March 21 daytime update

• 6:30AM - Maureen falls asleep from time to time.

• 6:45AM - Maya checked the diaper. It is now wet.

• 7:00AM - To this point, Maya has not given Maureen any water since she is not fully awake.

• Maureen began her day @ 8:10AM. She is in good form—chatty and smiling. Maya kicked off our morning routine by applying Tolcylen to both big toes. Diaper was medium wet. We performed a clean & change using all three 3M Cavilon products where appropriate. Last but not least, Maya cleaned all areas of focus on Maureen's upper body, armpits, at the elbows, underneath the breasts and the waistline area beneath the navel, with Aloe Vesta Cleansing Foam and warm wipes from the purple packet. We noted a slight bit of redness underneath the right breast, After a brief discussion, we decided that it was not necessary to apply any Nystatin Ointment.

• Breakfast service began @ 8:49AM. Posture in the geri chair is very good. Maureen is alert and engaged. Maya got the ball rolling with a teaspoon of Manuka Honey followed immediately by the administration of the thyroid medication with a tiny amount of applesauce.

• Maureen will consume 4 ounces of prune juice this morning.

• Daily MiraLAX dosage: None

• General observations @ 9:09AM> The day has gotten off to a solid start. Maureen 's energy is at a very good level. She is chewing and swallowing well. Communication/response with Maya as she eats is at a high level. Both Maya and I observe that Maureen is less congested this morning—let's hope the Claritin is having its intended effect.

• 9:33AM - Maya administered the blood pressure medication and the Claritin with a smattering of applesauce.

• General observation @ 9:35AM> Maureen's energy level has begun to dissipate. She has begun to utter the low moan/groan. Her eyes are almost fully closed at times.

• General observation @ 9:40AM> Maureen has regained most of her energy. She is now being more communicative and interactive with Maya and me.

• 9:50AM - Morning oral care routine.

• 10:05AM - We tilted the geri chair back one level for Maureen's comfort and to relieve pressure from her back.

• 10:35AM - Morning organic fruit smoothie.

• General observation @ 10:48AM> Maureen handled the organic fruit smoothie quite well. She did not cough at all. Energy level is starting to decrease.

• 10:51AM - Harms, arm, shoulder and leg exercises.

• 11:00AM - We headed to the bedroom in advance of Rest Break #1. Diaper was light wet. Maya and I performed a clean & change and then placed Maureen on her right side.

• 11:14AM - Rest Break #1 begins

• General observation @ 11:14AM> As with most other days, Maureen gets a material boost in energy when we place her in bed for Rest Break #1. She often continuously engages and talks with Maya and me while in bed. It is the rare occasion when she goes to sleep for any extended period of time.

• 12:15PM - Rest Break #1 ends. Diaper is light wet. We cleaned and changed Maureen and then headed to the kitchen for lunch.

• 12:33PM - Lunch | Maya prepared 1/2 an egg salad sandwich on toasted whole wheat and a large serving of a medley of brussels sprouts, asparagus and cauliflower. Maureen will drink one 12-ounce bottle of Harmless Harvest Coconut Water. For dessert, Maureen had a small cookie made by Michael Osel and 1/4 glass of milk

• General observation @ 12:38PM> Maureen was extremely talkative and engaged throughout her time in bed during the rest break. As soon as we got cleaned up and placed her in the geri chair, she began to lose a significant amount of energy. It is absolutely mind boggling.

• 2:00PM - We headed to the bedroom to prepare for Rest Break #2. Diaper was medium wet. While cleaning, Maureen had large formed bowel movement. She subsequently urinated on the pad. Maya and I replaced the pad and repeated the clean & change process. Upon completion, we set Maureen on her right side.

• 2:25PM - Rest Break #2 begins

• 3:00PM - Rest Break #2 concludes. Diaper was light wet. Maya and I performed and clean & change and then took Maureen to the front room for the remainder of the afternoon.

• 3:25PM - Afternoon fruit snack

• Daytime recap> Overage grade: Good. Maureen had an above average level of energy for significant parts of the day. Engagement and communication were very good. She had a large formed bowel movement. Chewing and swallowing went well. Coughing was low.

Daily Cough Count

​Breakfast	Smoothie	​Lunch	​Fruit Snack	​Other	Red Face
4	0	4		0	1