20 May 2025
If yesterday was a change of pace, today was an acceleration. But first let me tell you about yesterday.
YESTERDAY
USUALLY when Joyce gets dressed, I roll her wheelchair over to the gym door before going back to get her and walk with her to it. But yesterday I put Joyce’s wheelchair by the fish tank, which is about the same distance. Her Skechers stuck to the just mopped floor a couple of times but she righted herself with no trouble.
Kevin the Physical Therapist found us in the Pacific room where she was paying a few bills and wheeled her to the stairs where she went up three times, struggling with the third step. He thinks it's her reliance on the handrails, which level out about then.
Instead of going into the gym, he just had her walk. And it was quite a walk. She walked from the stairs to the scale, halfway round the building. Kevin is very impressed because she did it with just the trekking pole. That's the longest she's walked with just that aid (and me on the other side).
After he was done, I took her outside to get some sun on a 70 degree day. But just for a few minutes. Long enough for her to tell me walking makes her afraid.
She has her lunch in the Pacific room, which means I have to bring the tray there. On the way I check with the nurse on her Lexapro dosage to see if she’s getting what Dr. Khanna prescribed to address her fear.
It's a pill and a half or 15mg. I think it should be 30mg but when I look up the dosage I recorded on Joyce's blog, I see it really should be what it is. So that isn't the problem.
Back at the Pacific room an older guy comes in on his wheelchair and asks if we prefer some peace and quiet. Not really, we say. Is it OK if he watches TV? he asks. Sure, turn it on.
He puts on Eddie Cantor in a colorized Whoopie. And laughs at everything (including the dance numbers for some reason), which Joyce finds amusing. So we watch it with him. When he leaves before it ends, he tells us to feel free to change it, he can catch up with it later. "It was fun," I tell him.
I can't remember when Joyce was last amused by someone like that.
TODAY
KEVIN HAD A PLAN for today. I had taken Joyce to the gym where she was doing arm and leg exercises with video. He joined us and told her she didn't have to do stairs today.
I knew what was up because he told me yesterday. So I made sure Joyce had her sunglasses. We were going outside.
Kevin got his own sunglasses because the sun was brutal. Then he asked Joyce to walk around the cars in the parking lot. That's a bit shorter circuit than the hallways but not by much. It's also uneven ground, uphill in one direction and down in the other.
She kept asking how far she had to go but it was easy enough to get her to keep moving. I tried to get her mind on other things as we walked. And that seemed to help. Later she told me she wasn't really afraid.
She walked all the way around to our car and Kevin unlocked it and asked her to sit in the passenger seat. Which she managed to do, as she does when I take her somewhere.
But what I wanted to see, he knew, was how she got out. Because I've had to lift her out and put her in the wheelchair.
This time was different, though. She was able to get out of the car with the trekking pole (which we haven't used before) and sit in the wheelchair. Hurray!
AND TOMORROW
These two days represent some progress with her walking and her fear of walking. She's still not eating (today it was pizza and Brussel sprouts) but her weight is maintained by the Boosts. And she is brushing her teeth after lunch with my help.
Recently I heard about Program of All-inclusive Care for the Elderly or PACE that is something like nursing home care for seniors who can still live at home. Kaiser is just beginning to partner with PACE providers in Sacramento and Los Angeles but not San Francisco, where the program is managed by On Lok.
Our friend Carol mentioned as we discussed this that she had some experience with On Lok. "I worked with OnLok for a few years," she said. "They were awfully good."
There is a share-of-cost but it isn't clear if that would be the same as Golden Heights or significantly less (since the patient is boarding at home).
As an alternative to nursing home care, I thought it might be an answer for having her at home. But it seems she'd have to give up her doctors and we don't want that (particularly regarding her ongoing wound care).
But I'll be looking into it. Tomorrow. There's always tomorrow.