046278 - ..
046279 - Today, we got on the bed to help Linda turn Millie and hold her on her
046280 - side, in order to fix her bedding. Initially, explained that Millie
046281 - has been sleeping on her back for over a year due to rising IBC on her
046282 - chest, and now arms, which pinches and causes pain when she rolls on
046283 - her side. Rolling on her side will be painful.
046285 - ..
046286 - Linda felt it was necessary to roll Millie on her side despite pain,
046287 - in order to fix her bedding with a sheet for moving Millie up and down
046288 - the bed.
046290 - ..
046291 - So, we rolled Millie onto her side. She grimaced and moaned, but
046292 - could not cry out due to low energy. Hopefully, the morphine eased
046293 - some pain, but Millie was in severe distress.
046295 - ..
046296 - Linda decided that new clothing and bedding arrangements were
046297 - incorrect, so Millie had to be rolled onto first one side and then
046298 - another again.
046300 - ..
046301 - Since Millie died a few hours later, ref SDS 0 EK4I, all of this was
046302 - unnecessary, but nobody knew this at the time. Linda believed Millie
046303 - had several more days, or even a week, as estimated by Susan last
046304 - night, reported on 100728 1016. ref SDS C2 B757
046306 - ..
046307 - Linda took Millie's vitals, and they seem better than last night.
046308 -
046309 -
046310 -
046312 - ..
0464 -
0465 -
0466 - 1250
0467 -
046701 - Peggy calls to see how Millie is doing.
046702 -
046703 - Explain Linda is here and making new arrangements for Millie, who
046704 - seems to be declining more quickly than the nurse expected last night,
046705 - reported on 100728 1016. ref SDS C2 B757
046706 -
046707 -
046709 - ..
0468 -
0469 -
0470 - 1338
0471 -
047101 - Linda feels Millie should have a hospital bed brought in to make her
047102 - more comfortable getting care, and to make caring for Millie in bed
047103 - easier on care givers. She plans to order extra Hospice help to
047104 - change bedding and provide personal hygene. Linda explained this
047105 - support can only be ordered after Millie is in a hospital bed.
047107 - ..
047108 - Asked how Millie will be put in the bed? She needs to be maintained
047109 - in a completely flat postion to avoid pain from her IBC pinching her
047110 - skin.
047112 - ..
047113 - Linda said this is a close call.
047115 - ..
047116 - She said honestly, Millie could die today, tomorrow, or at any time
047117 - now. None-the-less, Hospice protocol requires following procedure to
047118 - provide care which the patient will need until passing.
047120 - ..
047121 - Linda said that after the bed is set up, customers call the Fire
047122 - Department. They are skilled performing this task routinely for
047123 - Hospice patients.
047125 - ..
047126 - Asked where to put the bed?
047128 - ..
047129 - Linda suggested the other bedroom.
047131 - ..
047132 - Linda ordered the hospital bed for delivery today.
047134 - ..
047135 - With Lilly's help, rearranged the bed in the other bedroom so there is
047136 - room for the hospital bed.
047138 - ..
047139 - Linda advised that customers supply bedding, but anything will do.
047141 - ..
047142 - Linda ordered an air matress so Millie will be comfortable.
047144 - ..
047145 - Lilly asked Linda about Fentanyl patch, which Susan advised last night
047146 - can be used to replace or supplement morphine to give Millie better
047147 - relief from pain, reported on 100728 1016. ref SDS C2 B658
047149 - ..
047150 - Ron Jr was deeply troubled about collaborating with Linda. He asked
047151 - for a meeting in the other room. Ron with quiet emotion and firm
047152 - resolve advised that he is very worried Linda is being inundated with
047153 - patient history from Rod. He feels too much information at this time
047154 - prevents Linda from providing care that his mother desperately needs
047155 - to live. He feels that even well meaning assistance being offered to
047156 - save Millie's life should be avoided at this time, so that Linda can
047157 - do her job professionally without distraction.
047159 - ..
047160 - Thanked Ron for calm comments and agreed to his request. We returned
047161 - to Millie's room.
047163 - ..
047164 - Linda discussed giving Millie decadron, which she prescribed with
047165 - increased dose last Friday, to ease pain from advancing cancer,
047166 - reported on 100723 1030, ref SDS C0 NC5G She asked how much Millie
047167 - has eaten today?
047169 - ..
047170 - Advised that Millie has been unable to eat anthing all day, per above.
047171 - ref SDS 0 JY46
047173 - ..
047174 - Linda feels that since Millie cannot eat, Susan's medication plan
047175 - yestersay to end Decadron is correct because decadron requires having
047176 - food in the stomach, reported on 100728 1016. ref SDS C2 3J9M
047178 - ..
047179 - Linda decides Millie needs an entirely new work plan changing
047180 - treatment prescribed by Susan last night, reported on 100728 1016,
047181 - ref SDS C2 TO6M, for care and medication during the weeks ahead,
047182 - including a decadron substitute. ref SDS 0 6S7H She goes into the
047183 - computer room next to Millie's bedroom, and asks for assistance
047184 - preparing a new work plan, based on patient history of the current
047185 - plan.
047187 - ..
047188 - Ron, Steve, Pam, Kim, and Lilly are in the bedroom to comfort Millie.
047190 - ..
047191 - Worked with Linda in the office to correlate Linda's findings today on
047192 - Millie's weakening condition compared to Susan and John's work
047193 - yesterday. Linda confirmed that prior plans must be totally changed,
047194 - and asked for the record on what was ordered yesterday?
047196 - ..
047197 - We looked at the computer (c16) running on the big table showing
047198 - patient history for Hospice prescriptions on 100728 1016, ref SDS C2
047199 - UN5O
047201 - ..
047202 - Linda prepares on her computer sitting on the small black table next
047203 - to the big computer table, a new...
047205 - ..
047206 - Medication Profile for Millie
047207 -
047208 - Date: 100729 1349
047209 - Patient: Millie
047210 - Physician: Doctor Johnson
047211 - Shivakumar, Srinivasa
047212 - Urva, Surekha
047214 - ..
047215 - Medications Strength Dose Instructions Class
047217 - ..
047218 - Atropine 1% 2 drops under toung every Opthalmic agents
047219 - 4 hours as needed relieve
047220 - resperatory rattles, repeat
047221 - 2 drops in no relief in 30
047222 - minutes.
047224 - ..
047225 - Biotine mouth 1-2 sprays into mouth as Mouth/throat agents
047226 - moisturizing needed for dry mouth and
047227 - throat
047229 - ..
047230 - Dexamethasone 4 mg/ml Decadron replacement apply Not coded
047231 - 1 ml to inner aspect of
047232 - forearm 2 times a day
047234 - ..
047235 - Fentanyl 75 Apply 1 patch to abdomen Analgesics OPIOD
047236 - MCG/HR and change every 72 hours
047237 -
047239 - ..
047240 - Hydrocortisone 1% Apply to affected areas 2 Dermatologicals
047241 - times a day as needed for
047242 - itching
047244 - ..
047245 - Lorazepam 1 mg 1 tablet every 4 hours Anxiety agents
047246 - Ativan as needed for nausea
047247 - restlessness or
047248 - agitation
047250 - ..
047251 - Lumigan 0.03% 1 drop both eyes Opthalmic agents
047252 - bed time
047254 - ..
047255 - Morphine 20 mg/ml Administer according Analgesics OPIOD
047256 - sulphate to instructions on
047257 - 100728, ref SDS C2 L456
047259 - ..
047260 - MTZ EKIT 1 Use only as directed by
047261 - {crossed out for use Hospice (call for guidance)
047262 - on Millie}
047264 - ..
047265 - MTZ EKIT 2 Use only as directed by
047266 - Phenobarb 100 mg Hospice (call for guidance)
047267 - {crossed out for use
047268 - on Millie
047269 - Indocin 50 mg
047271 - ..
047272 - Prochlorperzine 25 mg Compazine tablet substitute Antipsychotics/
047273 - insert suppository every Antimanic agents
047274 - 6 hours as needed for
047275 - nausea if Lorazepam not
047276 - effective
047278 - ..
047279 - Timolol Maleate 0.5% 1 drop each eye twice daily Opthalmic agents
047280 - for glaucoma
047281 -
047282 -
047284 - ..
0473 -
0474 -
0475 - 1538
0476 -
047601 - Steve and Pam return from meeting with Tina, Millie's attorney in
047602 - the city.
047604 - ..
047605 - Linda called and placed order at pharmacy for ...
047606 -
047607 - Dexamethasone
047608 - Fentanyl
047609 - Hydrocortisone
047610 - Prochlorperzine
047612 - ..
047613 - Lilly is vacuuming the floor where the bed was turned to make room for
047614 - the hospital bed delivery.
047616 - ..
047617 - Kim goes to Kaiser to get the additional medications Linda has
047618 - ordered.
047620 - ..
047621 - Steve, Pam, and Ron are in the room with their mom. Steve is reading
047622 - to Millie from a black book, not certain which one. Millie has been
047623 - reading a big black book on loan from Emily, so that may be it.
047624 -
047625 - [On 100730 1542 letter notifies Ron Senior that he can take
047626 - pride in his children working well together meeting the
047627 - crisis of their mom's passing with courage and dignity, as
047628 - Millie wished. ref SDS C4 9I8Q
047630 - ..
047631 - Linda says normally, her work is over after placing orders for care,
047632 - but she will stay because she feels now Millie can die at any time,
047633 - and she wants to be here to help the family.
047635 - ..
047636 - Hugged Linda and thanked her for caring support the past 2 months.
047637 -
047638 - [On 100731 2221 in memoriam for Millie - a life worth
047639 - living. ref SDS C8 RJ5H
047640 -
047641 -
047643 - ..
0477 -
0478 -
0479 - 1610
0480 -
048001 - Millie's lower left arm, and left hand are now noticably blue, even
048002 - purple, indicating blood pressure is dropping, and heart rate
048003 - increases.
048005 - ..
048006 - Linda takes Millie's pulse and it is over 150, like she is running the
048007 - hills at Lafayette reservoir.
048008 -
048010 - ..
0481 -
0482 -
0483 - 1632
0484 -
048401 - Millie breath begins to grow weak and struggle.
048402 -
048403 - This gets gradually worse.
048405 - ..
048406 - Everyone is in the room, and saying last words to Millie. This is a
048407 - very, very sad moment for us, but welcome relief, which Millie has
048408 - deserved for a long, long time.
048409 -
048410 -
048412 - ..
0485 -
0486 -
0487 - 1700
0488 -
048801 - Millie died - her last breath was taken with those she loved and
048802 - cherished.
048804 - ..
048805 - She departed her earthly assignment as if leaving work on the dot at
048806 - 5pm, now to rest from a life of labors, sorrows, and triumphs.
048808 - ..
048809 - Millie ended life in her own bed, and without prolonged infirmities,
048810 - suffering, nor medical care, just as she wished. This was a shocking,
048811 - unexpected loss, noted by Linda with Kaiser Hospice, above,
048812 - ref SDS 0 6Q4K, and coming after Millie's condition suddenly cascaded
048813 - yesterday, reported on 100728 1016. ref SDS C2 TF4J
048815 - ..
048816 - Realization there was nothing that could be done to help her was an
048817 - unnerving shock. I literally screamed something like "Millie don't
048818 - go! Please don't go!!"
048820 - ..
048821 - I ran from the room into the other bedroom, which Lilly and I had
048822 - setup to accommodate a gurney Linda ordered yesterday. Alone in the
048823 - room just screamed in agony, before finally gaining emotional control,
048824 - remembering Millie's concern to Linda during the first Hospice meeting
048825 - on 100604 1350. ref SDS A9 PU5O
048826 -
048827 - [On 100730 1433 Arlette called with condolences.
048828 - ref SDS C3 V15L
048830 - ..
048831 - [On 100731 1343 Doctor Johnson called with condolences.
048832 - ref SDS C7 5E5H
048834 - ..
048835 - [On 100731 2221 In Memoriam - Millie Walks with Angels
048836 - celebrates her life and accomplishments. ref SDS C8 RJ5H
048838 - ..
048839 - [On 100802 1707 Millie would be very pleased with
048840 - compliments on how neat and orderly her home remains.
048841 - ref SDS C9 7W8K
048843 - ..
048844 - [On 100804 0653 Karen, Millie's niece, and a nurse, feels
048845 - everyone did a good job making life's inevitable end
048846 - comfortable for Millie and binding for her family and
048847 - friends. ref SDS D0 PW5V
048849 - ..
048850 - [On 100807 1300 services for family and friends remembering
048851 - Millie at son's home of Ron and Kim. ref SDS D1 RJ5H
048853 - ..
048854 - [On 110502 2239 Emily, member Wellness Community notifies
048855 - memory of Millie inspires participating in Relay for Life
048856 - charity hike also raising funds for cancer research.
048857 - ref SDS D6 BH5I
048859 - ..
048860 - The hospital bed ordered by Linda was delivered. Steve went to the
048861 - door and told them it is not needed, and that they could return the
048862 - wheel chair ordered last Friday, delivered yesterday, and never used.
048864 - ..
048865 - Pam, Kim, and Lilly changed Millie into her new dress and outfit, just
048866 - as shown in the video...
048867 -
048868 - http://www.welchco.com/pic/buck/100714/100_1310.wmv
048870 - ..
048871 - Ron and Steve removed the bedding, and started a wash using Millie's
048872 - new washer dryer that has capacity for large loads, so even the big
048873 - kingsize, thick underpad was washed. Millie would have been pleased
048874 - that her purchase was useful, as she planned.
048876 - ..
048877 - Lilly, Pam, and Kim cleaned up the room, just as Millie always kept it
048878 - in spotless good order.
048880 - ..
048881 - All as Millie wanted to get things done efficiently with an eye on
048882 - cost containment.
048884 - ..
048885 - Millie would be very proud of her children pulling together, each
048886 - instinctively helping the other to make everything simple, easy, and
048887 - correct, like seasoned professionals trained to perform difficult,
048888 - sensitive tasks that are actually rarely encountered in daily life.
048890 - ..
048891 - She is smiling now, thankful passing the torch to the next generation
048892 - embracing life wih courage and dignity, as she did.
048893 -
048894 - [On 100730 1542 letter notifies Ron Senior that Millie was
048895 - proud of her children, and noting they worked well together
048896 - meeting the crisis of their mom's passing with courage and
048897 - dignity, as Millie wished. ref SDS C4 9I8Q
048899 - ..
048900 - [On 100807 1300 memorial services cite Millie's pride and
048901 - comfort knowing her children have become strong and capable
048902 - citizens of the world, and loving and caring parents for
048903 - her grandchildren. ref SDS D1 QT7J
048905 - ..
048906 - [On 101105 1632 Millie's oldest son diagnosed Hodgkin's
048907 - Lymphoma cancer. ref SDS D2 CU30
048909 - ..
048910 - [On 110124 2110 Millie's son, Ron Junior, age 56, died from
048911 - heart attack suffered in the hospital to recover from
048912 - another episode of painful breathing diagnosed as unknown
048913 - lung infection due to weakened immune system caused by low
048914 - blood counts from chemotherapy to treat cancer diagnosed in
048915 - November 2010, as Hodgkin's Lymphoma. ref SDS D3 OF5H
048917 - ..
048918 - [On 110129 2025 Pam's letter noting her mom would be
048919 - pleased how the family has pulled together. ref SDS D4 OF5H
048921 - ..
048922 - [On 110205 1143 Pam reports her father beginning to recover
048923 - from grieving loss of his son; Millie would be very proud
048924 - of Pam and Steve pulling together to help Kim with the
048925 - charity hike to finance cancer research. ref SDS D5 ON9M
048926 -
048927 -
048929 - ..
0490 -
0491 -
0492 - 1725
0493 -
049301 - We all went downstairs and talked. Finally, Pam called the morturary,
049302 - which Pam set up yesterday, reported on 100728 1016. ref SDS C2 4M7N
049304 - ..
049305 - Ron organized a toast for Millie. He offered a moving eulogy.
049306 - Everyone added their thoughts at this time of great sorrow, yet
049307 - celebration of Millie's life that has touched the hearts of everyone,
049308 - shown by the picture of Mil in her new dress...
049309 -
049310 -
049312 - ..
049313 - Still cannot believe the woman in the video on 100714, has
049314 - departed...
049315 -
049316 - http://www.welchco.com/pic/buck/100714/100_1310.wmv
049318 - ..
049319 - Kim called Millie's lifelong friend Marilyn and told her that Millie
049320 - has died.
049322 - ..
049323 - Pam called Mil's sister Dorothy.
049325 - ..
049326 - Steve may have called their dad, Ron Sr.
049327 -
049329 - ..
0494 -
0495 -
0496 - 1725
0497 -
049701 - Elizabeth called to talk to Millie from the Wellness Community to see
049702 - why Millie did not attend yesterday? Millie has been the shining
049703 - example for other patients to follow living with cancer for the past
049704 - 10 years.
049706 - ..
049707 - Told Elizabeth that Millie died. She began crying in shock, since
049708 - Millie has always seemed vigorous and strong.
049710 - ..
049711 - She will tell the Wellness Community that Millie's journey has ended.
049712 -
049713 -
049715 - ..
0498 -
0499 -
0500 - 1753
0501 -
050101 - Chris called from Millie's work and said that Tina, Millie's attorney,
050102 - called her and was crying after meeting with Pam and Steve earlier
050103 - today, per above, ref SDS 0 6Q9K, and learning that Millie suddenly
050104 - yesterday declined severely. She asked how Millie is doing now?
050106 - ..
050107 - [On 100731 0021 letter to Tina reports Chris calling today
050108 - and explaining Mil's long history of friendship with Tina.
050109 - ref SDS C6 ME9S
050111 - ..
050112 - Had to tell her that Millie died an hour ago. ref SDS 0 EK4I
050114 - ..
050115 - Chris was shocked, saying she talked to Millie just 2 days ago on
050116 - Tuesday, and she sounded strong and determined to get better, once
050117 - Kaiser approved her claim requesting treatment.
050119 - ..
050120 - Explained that Millie had trouble climbing the stairs on Sunday.
050121 - Tuesday could barely get around to do some work on the computer, but
050122 - by Tuesday night, she could not get out of bed. Wednesday, she asked
050123 - for help dying, so I had to call Hospice, and Millie's family.
050124 - ref SDS C2 TF4J
050126 - ..
050127 - Chris was crying. She will let the office know what happened.
050129 - ..
050130 - Thanked Chris for always being there for Millie.
050136 - [On 100731 0021 letter to Tina reports Chris calling today
050137 - and asking about filing wrongful death claim. ref SDS C6
050138 - ME9S
050139 -
050140 -
050142 - ..
0502 -
0503 -
0504 - 1830
0505 -
050501 - Atta Vista Mortuary two man team arrives. They bring Millie
050502 - downstairs on a stretcher and place her on a gurney. She is wearing
050503 - her new dress intended for meeting with Doctor Johnson to start her
050504 - next treatment, and instead this is Millie's final act.
050505 -
050506 -
050507 -
050509 - ..
0506 -
0507 -
0508 - 1919
0509 -
050901 - Family went to dinner at restaraunt in Clayton.
050902 -
050903 - Discussed memorial for Millie next week on Saturday at Ron and Kim's.
050904 -
050906 - ..
0510 -
0511 -
0512 - 2123
0513 -
051301 - Very lonely here. Nothing more can be done for Millie. Nothing can
051302 - be said; cannot discuss books she is reading, plans for breakfast,
051303 - chores, family visits, shopping, going to the movies, nothing....
051305 - ..
051306 - Rearranged the bed in the big bedroom which was moved earlier to make
051307 - room for the hospital bed, which turned out not to be needed.
051309 - ..
051310 - Everything is arranged the way Millie wanted.
051311 -
051312 -
051313 -
051314 -
051315 -
051316 -
0514 -