Sunday, July 15, 2007

Preparing for and Getting brainhell to Bed

brainhell needs to take his nighttime meds by feeding tube at least a half-hour before getting into bed. Please try to give them to him no later than 9 p.m. The meds, which will already be prepared by the morning caregiver, are in a small container near brainhell’s laptop computer. Mix them with 8 oz. water, give it to him through his feeding tube using a syringe, and then flush with 2 oz. of water from the same syringe.
Just before bed, brainhell needs to have his teeth brushed. Please also use the tongue-scraper to scrape as far back on his tongue as possible; then swab his mouth with the Nystatin liquid.
He will also need to use the urinal.

Please put the following things on the left-hand side of the bed just before brainhell rolls over to the bed: the word page, the hand bell, and the hand control for raising and lowering the foot and head of the bed. Put the folded green fleece blanket on the wedge; that will be his pillow.
Press the green button on the box at the foot of the bed to start the air flow over the mattress.

Raise the head of the bed to a 35-degree angle before transferring brainhell to the bed.

Katherine will do the transfer to the bed on her own. When Tiffany or Trina is on duty, she will need help. Leave brainhell’s shoes on for the transfer, as provide stability in the brief moments he’s standing. The transfer should be a squat-transfer, which Tiffany or Trina will do, from the seat of the wheelchair to the bed, landing brainhell’s butt at the place where the head angles up.

Move the wheelchair backward and out of the way; then you bring brainhell’s feet up while Tiffany/ Trina gently lowers his head and shoulders to the wedge. Put a rolled undershirt under brainhell’s chin. Take off his shoes and lay him out straight. Pull him up towards the head of the bed, then turn him gently onto his left side, holding him at the shoulder and the hips.

As much as possible, his hips and shoulders should be in a straight line. When he’s on his side, his hips should be “stacked” one right over the other. I adjust his hips with two hands, one underneath him at his waistband, and the other under him on his thigh. I pull his left hip gently back toward the closet. We use a pillow, tightly folded lengthwise, to support brainhell’s back when he’s on his left side. It should be placed between his shoulder blade and his coccyx and tucked in really tightly under his side. A folded towel can be used along with the pillow, if extra bracing is needed.

When brainhell wants his left shoulder adjusted, you’ll need to grab his left shoulder from underneath and shift it backward, toward the closet, “stacking” his left shoulder more directly under his right shoulder.

When brainhell points to his right ear (the one on top), he means that the left ear is uncomfortable. Please reach under and flatten out his left ear.

Sometimes brainhell’s head needs to be lifted gently and moved just a tiny bit back, towards the closet.

The undershirt under his chin may slip out. Reposition it under his chin, all the way back to his Adam’s apple. A small towel or washcloth needs to go under his chin and on the wedge to catch drool.

brainhell’s legs need to be bent in order to relax his leg muscles. While he can move and bend his right leg himself, you will need to bend his left leg up and far forward, so that it bends both from the hip and the knee. Hold it in place for a few minutes, squeezing the knee joint if necessary, to allow the muscles to relax.

brainhell will want a rolled-up undershirt in his left hand, to prevent the fingers from curling up too much.

Sometime in the middle of the night, brainhell will want to turn over onto his back to sleep. He’ll hit the pillow behind his back as a signal to you to move it.

After brainhell is settled in bed, check the level of charge in the wheelchair battery. If it’s down to the yellow, plug the charger into the wall, turn it on (switch is on the back), and plug the other end into the right arm of the chair.
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