friday, March 30th at ten in the morning. That morning my mom will drive Bob to his new temporary home, Kindred Transitional Care and Rehabilitation Center in Natick. Clicking on the name will take you to their website so feel free to explore. I have not been there yet.

Bob worked really hard today. He had physical therapy, group occupational therapy, music therapy together with speech therapy and occupational therapy.

During musical therapy, Bob tried to sing songs along with the therapist who played the guitar. One of the songs was "Over the rainbow". I saw a video of it and it was hard not to tear up. Bob really strained to copy the words. He was in good spirits and enjoyed the session. Caitlin was there helping him along.

Dan, Bob's physical therapist, taught my mom how to walk with Bob and how to help him travel from the chair to the bed and back. She saw Bob walk up ten steps. Dan felt it wasn't time for her to assist him with steps yet.

I arrived at Spaulding with the kids while Bob was finishing up his occupational therapy session with Amanda. They were listening to a song called "Amanda" and trying to get Bob to say her name. We all saw Bob get up on his own and take steps on his own. Here is a video of it:


You can see Bob using his hemi-walker. Unfortunately he will not be able to take the hemi-walker with him to Kindred nor will he be able to take the wheel-chair. Bob will be able to take the brace for his right foot as well as the arm brace for the right arm that he wears while sleeping. My mom was told that the next facility will provide Bob with a walker and a wheel-chair.

After therapy was over we all hung out in the lobby and my mom treated the grandkids to munchkins while Bob had a donut. It was nice to hang out until it was dinner time for Bob. He seemed happy. This was our family's last visit to Bob at Spaulding and I felt an odd sense of relief mixed with apprehension. I was glad he is well enough to have "graduated", but anxious about how Bob will adjust to his next rehabilitation place. Well, when things are out of your control you just have to go with it, there is no other choice.

Tomorrow Bob will have his last day of therapies at Spaulding. My mom will start to take down the room decorations: all the pictures and drawings by grandkids as well as get well cards sent by friends that were hanging up on the wall. Another chapter of the story of Bob's recovery ended - it was sooner than we expected. But here's to new beginnings.

Thanks for reading and keep the positive thoughts and prayers coming.


Tuesday, March 27, 2012

When Will Bob Leave Spaulding?

Today Bob had physical therapy, speech therapy, occupational and group occupational therapies and a new therapy: music therapy.

My mom met with Bob's case manager and was told he was ready to leave Spaulding as early as tomorrow. My mom was surprised by this because she did not know that Bob has met the goals set by the team. After speaking with Bob's occupational and physical therapists (not just in passing but in a meeting setting), my mom became more aware of how much Bob has progressed. For example, he can put on his shirt and pants independently now. It is the team's consensus that Bob should leave before the April 5th date set early on in order for him to qualify to be a patient at a skilled nursing facility. Bob needs to be able to be skill-able, to still have things to improve upon, living skills to be taught so that he can be admitted at a skilled nursing facility.

Tomorrow my mom will be at Spaulding early to attend some of Bob's therapies. Visiting hours are at one in the afternoon during the week and my mom usually arrives at Spaulding for lunch around noon. As a result she has not been able to witness Bob's progress up close since a lot of the therapy sessions happen before lunch. She is looking forward to watching Bob demonstrate his new skills and I look forward to reporting on them.

It is likely that Bob will leave Spaulding by the end of this week even though Bob has not met one of the speech goals. Bob's speech goal is not being taken into account and my mom was told that this is normal in deciding the patient's discharge date. One of the goals set by the team in late February, was for Bob to be able to speak 8 to 10 words that express need like "hungry", "toilet" and he unfortunately is not there yet. But this isn't to say that Bob's speech hasn't come a long way in the thirty-seven days Bob has been at Spaulding. Today, for example, Bob said "my foot" when referring to his foot, in the middle of a conversation about his foot. Sometimes he blurts out words that relate well to a conversation, yet he has a difficult time reproducing them out of context. If you were to ask him: "Bob, say foot", he probably wouldn't be able to out of the blue. But these blurted-out-in-context-words come more and more frequent, and his usage of "yes" and "no" is getting more consistent. Bob's ability to make sounds has definitely improved from the grunts in February. His vocal pattern resembles the cadence of regular speech with ups and downs in inflection and tone. This in another one of those times when we have to look at the big picture and realize then that he has come a long way.

He will continue to go a long way, whether at Spaulding or the new facility and then later at home. And we'll be cheering him on. Thanks for reading and keep the thoughts and prayers coming.

Monday, March 26, 2012

Dear Old Friends

Today Bob had full plate of therapies: occupational, physical, group occupational and speech.

During occupational therapy he practiced using a long grabber to put on his socks and pants by himself. Bob controlled a trigger which would open and close pincers at the end of a long stick. This can help him gain some independence while getting dressed.

At physical therapy, it was decided that a size eight and a half six wide would be the best fit for his right foot to comport the brace. His left foot will be his regular shoe size. My mom can now return the other pairs to the very generous New Balance store in Brighton. (I don't mind giving them a plug, they allowed my mom to purchase all pairs at a 50% discount!)

My mother took my son to see Bob at noon while I had a routine OBGYN appointment. I met them at Spaulding shortly after Bob had eaten his lunch and the four of us hung out for a bit until Bob's speech therapy began at one in the afternoon. It was right around that time that Max and Bill, friends from New York, came to visit Bob. They have been friends for decades, having met while living on Browning Drive across the street from each other. We all left Bob with Caitlin for his speech therapy and went to have lunch at the cafeteria. At two we came back up and after Dominic and I said our goodbyes, the two couples that used to have dinner together every single friday night, hung out until it was Bob's bedtime. Here is a picture of Bob with Max and Bill (and a little guy who loves to be in the middle of the action):

Bill showed Bob pictures from trips to Europe on his ipad and they all talked a lot. As blog readers, they were curious to see the traffic game and the tile game so my mom showed them what I have been writing about. It occurred to me to post a link to these two things in case anyone else out there is curious. Just click on the links that follow to get directed to the amazon site for these games. This is the traffic game, and this is the letter tile game. Bill and Max gave Bob a Nintendo Wii console along with some games so that when Bob goes home, he can continue to challenge his coordination and motor skills. Bob was very happy to see both Max and Bill and they had a good time catching up.

At the end of the day, after Bob was dressed for bed and my mom was getting ready to come home, Bob surprised her. Every day when my mom leaves she tells him she loves him. Today Bob said "I love you" back to my mom for the first time. She was very happy when she walked in the door this evening at our house.

On a sad note, one of Bob's dear friends passed away yesterday from a stroke she suffered on friday. Eleanor was Bob's associate Dean for part of the time that he was Dean of Arts and Sciences at Farmingdale. She was currently the Dean of Arts and Sciences at Farmingdale. Bob and Eleanor kept in touch both professionally (Bob would continue to give her advice long after retiring) and personally (Eleanor attended my wedding and came to visit my parents after they moved to Massachusetts). We are all shocked and deeply saddened by this news. We have decided not to tell Bob about her passing at this time. My mom has concluded, and I agree, that there is little Bob can do to comfort her family or even express his sympathies. We are also fearful that Bob could fall into a depression given how much Eleanor was dear to his heart. Her cause of death might also trigger feelings that would best be avoided at this time. I hope one day Bob understands our decision to keep this from him even if only temporarily. Again, I draw parallels to how I recently handled giving bad news to my children: It took me a few days to tell them about Bob's stroke and I did it in stages. Maybe that would be the way to approach Eleanor's death with Bob.

Thanks for reading. Today we offer our thoughts and prayers to Eleanor's family. She will be missed.



Sunday, March 25, 2012

Puppy Love

Today Bob had no therapies. Sundays are his rest day. 

He did have a different kind of therapy: Bob spent some time with therapy dogs. Below is a picture of him happily holding a pup on his lap. 



Bob played another "expert" traffic game well. He also did three five letter words using the tiles. He is doing ok with them. My mom remembered that in the beginning of him practicing with four letter words he had a similar experience so she isn't very concerned about Bob's less than perfect track record with five letter words. 

My parents had lunch in the cafeteria for the second day in a row. In the afternoon their friends Bruce and Simone came for their usual Sunday visit. 

That's all for today. Thanks for reading and keep the positive thoughts and prayers coming. 

Saturday, March 24, 2012

Bob's Burger

Bob had a good day today. He had physical therapy, speech therapy and group occupational therapy.

During group occupational therapy Bob played with the cones again, but this time it was a different game where he had to use them to bat away balls. My mom said she was not as good as Bob playing this game. The therapist commended Bob for his improved speech, noting Bob was making more sounds.

Our whole family went to visit Bob in the late afternoon and we noticed that he is more prolific with the sounds he has been making. Bob's "yeses" are more purposeful and actual words are popping out more frequently. This happens mostly when Bob is not being prompted to say anything in particular. The words just flow as a result of a particular circumstance. For example, my mom mentioned that the New Balance store (where she bought a lot of his sneakers) was close to Spaulding and then Bob said: "Where is it?". This was as much to his surprise as it was ours. When we made a big deal about his improved speech he protested, he even used his left hand to close up his left ear in an effort to shut out the praise. This "It's no big deal" behavior has been present from the start. Bob is very reluctant to accept compliments. I can just picture him saying: "Naaahh..." if he could.

My mom and Bob ate lunch at the cafeteria today. Bob chose a cheeseburger and when asked if he wanted lettuce and tomato on it, he was puzzled. The person working behind the counter was patient and showed Bob a piece of lettuce, to which he said "no" and then showed him a piece of tomato, to which he said "yes". My mom thinks Bob appreciated having choices to make. I imagine that after losing control and independence, it must be a big deal to choose what goes on the burger. When Jason asked Bob what he thought about the burger, Bob was not very enthusiastic. Jason asked him if he missed eating his own burgers and Bob replied "yeah".

My parents did not go out today, as the weather was chillier than it has been all week. But they enjoyed hanging out in the cafeteria and then in the dinning room on Bob's floor. There Bob played the traffic game, beating the first card of the "expert" variety. He has completed all of the "advanced" cards. Bob also played the word tile game but did not complete all ten words he is supposed to on the weekend. He did the exercise for seven words. Bob breezes through words that have consonants separated by vowels like "bagel" but has more trouble with words that have many consonants in a row such as "bench".

Below is a picture of Bob's leg brace. I have mentioned this brace on previous posts. Here it is inserted into one of the many shoes that Bob tried on during the past week. Behind it you can see the Charles and the patio that is connected to the cafeteria.



That's all for today. Thanks for reading and keep the positive thoughts and prayers coming. 

Friday, March 23, 2012

New sneakers for the new brace

Today Bob had another full plate of therapies. All the basics plus group occupational therapy. 

Bob's custom made leg brace has been made and is being used. My mom shopped at half a dozen stores and bought several pairs of sneakers over the last few days to find a pair that will fit his foot with the brace. Today she may have found the one! Bob did a lot of walking with his hemi-walker as he tried on all those different pairs of shoes. Tomorrow if Bob has physical therapy, Dan will test out a few pairs to see which one is the best fit. By the way, Bob now says "Dan" regularly!

When I called in the mid afternoon, my mom and Bob were outside enjoying another sunny spring day. Bob was playing the word tile game. He got "apple" right away but struggled with "grape". My mom had to get off the phone to give him undivided attention so I can't report on the last word of the day. 

That's all for today. Thanks for reading and keep the positive thoughts and prayers coming. 

Thursday, March 22, 2012

Plans for the future

Today Bob had physical therapy, occupational therapy, group occupational therapy and speech therapy. He had a good day, and was in good spirits. Bob completed a difficult car puzzle but had some difficulty with the five letter words during the tile game.

My mom made some important decisions today. She chose the companies that are going to install the stairlift and ramp in their house. She also spoke at length with someone from the assisted nursing facility that Bob is most likely going to after he leaves Spaulding. This person will speak with Bob's case manager at Spaulding to talk about Bob's discharge date. My mom spoke with Bob's case manager today and two of them discussed the reasoning behind Bob's new discharge date. In short, my mom was trying to understand why Bob would be released earlier when he has yet to meet the goals set by his team.

Thanks for reading and thanks to those that are writing encouraging emails snd comments. Keep the positive thoughts and prayers coming.

Wednesday, March 21, 2012

Shella's Birthday

Today Bob had physical therapy, occupational therapy and speech therapy as well as group occupational therapy.

Bob had speech therapy outside today to enjoy the sunny day. He was very talkative and even said the numbers one through ten after Caitlin wrote out the numerals on the board. Bob also practiced saying the days of the week. Sometimes he would say "oneday".

Bob played the word tile game well again, today. He only tripped up a bit with the word "April". Bob got "brave" and "close" right away. He continues to play the traffic game daily, one card per day, but he missed it today because of the birthday party.

My mom organized a birthday party at the dinning room on Bob's floor. She brought cake and Brasilian docinhos. Jason was able to leave work to attend and met me and the kids at Spaulding. Bruce and Simone also came to celebrate. Lots of staff werer there, too and we sang "happy birthday" both in English and Portuguese. Bob sang very well. He was happy and in a good mood. Bob had cake and a few docinhos. Everyone had a nice time.

After the party ended and everyone left, Simone described to my mom and Bob her impressions of the skilled nursing facilities she visited earlier in the day. Simone went back to the places my mom had liked the most to gather some more information and be another set of eyes. Bob listened attentively and followed along well while Simone provided details of her visits.

Tomorrow my mom will meet with Bob's case worker to discuss his progress. Thanks for reading and keep the positive thoughts and prayers coming.

Tuesday, March 20, 2012

Five

Today Bob had five therapy sessions: the usual three plus group occupational and group speech.  He worked hard on all of them and continues to progress.

My mom met with Bob's doctor today who told her that she is considering moving up the date that Bob will get discharged from Spaulding. This is because if Bob gets "too good", he will not qualify to be admitted into a skilled nursing facility. So far we don't know what the discharge date will be. My mom has yet to meet with Bob's case worker to discuss this.

Bob spent a bit of time outside today, but he decided to come back indoors quickly because the breeze from the Charles was too chilly. By the time my mom and Bob headed outside it was already late in the afternoon and the sun wasn't shinning as brightly. The weather will be nice for the rest of the week, we are supposed to hit eighty degrees by thursday so there will be plenty of opportunities for Bob to catch some sun light.

Bob did well with the letter tiles games today. He played three five letter words and correctly built and copied them all: "table", "chair" and "house".

Tomorrow is my mom's birthday and she reserved the dinning room on Bob's floor for a party from four to five in the afternoon. There will be cake, soda and Brasilian docinhos. We are looking forward to hearing Bob singing the birthday song! There might be a surprise...

Thanks for reading and keep the positive thoughts and prayers coming.