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Monthly Summary and Invoice Date: 03/03/15
A 24 hour, 7 days a week service of Personal Care Support.

Health Care Surrogate Provider: Peter L Izquierdo
Consumer: Eugene Harmon
Date of Services Provided: 02/01/15-02/28/15

Review from last month: Mr. Eugene was discontinued with In-Home supports and medical post-care from Gentiva Nursing Services on February 20, 2015 subsequence his results from his latest swallow test.
The doctor said that he will have to be tubed fed for the rest of his life. A full test result will be mailed to your office detailing the procedures that were done and a full report explaining the outcomes of Eugen’s conditions.
UPDATES: Coach continues be responsible for Eugen’s aftercare; insuring that Eugene practices the various exercises prescribed by all three therapist He continues all the past therapies that coach learned as he believes after researching Eugen’s condition and speaking with other health professional that there is always a chance for Eugene to recover. ‘The fight is not over yet!’
Eugene was caught having soup, while coach was napping on the couch. Eugene cannot be left alone or out of eye sight because he cannot control himself (understandably). As a result of this incident he started to develop chest congestions due to fluids going into the lungs and not down into his stomach. He was given antibiotics and prednisone for regulating breathing as a precaution and preventing infections. Eugene is currently ok.
Eugene continues to be under a progressive care-plan with coach, where he is never left alone. Coach now makes sure that anyone visiting Eugen’s residence is notified about Eugen’s status and to not leave any food of their own unattended. Unfortunately in regards to Eugen’s rights, coach has placed locks on the food pantries in the kitchen. The refrigerator however remains unlock as part of teaching Eugene to get his trust back and to motivate him to get better. These strategy-methodology are necessary to help Eugen understand the reality that he may never eat like he used too. And that he must practice honesty to himself.
Other Services Provided:
Medical and Health management:
UPDATES:
Eugene continues to be supervised by coach. Eugene has a new doctor. ‘We are looking for second opinions.’
Coach will be seeking a prescription for a long term way to feed Eugene through his G-tube. Medicare will cover the cost minus the co-payment which will be manageable financially for Eugene and no further financial assistance will be required or ask of Mr. Trows office.

Shopping:
UPDATES: Coach continues to personally do all his shopping. This includes purchasing men’s brief (“Depends”), specialize-reconstituted powder formula for the G-tube feeding catheter-cleaning and maintenance-supplies of gauze pads and normal saline solution, large plastic specialized syringe for G-tube feeding and sterile supplemental kits for tube feeding. This service is provided 3 times weekly for approximately 3-4 hours embedded as a physical-outing for Eugene who is accompanied by coach who is currently teaching Eugene how to purchase his own medical supplies. Eugene also takes the opportunity to purchase his art work supplies and but clothes and purchase other items of personal nature.
Clothing care/ Home maintenance/Personal Hygiene/ meal preparations:
UPDATES: Eugene continues his intensive in-home rehabilitation process. His muscles continue to need more therapy for better strength. Coach continues doing all of his chores from laundry to changing his soiled sheets that occur regularly due to the special liquid formula he is on, cleaning his special portable bedside toilet, vacuuming and shampooing his soiled bedroom carpet resulting from toileting accidents, shaving and bathing him and supervising teeth brushing. Eugene also continues to practice daily oral hygiene as required and important due to daily bacteria accumulations secreted into his lungs; causing infections such as phenomena.
Eugene continues to learn the process of tube feeding himself, although the preparation process is still done by the coach and strict supervision during the G-tube feeding.
Eugene continues to seek attention due to his frustrations of not being able to eat normally. Coach continues to use methodologies that redirect this natural emotional dynamic.
Mobility and travel skills:
UPDATES: Eugene does all the exercise with his coach twice daily and they are embed from daily routines to outings and shopping events.
Eugene still uses his walker but occasionally forgets to use it and coach has to advise and supervise. UPDATES: Speech therapy exercises are still performed with coach at least 30 minutes three times daily.
Facilitating relationships/ Recreational activities (OT orientated):
UPDATES: He continues to meet folks on each of his outing events; giving him the opportunity to talk about his life changing event and develop interpersonal communication with his community; coach encourages such emotional-therapeutic dynamics; facilitating such encountering relationships.
Eugene interacted with lots of new people at the trinity high school carnival, Ocala, FL. He rode the chairs and the Ferris wheel and carousels. Other outings included local theaters, walks in the park: lee-village, Belleview Lake, Daytona walk on the beaches with coach assists. And the villages with concerts-outdoors, trips to Clearwater festival and other nearby attractions in St. Petersburg, FL. The goal is to keep Eugene occupied mentally and increase his quality of life emotionally and spiritually.
Support counseling/ Interpersonal Communication:
UPDATES: Eugene continues to have hope that he will eat food again.. Coach is seeking out support groups that have similar obstacles.
He also continues interpersonal Communication supports; how to express himself about what is happening to him during his recovery process. How to talk about his feelings concerning his recovery process. Eugene has support from his former speech therapist that still stay in touch by phone with Eugene on their own time. He has establish supports. Coach continues to facilitate these interactions.

Documentation/Quality Assurance:
UPDATES: this month the complete report on Eugen’s swallow test will be hand carried over to Mr. Trows office for his files.
Administrative-housekeeping information: This concludes and accurate description of services and circumstances surrounding Eugene’s continued recovery-process and his continued new life-changing events.

Thank you for allowing mo serve Eugene.

Peter L Izquierdo, MS; Med-Waiver Provider; US Army, CBT-Medic (RET)

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