Carrie Simmons Daily Routine

THE MOST IMPORTANT THINGS ARE:
   do everything you can to prevent falls.  This means NEVER leaving
     her alone on the toilet or when she is in her wheelchair (even with
     brakes on, she can rock it and tip it over) PROVIDE HANDS ON
     SUPPORT during all transfers.   When she is being
     transported in the wheelchair, and also when she is doing a transfer,
     make sure you know where her hands and feet are.

Inside the house, Carrie uses the wheelchair that has a sign on
the back of it saying PULL BACKWARDS.  The other wheelchair is
used for taking her to and from Day Hab.

Carrie gets dressed for the day and also dressed for bed in
the bathroom.  I keep the bathroom stocked with underwear and
pajamas (the shelves on the left hand side) and I keep a few
outfits that she wears to her program hanging up on hangers on the
right hand side.  Also, keep small white waterpad pads in the
bathroom in case you need to take a wet one off.

CARRIE CANNOT BE LEFT ALONE when she is on the toilet, because she
tends to stand up and she could fall.  When she is on  the toilet,
I sit outside the bathroom and watch her.

I wake Carrie up at 6:45 a.m.(on program days)
  I turn the light on. Usually she is
 somewhat curled up, just move her gently to a flat on the back
 position and this will rouse her. She can stay in bed until her
 breakfast is ready. Put black sneakers on her before you get her
out of bed.  

Usually, she refuses a REAL breakfast, but you can offer egg and
toast or instant oatmeal.  What she prefers is BREAKFAST ESSENTIALS,
I warm the milk up for a minute in the microwave before stirring the
BE into the milk.  Also, stir in 17 gm POLYETHYENE (use the line inside
the cap to measure it).  Somedays, she prefers BOOST (cold)also with
Polyethyene Glycol.

Bring her to the table.  Put a bib on her and place her left arm on the
table. Start with about one inch of BE in her cup.  Its a good idea to
have a small kitchen towel handy in case of spills.

After breakfast take her directly to the toilet by pulling the
wheelchair  backwards until it is in front of the toilet.  Encourage her
to grab the grab bar with her right hand and help her to stand up.  Give
her a few seconds to adjust her feet to a better position and then
help her lower herself down onto the toilet.  Stand close enough to
catch her if she wobbles during transfer.

It works better if you leave the bathroom and sit at the table and keep
an eye on her.  It may take her several minutes to start urinating.

Leave her on the toilet while you dress her, comb her hair and brush
her teeth.  She cooperates with dressing.  When putting a shirt on her
put her left arm in first.  She wears her braces inside the white sneakers
to program every day, and they can come off as soon as she gets home.

TEETH BRUSHING:  her toothbrushes are the two small orange ones. Hold one
of them under hot water and put a tiny bit of toothpaste on it.  She will
only cooperate with brushing for a few seconds. After brushing, get a
clean washcloth wet (hot water) and use it to clean her mouth out.

Place the wheelchair in the other direction on the right hand side of
the toilet (Carrie's right hand side) the back of the wheel chair will
be pointing towards the dining room table.

When she is dressed and cleaned up, encourage Carrie to stand up by
herself (she can).  She grabs hold of the bar and pulls herself up and
can stand there while you pull her pants up. With your HANDS ON,
 encourage her to take
a step and grab the right hand arm rest and pivot before sitting
down in the wheelchair.

Pull the chair backwards (slowly) to the living room.  You will need
to turn it around and bring it up close to the couch, just past the
area where Carrie sits (it has a waterproof pad on it).  She will be
facing Phelps Street, with her feet all the way to the end of the
couch.  Encourage her to stand up, and she will do so, and she will
turn herself and sit down on the couch (be ready to offer support but
she rarely needs it). Once she is seated, encourage her to pull
herself back.

WE-CARE picks her up in the mornings (Monday through Friday) at around
8:10.  The bus aide will call when they are about five minutes away.
She returns home between 3:10 AND 3:40 P.M.  As soon as she gets into the
house, I take her to the toilet.  Often she has wet her pants, and if so
she can go directly to the tub for a bath.  If she is not wet, I give her
plenty of time to go and then take her to the couch for a half hour rest
before she is given her bath.

Carrie eats just about everything.  She needs a blue slip proof pad, her
bowl with rim and a small plastic cup, as well as a spoon. After bringing
her to the table, place her left arm up on the table.  It may slip off,
and you can put it back up.  When she is drinking milk, I keep a small
towel handy in case of spills.

Meds:  
a.m.  TWO 32.4 mg phenobarb      given with breakfast
      Two red-gel Duc-q-Lace capsules    
      one Vitamin D (1000 mg)  
      these can be stirred into a couple teaspoons of pudding

      three 100 mg Carbamazine
      two Senna-Lax
      one tab-a-vite
      these can be crushed OR dissolved in a small amount of water in a medicine
          cup.  It takes a few hours to dissolve them, so I put the water in the
          cup with the pills  the night before.  After crushing or dissolving
          stir into pudding with the other meds.  If the pudding comes out of
          the frig.  warm it a few seconds in the microwave before putting meds
          in

2 p.m.  two 100 mg Carbamazine
        one 16.2 phenobarb
        I crush or dissolve the carba. and stir the phenobarb into pudding

p.m.    same as a.m. except leave out the tab-a-vite
        I usually give these meds to her at 8:00 p.m.

IF CARRIE HAS DIFFICuLTLY SLEEPING:
she can have CLONAZAPAM, either stirred into her p.m. meds OR
given separately.  Once in a while, if I can tell she is having
difficulty getting to sleep, I prepare the CLONAZAPAM and take it
in to her and give it to her while she is still in bed.

The bottle says THREE tablets, but I was instructed by the
neurologist to give "as needed".  I have found that one-half
of one tablet is usually sufficient.

When Carrie is not at the kitchen table, in bed or using the bathroom, she
sits on the couch.  She likes to have a small towel to chew on (towels can
be found inside the brown footstool next to the couch)

BEDTIME:
I take Carrie to the bathroom at about 9:00 p.m.  and give her plenty of time
to go. Brush her teeth and then take her to bed.  She may need help positioning
herself after you help her into bed.  Pull bed rails up.  Do one at a time,
pull the knob in  towards the center of the bed, while pulling up.

She usually sleeps through the night.  If I wake up in the night, I go in and
check on her and make sure she is covered.  (without turning the bedroom
light on)