Arla is doing well and progress is slow.  The pace of skilled nursing rehab is slower than the intensive rehab hospital.  There are pros and cons to this situation.  Arla is more alert and seems to be sleeping more soundly.  That is a pro.  However, she spends much of her day in bed and doesn’t tolerate being up in a chair as long.  That is a con.  She does do daily therapy and is doing well with that. 

Since she is basically helpless, in the sense she cannot ask for help and often doesn’t really know what she needs, the family finds it necessary to check up on Arla’s situation more frequently.  The ratio of nurses to patients was very low at the rehab hospital.  The ratio of patients to nurses is much higher in a skilled nursing facility.  We are also dealing with Arla’s medical care being overseen by a physician who will not see her very frequently.  So we become proactive, and agressive if necessary, as we advocate for what Arla needs.  Already, on one issue, the RNs said they would call the doctor so that the oldest daughter doesn’t have to.  I guess the word has gotten around that Mary Ann knows what she is talking about and is on top of all medical and financial situations. 

Please visit Arla.  She is still unable to talk, but she knows people.  We would like you to know that Arla becomes very emotional at times.  This is a normal process of a stroke and comes from the fact that Arla really has reason to be emotional.  She misses her old life.  She wants to speak with old friends and cannot.  She misses her loved ones.  And losing so much is emotional.  So… if you visit her and she cries, do not be surprised.   If you cry too, there are kleenex handy, and Arla will think nothing of it.  Arla has a huge heart to love so many and some days that love bubbles up in tears.