Music Therapy

Sing Song, Janet and John hit it off. #TSJ

SORRY. WORDPRESS APP GIVING ME A FEW PROBLEMS SO THIS POST DIDN’T PUBLISH YESTERDAY. WEDNESDAY’S UPDATE COMING SOON.

I arrived a little earlier than usual today as I wanted to meet John who is going to spend some time singing with Janet. Lorne was in the process of toileting Janet as I walked into her room and we just had time for our daily debrief before John showed up. The gym was really busy when Janet went down there this morning so Jess did some stretching with her on her bed and said that worked fairly well. Janet remembered that she didn’t go to the gym and that she did some stuff in her room. She told me she had sandwiches for lunch but wasn’t sure what kind. The rest of her report was pretty garbled so I focused on getting her ready for singing with John.

We met John in the Den and Janet had a nice smile for him right away and kept it on the whole half hour they were together. John has a very positive attitude and an energetic personality and I could tell Janet liked him right from the start. I left them alone partly because I don’t sing but mostly because I want Janet to feel that is her time to learn and have fun on her own. I came back after a half hour and Janet was still smiling and gave a nice encore performance of My Grandfather’s Clock and a song about Titanic. John asked if he could come back next Tuesday and Janet said of course. When I asked her what she had done today she couldn’t remember most of it but when she and John started singing songs she hasn’t sung in years, the lyrics were rolling off her tongue like she wrote them. Blows my mind. That, combined with the big smile is more than enough to keep this going.

Janet reluctantly agreed to a rest time after her session with John and slept for almost an hour. Once again she denied sleeping so I think it might be fun to record her snoring away and play it back for her sometime. Because of the nap we were a little late in Skypeing Mary/Gaga and Keith and Janet wasn’t totally back in form but had a nice conversation anyways.

Garrett and I took Janet to the gym for some leg strengthening work on the Shuttle. Janet complained about pain in her right knee a lot, could be from her fall off the toilet, but tried really hard with only one band of tension. I was happy she tried but disappointed with the results and hope that was a one off and not a trend. In the interest of helping reduce the pain and relax her legs Garrett suggested getting Janet onto her tummy so we took her back to her room thinking she’d be more comfy on the bed. That turned out really well and her legs relaxed nicely and I was even able to massage them for a while. I’d like to see that be an every other day type of thing and will talk to Tez about it.

Tonight was Janet’s night to help make dinner and she chopped onions and tomatoes and helped make seasoning for tacos. She was pretty tired after her workout but really wants to do this sort of thing and was determined to it well and she did.

Andrew was up next for a Skype chat and for a while Janet had Andrew on the brain, referencing him repeatedly when trying to talk about Cam even though she was looking at Andrew. Janet read a little bit for me afterwards then it was time for bed. We are still watching her former peg site closely. It is healing well but still oozing slightly and based on that we are delaying her start at the KGH Rehab pool. Don’t want her getting infected or causing anyone else too.

Praying for a healing night and a productive and fun day tomorrow.

Free Falling. An oops from Janet, a solid response from Connect. #TSJ

I met Janet today in our usual meeting place, the living room. She laughed when I came in and said “I always seem to meet you here”. That is true pretty much everyday and I like seeing her smiling face as soon as I walk in the room. Jess was there too and reported Janet had a busy day with a trip to the gym, Speech with Mary Lou and best of all, making cupcakes with Jess. One of the residents from the house above Janet’s is moving out tomorrow and there was a party for her tonight so Jess and Janet made some chocolate cupcakes and Janet seemed quite excited about that. She was not excited about going to the party though.

It was a beautiful sunny afternoon so I took Janet outside to get some rays and fresh air. Unfortunately there was just enough of a cool breeze to be annoying and we couldn’t find a place to escape it but we had a nice walk around the complex anyways. There was a sunny spot in the living room so we hung out there for a while before taking a bathroom break. Janet was on the toilet for a few minutes with nothing happening so as usual I asked her if she wanted more time. She said yes, I walked toward her desk and heard a loud crash. I ran back to the bathroom and she was on the floor beside the toilet crying. I pressed her alarm button and tried to calm her while waiting for help. Jess came seconds later and called the troops. We didn’t want to move Janet without being sure she was OK so we waited for Tez who took charge and determined Janet was alright and he and I moved her back up to sitting on the toilet. By the looks of things she scared herself more than anything and has a couple little cuts on her right cheek bone and a small scrape on her right knee. She told us she was trying to reach for something when she fell but couldn’t remember what she was reaching for. The Connect team responded quickly and professionally and Janet was well cared for.

Tez took advantage of the opportunity to observe me using a standing transfer with Janet from the toilet to the wheelchair. I thought Janet did very well especially after her scare. She calmed down a lot after we got her out into the room and Tez checked her over again to make doubly sure she was OK and also took time to check the spasticity in her legs. I asked him about Botox and he thought it would be well worth a try and suggested I contact Dr. McCann to get that ball rolling as well as the hydrotherapy idea. Here’s hoping.

Janet didn’t argue at all about laying down for a rest after all that but did manage to express her fear of going to the farewell party tonight again. Not sure what she was so afraid of and figured she’d come around when it was time to go.

After a short nap Janet was happy to lay in bed and chat for a while. She was quite happy and not showing any ill effects from her toppling. We went down for dinner and noticed most of the guys were having a pot roast and veggies. That reminded Janet of beef stew so Garrett made her some chili with a little pasta and that worked out fine. I watched Janet go over her med booklet with Garrett just before eating and noticed some improvement since yesterday. Back in her room after dinner she wanted to “read something interesting on the iPad”‘ her new thing, so I asked her what’s interesting to her. She said “you”. So we Googled me with Janet typing my name with some help and we found a few things out there about me. One of the results was the Janet After 100 Days video and I realized she has never seem it. I was surprised at her reaction, she watched intently, laughing in spots and shaking her head in others. Overall she agreed she has come along way and asked “what was wrong with me then?” and “how did you have the stamina to do all that for so long?” I half expected her to get all emotional watching herself but she seemed quite intrigued by it all and has no recollection of any of it.

Just before seven, Jess came by to see if Janet would come up to the farewell party. She didn’t hesitate at all in agreeing and had a nice smile on her face the whole time she was there. She was warmly welcomed by a lot of people and the cupcakes her and Jess made were a huge hit. Connie was there and had a nice chat with Janet and I saying she’d be back next Wednesday to watch Janet at dinner time. It was really nice to see a lot of off duty staff there to say farewell to Ellie, even Brian showed up.

20130221-222944.jpg I’m really glad Janet made the effort to go to the party and I think we can now get her to the ladies night they have there on Thursdays. It would be really good for her.

Not quite ready for bed after the party Janet wanted to watch a little TV. We watched the last few minutes of the hockey game with Chris and that was actually kinda fun. All tucked in with her falls mats in place Janet is looking forward to coming home for the weekend and I’m looking forward to having her here. Praying for a restful night and a hard working morning before a fun weekend at home.

Independence Day. Janet gaining responsibility #TSJ

I was not surprised to hear that Janet made it through last night without falling out of or escaping from her bed. She continues to chuckle at the thought so I think if she ever does wind up on the floor it truly would be an accident. I also sense a little pride coming from her for being able to sleep with no rails.

Lorne reported that Janet’s first half of the day was quite busy. They had a good session in the gym and he very happily told me Janet asked to go to the bathroom twice for him and was successful both times. That continued with me for the rest of the day as Janet continues to improve in that category. Mary Lou saw Janet for Speech this morning as well and with her nodding off while waiting for me in the living room when I arrived it was clear she had been busy.

We went down to her room to debrief and wait for our meeting with Brian when nurse Jen stopped by. She surprised me by announcing that Janet is going onto the self administered medication program. I would not have thought Janet was ready for something like this but as it was explained I can see where it is a good time to start training Janet to be independent with her meds. She was given a booklet that describes the program, her medications, has a schedule for when each is to be taken and a log that Janet can sign off on each time she takes them. I expect her to pick up on the timing pretty fast as most of her meds are associated with meal times with the last one being at bedtime. The challenge will be in learning the names of each and what they are for. The staff will continue to help her and score her each day on how well she’s doing and look for ways to help her with what she’s not doing well. Janet seemed receptive to the idea and remembered at dinner time that the booklet was for her meds but that was it. Baby steps. Jen had a look at Janet’s former peg site and agreed it is healing very well, suggesting that after Janet’s shower in the morning we leave the dressing off and see if all stays nice and dry. If so, no more poly and no more dressings. Yay!

Mary Lou tracked us down in the kitchen a few moments later to say she had spoken with John, a gentleman I talked to last week about coming in to sing with Janet. Turns out they know each other from church and Mary Lou is totally supportive of John working with Janet. He is not an accredited music therapist but is an accomplished singer and conductor and based on my initial conversation with him, quite a positive, high energy older guy that loves life. Mary Lou doesn’t see a need to meet with him before hand so I will arrange for him to visit Janet next week for some sing along fun.

While I was talking to Mary Lou, Janet wondered off for a few minutes and came back with Brian in tow. Better late than never. We had a good chat about shower/bathtub aids for the house and I will try and figure out which option will work best for us this weekend. I’m thinking a bench for the bathtub but we’ll see. We also talked strategy for getting Janet in for some outpatient hydro therapy at KGH Rehab. I think Janet and I will try and pay a visit there on our way home Friday.

With the meetings finally done Janet was in clear need of a nap and more than willingly lay down on her bed falling asleep within minutes. When she woke up I lovingly told her she was snoring for over an hour and she tried telling me that she wasn’t even sleeping. Cute.

The nap was probably not long enough as Janet’s energy level was not near what it was last night. She ate a good dinner, impressively peeling a mini mandarin orange all be herself as part of dessert but faded quickly after that. She went upstairs with me, Garrett and Humberto to listen to some live music that never happened but I’m not sure how much she would have been into it anyways. We did have a nice little chat before bed though and she was pretty much asleep before our prayer ended.

Praying for a healing and restful night and thanking Jesus for the progress made so far and all the good people looking after Janet.

Easing Back In #TSJ

Monday, a day to get back into the “normal” routine. Janet apparently was too tired to jump back into her routine so took it pretty easy today with just a short workout in the gym and a little bit of reading for Speech. The rest of her time before I arrived was spent hanging out in the kitchen and living room mostly just watching what was going on. She was pleased to see me when I got there and seemed upset that she hadn’t done much but when she was reminded of what she was offered and attempted she agreed she was kinda tired. That led to a more than an hour long sleep with some of the loudest snoring I’ve ever heard from her.

I was prepared to let her sleep until 4:30 but she woke up just after four and wanted “to do something”. She managed to get herself up from laying down on the bed and elected to go and see if she could help prep dinner in the kitchen. She flat out refused my offer of playing games or reading. Just not into “school” today at all. It’s a good thing we went to the kitchen when we did as the guys had made another beef stew but there was plenty of time to prepare something else for Janet. Bob made her a nice chicken and pasta dish while we laughed at the movie Happy Gilmore. Janet wasn’t too thrilled by the pasta dish and was kind of jealous of the leftover enchilada I had brought for me. I continue to struggle with this dinner thing. I want her to participate in the Connect dinners and she really wants me to eat with her. If I bring my own dinner then she’s going to want that instead of what Connect has made, evidenced tonight. If I bring her dinner all the time then she’s somewhat disconnected from Connect. I think I’ll stick to eating when I get home for now.

After dinner we got a Skype call into Andrew and I was pleasantly surprised at how well Janet spoke to him. She had been pretty quiet and gurgley before that but turned it on nicely for Andrew. We listened to some music after that as I tried to find some she could sing along to. She was all over a couple of Brian McKnight songs and very readily agreed with me that she likes muscley black guys that can sing. I’m OK with that as I tan pretty good in the summer so I just need to work on the singing part and I’ll be fine.

Lights out at 8:30 for a tired but content Janet. The chat with Andrew and the singing before bed really seemed to brighten her spirits and I think set her up for a good nights rest. Praying for an active day of learning tomorrow.

Terrific Tuesday #TSJ

Janet had had another shower, finished her breakfast and was wheeling down the hall looking for help going to the bathroom when I arrived this morning. I reminded her she needs to use the pendant alarm to call for help instead of wheeling around looking for someone. She said ok. She laughed about having a shower this morning after having one last night too. I guess you can’t be too clean. After her bio break we took off for the eye doctor to see what she can see.

The test Janet did is a standard vision field test and was quite difficult for her. I can now see why Dr. McCann was reluctant to send her for one while she was in the hospital. If you’ve never had one, you stare at a little pin point of light in the centre of a vertical bowl while other pin points of light randomly flash around the bowl. You are to click a button every time you see one of those random flashes. Those flashes are fast but the test is not nor is Janet’s response time. Each eye took about nine minutes to test including a short break mid way through each eye so Janet could rest. Dr. Percival came in after to review the results and as expected Janet’s vision is noticeably stronger on the left side of each eye and in the lower half of the field of vision. He showed us an example of someone that suffered a stroke and how their entire right side of both eyes was blacked out initially then after six to eight months some vision was starting to return to those quadrants. I think Janet has been through a similar pattern and may still be changing so we’ll likely run the test again in three months. There is nothing medically that can be done to improve Janet’s vision but at last now we know what’s going on and can monitor any changes.

We spent the rest of the day at home having lunch, playing with Nash, doing a really good job of asking and going to the bathroom, having a long nap, Skypeing Mary/Gaga and Keith who are heading to Africa in a couple days, watching Pick a Puppy, rearranging furniture in the family room, having dinner and watching American Idol. My contribution to Janet’s rehab lately has been more involved with common things she would do around the house. One reason for moving the furniture around is to try and position a comfy chair for her to use instead of being in her wheelchair all the time. She can now get a treat for Nash out of the fridge by herself but her voice isn’t quite loud enough to get him to sit and wait while she puts it in his dish. The singing is helping with her volume and with her state of mind too. She always sings with a big smile on her face. She’s getting better at setting the table but her vision is hampering her a little there so I’m going to try and set things up in the drawers differently so she can see them better.

The drive back to Connect was fun with Janet singing a lot especially to The Carpenters, Close to You. Great moment. Praying for a good night of rest and an active day of learning tomorrow.

Sing Along #TSJ

A rare morning start for me today as I wanted to be sure we were able to Skype Cam for his birthday. Janet was finishing her after breakfast bio break and was quite cheery about it all when I arrived. This is the first time in a while I have seen her early in the morning and was impressed with how bright she was and how well she was talking. Garrett said that was typical. I was also impressed with how straight she stood up in the Arjo type machine that Garrett was transferring her with. All she needed was skis and poles and away she’d go. We ended up Skypeing Cam from a slightly noisy gym but Janet managed to sing happy birthday to him. Even after about four perfect practice runs she still called him Andrew when it came time for the real thing but she is no longer singing Karaoke style. It’s all her.

Janet’s workout was actually pretty good including a real strong effort on the Shuttle. Janet set a personal best doing seventeen reps with one band with her right leg only. She got good extension most of the time and was visibly working hard. First time I’ve seen the effort in the face. A very welcomed sign. By the time we were done in the gym it was lunchtime and Janet ate well as expected after a good workout. I took her to the laundry room after lunch to transfer her clothes from the washer to the drier. She very confidently did that chore then we got ready for our appointments downtown.

The meeting went well but ended sooner than I thought it might so we had time to use up before our next appointment. We spent that time talking about Invue and looking at it from a block away. I used that time to check Janet’s vision a little. She for sure could see vehicles approaching us and crossing in front of us. She could see Invue and commented that there was a lot of big windows but couldn’t zero in on details like the large concrete pole running through all the west side balconies nor could she see the light pole kitty corner to us. I think this is all associated with her processing challenges and not an inability to actually see something. When we finally got into the building Janet had no recollection of having been there before but still said it’s pretty nice and she would like to live there. With the help of Courtney’s boyfriend, Mike, we are putting forward two proposed changes to the balcony door to the Strata Council. If they say no then we forget about Invue as it would not be fair to Janet to not be able to access her own balcony by herself.

Because Janet did so well in the gym this morning I allowed her to come home for dinner when usually she would be back in the gym for another workout. We had a little snack as we had been out for a while and we really had no clue what to get for a snack while out. Laurel got in on a Skype call and I had to keep coaching Janet through it as she was getting pretty tired. So much so that by the time I served dinner I thought she was going to fall asleep in it. After a few mouthfuls she seemed to gain enough energy to make it through the rest of the evening. As I was getting her ready for her after dinner bio break I could tell she was really full and when I got her onto the bed she commented, “are you OK with girls that eat too much?” The only proper answer was to laugh. I made sure we headed back to Connect in good time as I want Janet well rested for the weekend coming up. The drive back was the most fun one yet as Janet asked to listen to the XM channel that plays all these old sappy love songs. I placated her but asked her if she thought there was a channel that played songs you could sing along to easily. She immediately started singing to the song that was playing and continued for four or five more. They were all familiar songs of course but she still surprised me with her knowledge of the words and melody. I always hated the thought of family sing songs on car rides but this one made me smile.

Praying for a night of rest and healing, and an active day of recovery tomorrow.

Planning #TSJ

Janet was happily eating a bowl of what looked like soup to me when I arrived at Connect this afternoon. Turns out it was actually chicken pot pie, or at least it used to be. Hopefully we are nearing the end of the pureed diet. Mary Lou dropped by the table and gave a very positive report on Janet’s Speech session for the day. They have been working towards getting Janet to turn up the volume and part of that process is being able to string at least five words together on one breath. Janet is now doing that and Mary Lou is quite happy with her progress. Mary Lou was standing and talking to us on Janet’s right and I noticed a couple of times that Janet turned her head way to the right to look at Mary Lou. I have noticed Janet more aware of things on the right side lately but have not seen that extreme of a turn before and asked Mary Lou if she is noticing more right side awareness and she said yes. Good news. Janet seems to be responding well to Mary Lou and I think she’s got a good program in place for her. Once Janet was finished her “soup” I took her for a bathroom break before our meeting with Brian and team. The bathroom breaks have been going well lately, Lorne even took her for a successful one this morning.

Brian led us through the first of what will hopefully be a bimonthly team meeting. Janet’s ABI Coordinator, Terri was there along with Lorne and Jen, the house manager. It was a good chance to get to know each other a little, especially for Terri as we had only spoken on the phone previously. She won’t be as directly involved as Cathryn was during Janet’s stay at KGH but once we get closer to Janet moving home then Terri will become the key player. One priority for this meeting was to come up with a rough schedule for Janet’s day. That schedule will be built around meal times and a quiet time in the afternoon. We know that Janet likely will not sleep and will not want to go to bed during that time so Jen came up with a good idea of putting a lazy boy type chair in the living room and having Janet chill in it from two ish to three ish each day. Worth a try. We also agreed to let Janet try and sleep at night with no rails on her bed. Connect will procure a couple of fall mats and once in place the experiment will begin. I’m confident HouDieno will exit the bed at least once but I believe she is more aware of her surroundings now and will learn from any such fall. Janet says she doesn’t remember any of her previous escapes but accepts her nickname for what it’s worth. I can understand Connect being nervous about doing this but I really don’t see how else Janet will progress if we don’t give her the chance. There are a few things to discuss with Tez before finalizing Janet’s schedule and hopefully we can do that before the weekend. Brian says he has feelers out for a music therapist for Janet and has a couple nibbles. I’m really hopeful we can get something going that way as I believe Janet will respond very well to it. Today’s meeting was a good foundation builder and I am confident Janet has a good team looking after her.

After another successful bathroom break I took Janet to the gym for a good leg stretch and some work on the Shuttle. She set a personal best today going for thirty two reps at two bands of tension, then six reps with three bands and thirteen reps with one band using her right leg only. High five! She required a fair bit of encouragement during the routine as she keeps saying things like “it doesn’t matter” and “so what” when given the reason for doing something. I’m confident these responses are coming from a lack of confidence place rather than an unwillingness to get better place. She managed a big smile after doing the thirty two reps as I reminded her she only did sixteen the last time.

Dinner was fun tonight as Janet reluctantly chowed down on pureed Spaghetti and all the guys were BBQ’ing steaks and Leanne was making baked potatoes for them. The chatter was good and that helped Janet plow through her mush. We played a game of Chutes and Ladders before bed and Janet won easily. She had a lot of trouble spinning for her turn no matter where I placed the spinner. She said she could see it fine but couldn’t make her hand do it. I noticed a few times today that she was trying to get her right hand involved in things and she did try and lift it to spin a couple times. I want to think this is a sign of something coming back to her right arm but won’t go there yet. She asked if I would read some Slow Dance to her in bed and four pages into it she was snoring. It really is an interesting book, she was just played out from a busy day.

Praying for rest and healing tonight, a good workout in the morning and a bright and ready to swallow strong Janet for the afternoon.

Sing Sing Sing #TSJ

For the first time in a long while Janet was smiling at me as soon as I entered the house today. Typically when I arrive she doesn’t clue in until I’m a couple steps away from her but this time I saw her smile as soon as I cleared the door. She was holding a picture of her four kids and was proud to show me Andrew and Laurel but she couldn’t get Heather or Cam. Lorne told me he experienced the same thing earlier as he had been using the picture to have a little conversation with Janet. She would often get parts of questions right but not the whole thing. That’s been the more common result with Janet for a long time. We started playing match the Sesame Street characters when I realized it was time to Skype Mary/Gaga.

We got to Janet’s room just in time and Janet was all smiles throughout the conversation blowing her mom many kisses at the end. A call to the birthday girl, Leslie, was next. Janet is always happy when its her younger sister’s birthday as she catches up to her in age. Like Janet, Leslie is not the most technologically adept person so her husband Gavin has to set things up for her prior to each Skype call and we usually get to say hi to him as well. Many of you don’t know Gavin, or do you? I made sure to get his permission to release this photo of him as identified by Janet today.

20130122-223658.jpg Cute isn’t he.

The highlight of the call to Leslie came when Janet sang in loud voice the Happy Birthday song to her sister. It was kind of a karaoke thing as I played the song on my iPhone and Janet sang along. Pretty cool.

With the chit chatting done we went to the gym and I tried putting Janet on the Shuttle to start this time. Fail. All she did was complain how “everything hurts”. Off to the mat we went and had a good stretch. Bob joined us for part of it and reminded me of a couple things Tez wants Janet to do on her own while stretching. Both exercises involve Janet moving her legs individually and I’m really glad Bob got her doing them as she did really well. I’m impressed considering how tight everything seems. After a couple of goes at the stripper pole it was back to the Shuttle and this time Janet worked hard with only a minor breakdown. She managed thirty reps at one band, twelve at two bands and six with her right leg only and one band of tension all done at a nice controlled pace. Good workout.

Janet gobbled up her dinner then played a good game of match the Sesame Street characters. She is improving on naming them and matching. She was reluctant to do any sing along stuff but jumped right in as soon as I started playing the songs. She sang My Bonnie Lies Over the Ocean, Row Your Boat, You Are My Sunshine, Take Me Out to the Ball Game and Zippadee Do Dah nicely loud and clear and smiling all the time. Really fun to watch. To continue the singing theme we watched a little YouTube before shower time including Susan Boyle’s audition on Britain’s Got Talent. Janet really enjoyed it and was very surprised she sounded so good and even said she “remembers her winning”.

We had a little time after her shower before bed and Janet asked to watch something funny on YouTube so I found some clips from the Carol Burnett Show. One of which featured a young Robin Williams that Janet laughed out loud at a couple of times. We ended with Carol’s closing theme song and Janet had a huge smile on her face as she clearly remembered I’m So Glad We Had This Time Together. I’m glad for every minute I get with Janet and today’s were all positive. Praying for a restful night and a day full of recovery and learning tomorrow.