Alzheimer's: A Caregiver's Story: Her Last 3 Years

By William Holland

• Language: English
• Publisher: Fulton Books, Inc.
• Release date: Aug 1, 2022
• ISBN: 9781639855346

Book preview

Contents

Introduction

Chapter 1: January through May 2017

Chapter 2: June through August 2017

Chapter 3: September through November 2017

Chapter 4: December 2017 through February 2018

Chapter 5: March through May 2018

Chapter 6: June through August 2018

Chapter 7: September through November 2018

Chapter 8: December 2018 through February 2019

Chapter 9: March through May 2019

Chapter 10: June through August 2019

Chapter 11: September through November 2019

Chapter 12: December 2019 through February 2020

Chapter 13: March through May 24, 2020

Chapter 14: Review of Selected Activities and Final Observations

Final Observations

Introduction

My name is William. This is my story about my wife, Doris. We lived in Woodstock, Georgia, during the time of my story. There were no other family members living within five hundred miles of our home. Doris was diagnosed with Alzheimer’s disease in 2007. At that time, Doris was only fifty-six years old. During her annual physical, a potential memory problem was identified. She was referred to a neurologist for additional examinations after that visit. The neurologist MD determined that my wife had dementia symptoms, probably early-onset Alzheimer’s disease. The neurologist prescribed Aricept and Namenda for my wife after the exam in August 2007. My wife continued seeing that neurologist for the next two years.

Then I decided to change my wife’s doctors and schedule an appointment with a neurologist at Emory Neurology Healthcare in Atlanta, Georgia. The neurologist MD at Emory specialized in dementia diseases. My wife remained under the care of Emory doctors and advanced practical nurses from 2009 to 2018. During that period, my wife participated in several clinical trials relating to potential treatment of Alzheimer’s disease. As the disease slowly progressed, we lived an almost normal life together up to 2017.

During the period before 2017, I also planned for the time when my wife would no longer be able to perform normal functions due to the disease. In 2014, I had a lawyer prepare legal documents to include my wife’s will, advance directive for health care, and durable power of attorney. These activities were accomplished while my wife was still judged to be able to understand and sign these documents. My wife voted in the 2016 presidential election. However, she could no longer write. I was able to help her sign the ballot form with an X, and she selected the candidates she wanted to vote for.

Then in January 2017, my wife began to start having several significant behavioral issues associated with Alzheimer’s disease. These events placed an additional burden on me. After three months, I had to place my wife in an assisted living, memory care facility. This story is focused on the period beginning after I placed my wife in the assisted living, memory care facility until her passing in May 2020.

This book is divided into chapters, mostly based on three-month intervals. The first few chapters are short due to my limited knowledge and no experience on what to expect when my wife moved to the assisted living/memory care facility. I gained some experience on what to expect during the first eight months after my wife’s move to the facility. Starting in January 2018, I established objectives for my wife’s care. The objectives were as follows:

First, I wanted to help my wife by minimizing the amount of pain she was in as close to twenty-four hours a day as possible.

Second, I wanted to help my wife experience the best quality of life that she could have during the time that she had left.

Third, I wanted to ensure that my wife was treated with dignity for the rest of her life.

Each month, I reviewed how my wife had been treated based on my observations for each of my objectives and documented my observations. I also discussed my observations with the assisted living/memory-care facility Healthcare Director. I had developed significant trust in the Healthcare Director based on my observations and discussions I had with her over the first eight months my wife had been in the facility.

Then in April 2019, I decided to bring my wife home from the facility. This decision was based on my loss of confidence in the care being provided for my wife at the assisted living, memory care facility, mainly due to the Healthcare Director leaving the facility.

If you wonder why I decided to write this book about the way Alzheimer’s disease affects individuals, then you probably do not need to read about my experiences. However, if you are caring for a loved one who has Alzheimer’s disease and would like to know what to expect for the last few years, then my experiences may help you in making the final years of care more comforting for you and your loved ones with the disease. It may also help you in recognizing Alzheimer’s disease patterns that your loved one experiences and in identifying and minimizing the activities that could have negative effects on you and your loved one.

Finally, the primary reason I decided to tell my story is that I wish I could have found a book similar to this one to help me provide better care for my wife during her final years.

Chapter 1

January through May 2017

At the beginning of January 2017, my wife was in her tenth year after the initial diagnosis of Alzheimer’s disease. She had just completed participation in a four-year clinical trial for a drug being evaluated for the treatment of Alzheimer’s disease. Initially, the drug seemed to show some promise in treatment. However, by the end of the fourth year, my wife was continuing to decline in memory capability. She no longer was able to perform simple tasks like dressing, fixing simple meals, or walking in our yard without my help and guidance. I was her only caregiver during this period. I took my wife to grocery stores, clothing stores, and other outdoor events in order to allow her to experience some of the normal activities in our lives.

Then in February 2017, my wife began to exhibit significant behavioral issues. She was becoming more confused and having hallucinations and delusions more frequently. She tried to leave our home several times. My wife began to use profanity toward me. She would accuse me of having other women in our house and other obscene actions. I would try to calm her down and told her that I loved her all the time. Several times, I had to call my wife’s friends in Knoxville or family members in Virginia to talk to her and help me in calming her down.

I was becoming emotionally stressed and depressed. I contacted her nurse practitioner at Emory Neurology Healthcare for help. She prescribed other medicines to help with antipsychotic conditions that my wife was experiencing. The medicine helped some; however, the behavioral issues were getting worse. I was becoming more stressed and depressed. After two months of caring for my wife in this condition, I started to look for a facility that could provide temporary care for my wife and give me some respite time.

In April 2017, I visited an assisted living/memory care facility near our home. I discussed my situation with their marketing director and was provided the necessary information and Georgia state requirements for my wife to stay there and give me some respite time. I sent the necessary paperwork to Emory Neurology Healthcare for their review and approval in order to have my wife stay at the facility.

In late April 2017, my wife and I went to the assisted living/memory care facility. I planned on having my wife stay at the facility for a few days for me to have some respite time. I met the Healthcare Director for the facility then, and my initial impression of her was good. Over the next few days, my wife stayed at the facility without her seeing me.

I met with the Healthcare Director several times during this period to find out how my wife was doing. The Healthcare Director said that my wife was doing good and becoming acclimated to living at the assisted living/memory care facility.

My level of stress was declining and my trust in the facility Healthcare Director continued to develop. After my wife had been at the facility for four days, I decided to have the facility become the permanent residency for my wife. I was told that I should not come to visit with my wife for the next four or five weeks so that she could become adjusted to the facility as her new home and to build a relationship with the facility caregiver staff. I note that this assisted living/memory care facility cost was $6,500 per month and required an initial community fee of $2,500.

I had weekly meetings with the facility Healthcare Director during the five-week separation period. I asked questions about how my wife was doing. I also coordinated with the facility Healthcare Director on how my wife’s prescriptions and supplements would be dispensed. I was told that all prescription medicines would need to be bubble-wrapped for the facility medicine technicians (Med. Techs) to dispense. The facility Healthcare Director was very helpful and forthright in our discussions. This style of communication earned my unwavering trust in the Healthcare Director. My wife was able to walk with minimal help in the facility during this period.

The following information is provided here to help readers better understand my observations in future chapters. After my wife had been at the assisted living/memory care facility for a few months, I had formed opinions and made judgments about the facility.

First, the assisted living/memory care facility had approximately thirty-nine residents, on average, at any one time. Half of the residents were memory care (dementia) patients.

The facility management was composed as follows:

One Executive Director

One Healthcare Director

One Director of Sales and Marketing

One Maintenance Manager

One Culinary Manager

One Administration Manager

One Life Engagement Manager

Management normally worked day shifts (eight to five) with the exception of the facility Healthcare Director. She worked different days and different shifts. She was on call 24/7. She was the primary supervisor of the facility Med. Techs and caregivers.

The facility staff consisted of four Med. Techs. They worked twelve-hour shifts and were responsible for medicine distribution to patients. The Med. Techs on back shifts were the facility contact persons for family members. There were approximately ten to fifteen caregivers each day. Day shift usually had about seven or eight caregivers and each back shift had two to four caregivers.

The primary reason I selected this assisted living/memory care facility was the trust that I had developed in the facility Healthcare Director. This trust will be evident as you read the following chapters.

In summary, during the past five months, I focused on my wife’s behavioral issues, my decision process in selecting an assisted living/memory care facility, the organizational structure of the assisted living/memory care facility staff and the trust that I developed for the facility Healthcare Director.

Chapter 2

June through August 2017

This chapter focuses on my actions to address my wife’s pain associated with chronic spinal pain issues, her adjustments to being at the assisted living/memory care facility and incontinence issues.

On June 2, 2017, I visited my wife again for the first time since late April 2017. This meeting went well and my wife did not seem to recall any of the behavioral issues that she had prior to coming to the assisted living/memory care facility.

During the month of June, my wife continued to adapt to living at the memory care facility. I visited her two or three times a week. Also, I continued to discuss additional needs for my wife with the facility Healthcare Director.

My wife fell several times during the month of June. Facility caregivers were working to transition her to a wheelchair. My wife’s falls were due to a chronic condition (lumbar disc degeneration) that caused her to experience significant lower back pain. My wife was under the care of an orthopedic doctor (MD) who was using the medication (Tramadol) and physical therapy to manage her pain. I continued to take her to the doctor’s office when she had appointments. My wife continued to remain ambulatory during this period.

In late June 2017, my wife fell out of her wheelchair at the assisted living/memory care facility and hit her head on the floor. She was transported to a local hospital emergency room by ambulance. When my wife arrived at the hospital, she was in significant pain and not able to move easily. She was given generic Percocet, an opioid pain medication. After a short period, my wife’s pain eased significantly. My wife was then able to have several X-rays and CTs performed. No other medical problems were noted and my wife was transported by ambulance back to the assisted living/memory care facility. The hospital doctor also provided a five-day opioid prescription for my wife. My wife was in less pain and able to move easier after arriving back at the assisted living/memory care facility due to the opioid medication provided at the hospital.

Two days after my wife’s return to the assisted living/memory care facility, I talked to the facility Healthcare Director about my wife’s pain management at the hospital. She said that the new generic opioid medicine was helping to relieve my wife’s lower back pain. I discussed the opioid medicine results with my wife’s orthopedic doctor. The doctor prescribed hydrocodone/acetaminophen tablets for my wife. This new prescription continued to help in relieving my wife’s lower back pain. However, the pain medicine would not keep my wife out of pain for the full period between scheduled doses.

On August 2, 2017, I took my wife for a checkup with her orthopedic doctor. I asked if she could prescribe an extended-release hydrocodone medicine for my wife. The doctor prescribed a twelve-hour opioid medicine (Zohydro 10 mg). My wife started taking this new medicine as soon as the prescription was filled. It provided extended pain relief.

During my visits starting in August 2017, my wife would tell me that she was scared when I started to leave. I had to redirect her attention to some other activity in order to leave. My wife’s comments would bother me. I discussed my wife’s being scared comments with the facility Healthcare Director. She said that my wife was still adjusting to the facility life. I also noticed that my wife was becoming more incontinent. The Healthcare Director said that my wife would start being checked every two hours to see if she soiled herself.

On August 15, 2017, I took my wife to see her primary care doctor for a follow-up appointment. The appointment went well. I also took my wife to see an Emory dentist at the end of August 2017. That appointment also went well. I continued to take my wife to see her regular doctors as long as she was able.

In summary, during the last three months, my wife’s pain issues were being better managed, and her adjustments to the assisted living/memory care facility were being monitored.

Chapter 3

September through November 2017

This chapter focuses on my wife’s pain medicine adjustments, hospital emergency room visits, and other doctor appointments.

In early September 2017, I took my wife for her annual eye exam. Her eye doctor noted that cataracts were forming in both eyes; however, they were not to the point that vision was affected to warrant cataract surgery.

On September 5, 2017, I took my wife to Emory Neurology Healthcare for an Alzheimer’s follow-up appointment. After the visit, the advanced practical nurse at Emory told me that my wife was probably entering the final stage of Alzheimer’s disease.

During the first part of September 2017, I told my wife’s orthopedic doctor that her pain level was not being effectively managed by the Zohydro 10 mg. The doctor then increased my wife’s dose of Zohydro to 15 mg. She started taking the new prescription in the middle of September.

On September 14, 2017, I took my wife back for a dental appointment at the Emory dentist. He was able to fill three of my wife’s teeth in her lower jaw. This allowed for my wife to continue wearing her lower partial denture and helped her when she was eating.

On September 22, 2017, I went to the assisted living/memory care facility for family night. When I arrived, my wife was slumped over in her wheelchair and barely responsive to my talking. I had the assisted living/memory care facility Med. Tech check her blood pressure. It was not normal, so I took my wife to the local hospital emergency room. She was checked out, and they determined that my wife had a urinary tract infection. No other medical problems were noted except confusion due to Alzheimer’s disease. My wife received initial treatment for the infection at the emergency room by IV and was discharged. I stopped on the way back from the hospital to have a prescription for the urinary tract infection filled and to get us some food. My wife seemed to be much better during the drive back to the assisted living/memory care facility. After taking her back to the facility and giving the Med. Tech the prescription, I left to go home. My wife was upset when I started to leave, so I redirected her attention. I called the Med. Tech the next morning and asked how my wife was doing. She said my wife was doing better.

On October 1, 2017, my wife’s son and family came to the assisted living/memory care facility to visit from Virginia. It was a good visit; however, her son and family did not react well to seeing my wife in the condition she was in. They left to go home to Virginia that afternoon.

On October 3, 2017, I picked up my wife at the assisted living/memory care facility, and we went to get our yearly flu shots. During that trip, my wife seemed very tired and was always looking down in her wheelchair until I talked to her.

On October 9, 2017, I went to see my wife at the assisted living/memory care facility. She was in a recliner chair looking down and complaining about pain in her upper spine. I decided to take my wife to the local hospital emergency room to be checked out. She was checked out, and no other medical problems were noted except confusion probably due to Alzheimer’s disease. My wife was discharged from the hospital, and I drove her back to the assisted living/memory care facility.

In the middle of October 2017, two friends from Knoxville, Tennessee, came to visit my wife. They stayed for two days and visited my wife three or four times at the assisted living/memory care facility. The visits seemed to help my wife’s spirit a lot.

On October 23, 2017, I talked to the facility Healthcare Director about my wife seeming to be very tired and always looking down in her wheelchair until I talk to her. I told the Healthcare Director that I requested my wife’s orthopedic doctor to decrease the Zohydro 15 mg prescription back to 10 mg every 12 hours to see if the medication was causing any problems. The pharmacy delivered the reduced Zohydro 10 mg prescription to the Healthcare Director on October 27.

On October 30, 2017, I took my wife to see her primary care doctor for a follow-up appointment. I also took a urine sample from my wife to the doctor’s office to check. The sample did not show any urinary tract infection; however, the doctor did prescribe an antibiotic for my wife to take for the next five days. My wife started taking the new prescription the next day.

On November 1, 2017, I took my wife for a checkup with her orthopedic doctor. My wife seemed to be very tired and was always looking down in her wheelchair. After examining her, the orthopedic doctor said that she believed my wife was overmedicated and recommended weaning her off of Zohydro during the next two weeks. The orthopedic doctor changed her pain prescription back to Tramadol. After returning to the assisted living/memory care facility, I talked to the Healthcare Director, and my wife’s weaning off of Zohydro was started that evening.

On November 3, 2017, my wife fell again at the assisted living/memory care facility and hit her head on the floor. She was transported to a local hospital emergency room by ambulance. I was called by the facility and drove to the emergency room and stayed with my wife until the examination was over. The emergency room doctor did not find anything wrong with my wife relating to the fall so she was discharged. I then drove her back to the assisted living/memory care facility.

On November 5, 2017, I went to visit my wife at the assisted living/memory care facility. My wife seemed to be more alert; however, she was in more pain. I believe the pain was due to her being weaned of Zohydro. I went with my wife to her dining room to observe how she eats dinner. I noticed that she no longer knew how to use her fork or spoon. I helped feed my wife her food. My wife used her fingers to pick up food and put it in her mouth. I fed my wife her soup. The eating process was very messy. I noticed a caregiver was at the same table my wife was at, and the caregiver was feeding another resident a soft diet meal.

On November 7, 2017, I visited my wife at the assisted living/memory care facility and noticed that she was in significant pain from her lower back area migrating down her right leg. I had the medical technician (Med. Tech) give her two Tramadol tablets. After a period of sitting in a recliner chair, my wife felt better.

On November 9, 2017, I visited my wife at the assisted living/memory care facility. We listened to a singer in the main living room. After the entertainment was over, I tried to help my wife get into her wheelchair. My wife was unable to stand from her sitting position due to pain. A caregiver and I helped my wife get into her wheelchair. I stayed through lunch and helped my wife eat. She used her fingers to eat her lunch. I fed her some strawberries. Once the spoon touched my wife’s mouth, she would open wide and did not have a problem chewing or swallowing. Again, the eating process was very messy.

On November 11, 2017, my wife fell again. I was called by the facility Med. Tech about 8:00 p.m. The Med. Tech said my wife did not hurt herself and was okay. My wife seems to be falling more often since weaning off of Zohydro. I believe it was because she had more pain from her chronic spine degeneration condition.

On November 15, 2017, I visited my wife at the assisted living/memory care facility. She was in her room taking a nap. I woke my wife up and brushed her hair. I tried to get her up; however, she was in too much pain when she tried to stand. I was unable to help her up, so I let her keep napping and left the facility.

On November 27, 2017, I visited my wife at the assisted living/memory care facility. I found her drifting down the dining room hall with no escort. I helped her get to the television (TV) room and into her wheelchair. I asked the facility Healthcare Director if more attention could be placed on my wife if she was standing or walking to minimize her chance of falling again.

In summary, during the last three months, my wife’s pain issues were not being managed well. This condition caused her to fall more often. Also, I noticed that she needed more help when she was eating meals.

Chapter 4

December 2017 through February 2018

This chapter focuses on obtaining a nurse practitioner (NP) for my wife’s care, additional pain management for my wife, caregiver issues, incontinence issues, and my wife’s eating difficulties.

On December 4, 2017, I visited my wife at the assisted living/memory care facility. I rolled her in her wheelchair to the television room after she was given her shower. I had not been able to get in touch with the orthopedic doctor since early November, so I went to talk to the facility Healthcare Director about other pain medication options. She recommended I consider getting a nurse practitioner (NP) that cares for several patients at the facility on a monthly basis. I said that I would consider having the NP that she recommended taking over for my wife’s medical care in the next week or two.

On December 6, 2017, I visited my wife at the assisted living/memory care facility. I talked to the facility Healthcare Director about seeing my wife from the side with a caregiver in the hall. I said that my wife looked bent over in a manner like she had osteoporosis. I said that I would ask her internist doctor if my wife could get a bone scan. Then I fed my wife a Chick-fil-A milkshake. My wife was very happy during this visit.

On December 7, 2017, I visited my wife at the assisted living/memory care facility. My wife was in pain in her lower back area and a urine sample had not been collected. This was not a good visit for me.

On December 8, 2017, I visited my wife at the assisted living/memory care facility. I talked to the facility Healthcare Director about no urine sample being collected from my wife. The Healthcare Director said they were unable to collect a urine sample. She said that she called my wife’s internist office to see if medicine could be prescribed for my wife based on the symptoms she was experiencing. The doctor said yes and prescribed an antibiotic. I picked up the prescription and took it to the facility Healthcare Director. It was snowing that day.

On December 11, 2017, I visited my wife at the assisted living/memory care facility. She was standing in the main TV room and was in pain. No assisted living/memory care facility caregiver was around. I helped my wife sit in a recliner chair and fed her a cup of pudding. She told me that she needed to potty. I looked for her wheelchair and could not find it. I had a facility caregiver help her to a toilet room to potty. My wife slowly walked to the toilet room and back with the caregiver’s help. My wife was slowly walking and in pain during this time. I helped her sit down in a recliner chair after she returned. She was tired and went to sleep in the recliner chair. No one had found her wheelchair when I left.

On December 12, 2017, I visited my wife at the assisted living/memory care facility. I talked to the Healthcare Director about my experience yesterday. Then I went to the dining room and noticed my wife was sitting at her dining room table not eating. I helped my wife eat her lunch and then went to talk to the Healthcare Director again. We discussed getting a nurse practitioner (NP) to take over all medical care for my wife. In addition, I said that I would be taking my wife to the hospital for an MRI of my wife’s spine on December 20.

On December 13, 2017, I visited my wife at the assisted living/memory care facility. I found my wife sitting on a couch in the main television room. I helped her move from the couch to a recliner chair. She was in pain when moving to the recliner chair. I fed her a cup of pudding. My wife was tired after eating the pudding and dozed off in the chair. I left at this time.

On December 15, 2017, I visited my wife at the assisted living/memory care facility. My wife was happy to see me and did not seem to be in much pain that day. I also met with the Healthcare Director and the nurse practitioner (NP) to discuss moving my wife to the NP’s care for all medical services. The NP seemed to be very experienced in the treatment of Alzheimer’s patients. After our discussion, the NP met with my wife and gave her a general examination. My wife was very accommodating to the NP during the examination. After the exam, I signed a document for the NP to manage my wife’s Alzheimer’s disease as her primary care practitioner (PCP), including management of my wife’s medicines at the assisted living/memory care facility. I told the NP that my wife would be getting an MRI of her spine on December 20. I also discussed with the NP my three objectives for my wife’s care. They were minimizing my wife’s pain, quality of life, and treatment with dignity. After the meeting, I left the facility.

On December 20, 2017, I visited my wife at the assisted living/memory care facility. I picked up my wife and took her to the hospital for an MRI of her spine. My wife was sedated during the MRI. We returned to the assisted living/memory care facility, and I fed my wife her dinner. She was very tired after eating and went to sleep in a recliner chair. Then I left the facility.

On December 21, 2017, the orthopedic doctor called me. She said the MRI of my wife’s spine did not indicate any spinal cord pinching or any other problem that may be relating to my wife’s head bending down at her neck. I told the orthopedic doctor that I was having an NP manage my wife’s Alzheimer’s disease as her PCP, including management of my wife’s medicines. I said that I would keep her updated on my wife’s status. Later that day, I went to the assisted living/memory care facility to be with my wife for family night. I fed my wife her dinner and helped her walk to the main TV room. My wife said that she was in pain, so I helped her sit in a recliner chair. I stayed with my wife until she went to sleep in the chair. Then I left the facility.

On December 25, 2017, I visited my wife at the assisted living/memory care facility. My wife was in the main living room when I arrived. I took her by wheelchair to her room, helped her potty and cut her fingernails. Then I rolled her to the dining room and fed her dinner. After eating, I rolled my wife to the main TV room and helped her sit in a recliner. My wife said that she was in pain in her lower back, so I had the Med. Tech give her two Tramadol tablets. I stayed with my wife until she went to sleep. Then I left the facility.

On December 28, 2017, I visited my wife at the assisted living/memory care facility. I found my wife in the dining room. She had already eaten. I helped her walk to the television room, helped her sit in a recliner, and fed my wife a cup of pudding and a coke. My wife was not in much pain and fell asleep. Then I left the facility.

On January 1, 2018, I visited my wife at the assisted living/memory care facility. I found her sitting in a chair in the hall. I helped her set in her wheelchair and rolled her to the dining room for lunch. I fed my wife her lunch and rolled her to the main TV room. I helped her get into a recliner and fed her some Coke and oatmeal cake. My wife was in some pain; however, she was tired and went to sleep. Then I left the facility

On January 4, 2018, I visited my wife at the assisted living/memory care facility. She was in the dining room eating her lunch with her fingers. I cleaned her hands. Then I fed my wife the rest of her food with a spoon. After lunch, I rolled my wife to the main TV room and helped her sit in a recliner chair. I talked to the Healthcare Director and gave her a copy of the message from my wife’s Emory nurse recommending that my wife’s Risperidone medicine be reduced to see if it would help her hold her head up. Then I fed my wife a cup of pudding, and she took a nap. Then I left the facility.

On January 6, 2018, I visited my wife at the assisted living/memory care facility. She was in the dining room eating her lunch with her fingers. I cleaned her hands. Then I fed my wife the rest of her food with a spoon. My wife was able to stand and walk to the television room. She seemed to be in less pain and was holding her head up a little better. I helped her sit in a recliner and fed her a pudding cup and some coke. She took a nap after eating. Then I left the facility.

On January 9, 2017, I went to the facility to pick up my wife and take her to have a bone scan. The bone scan went well. The technician performing the scan was very caring relating to my wife’s condition. Then we went to Chick-fil-A and ate lunch together in the car. I fed my wife some chicken and a milkshake. We returned to the assisted living/memory care facility after lunch. I rolled my wife to the main TV room and helped her sit in a recliner. My wife took a nap in the recliner. Then I went to talk to the Healthcare Director. I said that I informed my wife’s primary care physician that the NP would be my wife’s PCP starting today. Also, I asked the Healthcare Director to let me know when the NP would be back to the assisted living/memory care facility so I could talk to her about my wife’s medicines. The Healthcare Director said that she would let me know. Then I left the facility.

On January 11, 2018, I visited my wife at the assisted living/memory care facility. I found my wife in the dining room. She was standing up and very upset. I went over to her and calmed her down. She had just eaten and had food all over her top and pants. I helped her sit in her wheelchair and rolled her back to her room. I helped her potty, cleaned her up, and removed her soiled clothes and diaper. I noticed that my wife had an extra sock stuffed in one shoe, and her pants were not hers. She also had two soiled diapers on. I put a clean diaper and clean clothes on my wife and rolled her back to the main TV room. I helped her get in a recliner chair. I fed my wife a cup of pudding, then I went to talk to the Healthcare Director. I described the above and said that what happened to my wife indicated that she had not been treated with dignity by someone. The Healthcare Director agreed with me and said she would discuss this item as a teaching issue with her staff at the next meeting. I went back to the TV room to be with my wife. She said that she needed to potty again. I rolled her back to her room to potty. She had a good bowel movement. Then I cleaned her up and rolled her back to the main TV room. I stayed with my wife for about thirty minutes until she took another nap. Today was not a good day for me.

On January 13, 2018, I visited my wife at the assisted living/memory care facility. I found her in the Harbor Hall TV area. I helped my wife get in her wheelchair and rolled her to her room to potty. Then I rolled her to the main living room to listen to a country singer. We both enjoyed his singing and guitar playing. Then I rolled my wife to the main TV room and helped her sit on the couch. I fed my wife a cup of pudding and a Coke. My wife took a nap after about thirty minutes. Then I left the facility. It was a good visit.

On January 16, 2018, I visited my wife at the assisted living/memory care facility. I found my wife in the Harbor Hall TV area. I helped my wife sit in her wheelchair and rolled her to her room to potty. Then I took my wife to the dining room for lunch. I spoon-fed my wife her lunch. I rolled my wife back to her room to potty again after lunch. My wife said it burned when she was peeing. I rolled my wife back to the main TV room and helped her get into a recliner. I told the Healthcare Director about my wife possibly having another urinary tract infection. Then I showed the Healthcare Director some bruises on my wife’s hands and arm. I was concerned that some of the facility staff may be handling my wife in a manner that caused the bruises. The Healthcare Director said that she would discuss the bruising with her staff at their next meeting. Then I rolled my wife back to the Harbor Hall TV area until her therapy person arrived to give my wife shoulder and neck therapy. I left the facility at this time. Again, some of the quality of life and dignity expectations I had for my wife’s treatment were not being met.

On January 18, 2018, the facility Healthcare Director called me and said that my wife had fallen again. The Healthcare Director said that she was not hurt. I said that I would be coming to the facility tomorrow and we could talk more about my wife’s fall.

On January 19, 2018, I visited my wife at the assisted living/memory care facility and to talk to the Healthcare Director. I found my wife in the dining room. She was trying to eat her lunch with her fingers. No one was helping my wife eat. I then fed my wife her lunch. I asked if anyone knew where my wife’s wheelchair was. The answer was no. Then I helped my wife walk from the dining room to the main TV room and helped her