My first patient today is Mrs. Beth. She is a lovely woman in her mid-fifties. She has multiple sclerosis with minimal use of her left hand and no use of her right hand. I provide her personal care and we catch up on what has been happening on the television series that we both enjoy. I transfer her into her electric wheelchair with the help of a mechanical lift and position her with her pillows meticulously placed for comfort. I offer to get her something to eat, which is usually a bowl of cereal with milk. Before I leave, we talk for a little while longer, which she always enjoys. Mrs. Beth is a very inspiring person. Although her independence is slowly deteriorating she is still a positive and bubbly woman. She always sees the positive in any situation and is always grateful for what she continues to have and enjoy.

As I travel from patient to patient, I can only hope that there are no accidents, roadblocks, detours, nor inclement weather that prevent me from being on time for my next visit. The winter months are rough, especially with the ice and snow. Of course, the super-hot months are difficult too! Mr. Jerry is a 92-year-old man with end-stage Alzheimer's disease. I have been visiting Mr. Jerry off and on for the past 3 years. He chose hospice care about 6 months ago. In recent days, he has not been doing well and his health is declining. His wife is his primary caregiver and is extremely capable with her abilities and her dedication to her husband. Mrs. Jerry and I have had many conversations discussing what is best for her husband; his sleeping arrangements, diet preferences, or behavior changes. I listen and offer moral support. I can recall a time when Mr. Jerry insisted on speaking to me only in Polish. Before Mr. Jerry's disease became advanced, he would often try to be comical and do something silly to see if he could get a rise out of me. I needed to hide my laugh from him because it would only encourage that specific behavior. My responsibilities include getting Mr. Jerry bathed, shaved, repositioned, and fed if he is hungry. He and his wife have been a delight to visit.

My last patient of the day is Mr. Bob. This is Mr. Bob's second time on our home care service, both times following total knee replacements. Mr. Bob went into surgery thinking he was to have a partial knee replacement but when the surgeon saw the damage from years of arthritis and deteriorating cartilage, the surgeon decided it would be best to perform another total replacement. After I called and set up an appointment for me to visit, the first thing I said to him was "long time no see." We both laughed for a bit and chatted while I assisted him with personal care. During the visit I assisted him with most of the exercises that the physical therapist had instructed Mr. Bob and me on, staying within his comfort limits. Following his exercises, he took his prescribed medication and I gave him his ice pack from the freezer. Mr. Bob lives alone and does not have any relatives who live nearby. I know he both enjoys and benefits from my visits. In a few weeks, he will be discharged by the nurse and physical therapist and he will enjoy going back to the diner for lunch with his pals.

I miss all my patients when they are either discharged from our service or pass away, but it feels good to know I was there for them when they needed me.