Dr. Miller

Janet was flying through the air on her way to her wheelchair as Mary/Gaga and I arrived this morning. She had a big smile on and not just because we were there. I think she is used to flying now and is OK with Amy as her nurse. Mary/Gaga had a gag gift of a tiara for Janet as she has been referenced as getting treated like a princess a lot. Janet thought “it looks fine” so she kept it on as she went out for breakfast. Her table mates got a chuckle out of it. Janet did not eat a ton for breakfast but enough to pass the test and Mary/Gaga escorted her to her therapy sessions afterward.

Being Monday, all the important people were back on the scene so I was able to have some productive conversations with a few of them. Cathryn was first as I reviewed our visit to Connect with us agreeing in the end to start the application process and when the team feels the timing is right Janet will move there as long as Interior Health and Connect approve. Cathryn and I then met with Dr. Miller and we had a good chat about Janet’s situation now and what it might be like at Connect. I asked him about Janet’s emotional outbursts and her asking “what’s happening” etc. He said to reassure her, change the subject and or the environment in order to “get her mind off of it”. He feels she is unable to process what happened to her and is “living in the moment”. Retaining and expressing memories is very difficult for her as right now her brain is still healing. That explains Janet’s automatic response of “no” and “terrible” to questions about her day. He advised the following as ways we can help.

– Try to build memories from old ones. A good example is the Do Re Me Fa song. Janet knew that without hesitation and we can try and find similar memories for her. When she brings those out she also has to activate the area of her brain that creates new memories and that will aid recovery of that area. Family memories are good ones to focus on.
– Treat Janet as an adult. No baby talk. No preschool books or activities unless it is done as something totally fun like singing a silly song that she may have sung to the kids a lot. Janet is 54 years old and may be challenged but is still an adult.
– Short visits. Keep visits to preferably one or two people at a time and only for twenty minutes or so. It is difficult for Janet to process things and the longer we are presenting things to her the more overwhelmed she can get.
– Community. Adventures like the one to the play on Saturday are really good for Janet, especially ones to familiar places.

Dr. Miller is confident Janet will continue to heal and progress and feels she is ready to get out of the hospital as it is a place for sick people. He emphasized the therapy at Connect is not delivered in pure focused bursts but inserted into activities of daily living throughout the day and patients are encouraged to participate as much as they are able at all times. He said, “people are not left alone in their rooms”. Over the next few weeks the team will discuss Janet’s case in more detail and “finish up” their work with her so she is fully prepared for the next step. I hope to speak to Dr. McCann tomorrow for his take on the timing and what the goals for Janet might be.

Mary/Gaga reports that Janet did well in physio. One exercise involved trying to stand from a kneeling position and apparently Rob loved her tiara and wants to wear it for his birthday tomorrow. Janet had a little melt down during Speech today and that session is proving to be the most challenging for Janet. It will be interesting to see how it changes at Connect. Jessica worked on Janet’s right arm and shoulder today. I find that area to still be under the influence of the Botox so that is good. I gave Jessica the all clear to find a wheelchair for Janet as she will need her own at Connect.

Lunch was cream of broccoli soup and Janet ate it all then when I returned to pick up Mary/Gaga, Robyn and Tammy Arjo’d Janet onto the toilet which was successful for Janet and reconfirmed to the nursing staff that it is perfectly safe to Arjo Janet.

A busy day so far. Looking forward to more this afternoon.

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