THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700


S U M M A R Y


DIARY: June 19, 2002 10:00 AM Wednesday; Rod Welch

Visit Ron in Scotts Valley; making good recovery with family support.

1...Summary/Objective
2...Ron Looking Fit and Well, Home Seems in Good Order
3...Divorce and Business Stress Cause Strong People to Suffer
4...Family Very Helpful for Ron's Recovery; Needs Assistance Remembering
5...Ron Feels Medication Not Helping, Needs Refill on Mevacor
6...Cognitive Therapist Arrived for Treatment
7...Medication Refill Ordered for Mevacor; Need Follow Up on Delivery
8...Relaxation and Instructional Therapy for Ron
9...Narrative Therapy Aids Patient's Memory, Demonstrates Progress
10...Therapist Advises that Ron Needs Someone with Him
11...Family Needs Professional Advice to Aid Decisions on Helping Ron
12...Excursion to Scotts Valley for Ice Cream
13...Ron Astute Giving Instructions for Driving Commenting on Business
14...Memory of Distant Events Better than Near Term Activity
15...Visited Kurt's Home and Reviewed Construction, Astute Business Sense
16...Visit Ends, Plan to Keep in Touch, Advice Ron Needs Assistance
17...Comments on Visit with Ron and Need for Regular Support

ACTION ITEMS.................. Click here to comment!

1...Ron's doctor should be consulted about these matters based on written
2...Some proactive support seems needed and so the machinery necessary to
3...Another idea would be to get a big portable blackboard and set it up

CONTACTS 

SUBJECTS
Leadership Helps People Take Paths they are
Ron Useldinger

0504 -    ..
0505 - Summary/Objective
0506 -
050601 - Follow up ref SDS 29 0001, ref SDS 27 0000.
050602 -
050603 - Richard called this morning and said that he called Ron's phone number
050604 - several times and got a message that the phone has been disconnected.
050605 -
050606 - He is worried about Ron.
050607 -
050608 - Richard said he cannot participate in the visit today due to a meeting
050609 - that has come up that requires his attention in the afternoon.
050610 - ..
050611 - After talking to Richard, I called and got the same answering
050612 - machine message that has occurred on previous calls, assume the line
050613 - is still active, and will go ahead with the visit planned previously
050614 - on 020604 when Ron asked me to come see him, ref SDS 27 BT4K, and
050615 - later on 020606 Kurt asked for comments on a visit with his dad.
050616 - ref SDS 28 XC9K
050617 -
050618 -      After the visit with Ron, submitted email to Kurt with a link to
050619 -      this record for comments, per his request on 020606. ref SDS 28
050620 -      PE3K
050621 -
050622 -      [On 020621 called Ron to follow up. ref SDS 31 0001
050623 -
050624 -
050625 -
050626 -
050627 -
050628 -  ..
050629 - Ron Looking Fit and Well, Home Seems in Good Order
050630 -
050631 -
0507 -
0508 -
0509 - 1144
0510 -
051001 - Arrived following Kurt's instructions in his letter last night.
051002 - ref DRT 1 0001
051003 -
051004 - Ron looked very good, healthy and fit. His handshake was strong as
051005 - always.  This differs a bit from discussion with Kurt on 020606.
051006 - ref SDS 28 J86K  He was dressed in casual clothing, his shirt seemed
051007 - to be pressed, all indicating grooming and personal hygiene are okay.
051008 - The grounds of the property are maintained, perhaps indicating he is
051009 - keeping active.
051010 -
051011 -     [On 020705 Ron was clearing brush to reduce fire hazard.
051012 -     ref SDS 32 IZ3F
051013 - ..
051014 - He had a little trouble remembering his dog's name, but
051015 - eventually introduced Conine.  Ron responded with normal attentiveness
051016 - to the dog, getting up to open a sliding door in the living room, and
051017 - let him outside.
051018 -
051019 - Ron showed me through the house, since I have not visited in 10 years
051020 - or more.  The house is fairly well maintained, although it needs some
051021 - cleaning.
051022 - ..
051023 - Ron asked if Richard is coming, and I explained that Richard has
051024 - a meeting this afternoon, and so cannot come this trip.
051025 - ..
051026 - Ron showed the room where he works out with the Isorobic
051027 - Exerciser, and explained that he changed the rope this morning, after
051028 - 12 years of use.
051029 - ..
051030 - We hiked up the stairs in the back yard and admired the view of
051031 - the area.  I remembered this from helping Ron move in 20 some years
051032 - ago.  This is a vigorous hike that can help maintain cardiovascular
051033 - condition, or cause a heart problem for those not in shape.
051034 -
051035 -
051036 -
051037 -  ..
051038 - Divorce and Business Stress Cause Strong People to Suffer
051039 -
051040 - We sat on the deck for about 20 minutes.  Ron was happy about closing
051041 - a transaction on selling some property yesterday.  He mentioned
051042 - several times this was a very, traumatic and difficult deal to
051043 - accomplish, so he feels it may have contributed to his stroke.
051056 - ..
051057 - We talked about old times when he was a coach.  He remembered my
051058 - record wrestling from many years ago, and recited many details that I
051059 - had forgotten.  Ron remembered having departed Cupertino High School
051060 - to take a job as head football coach at Homestead in 1963, and he was
051061 - wistful about not staying one more year to coach the wrestling team he
051062 - built at Cupertino.  He recalled that Dennis Blacklock was the only
051063 - state champion who graduated, and so the team was basically in tact,
051064 - if he had returned to coach the 1963 team at Cupertino.  We talked
051065 - about Ron's success building a winning football and wrestling program
051066 - at Homestead High School, and we also, remembered he had the
051067 - rotatilling business during the summers probably in 1963 - 1965 or so
051068 - when he was off from teaching and coaching.  Then in the 70s he left
051069 - teaching and coaching and went into business, and became a successful
051070 - entrepreneur.  This was an impressive, positive sign of good memory
051071 - for a stroke patient.
051072 - ..
051073 - Ron explained his second wife, Gena, left him because she was
051074 - aging faster than he was and this created an emotional issue that she
051075 - could not face.  He feels Gena's sudden departure, and difficult
051076 - business matters just caught up with him and the stress took its toll.
051077 - ..
051078 - We considered how such events along with Ron's strong drive for
051079 - excellence would over stress anyone.
051080 - ..
051081 - I joked that driving to and from his house would give most
051082 - people a stroke dealing with traffic at 60 miles per hour in making
051083 - sudden sharp turns for getting off and onto Highway 17 in the
051084 - mountains, and then maneuvering the long, difficult roadway up and
051085 - down the hill to his house where you cannot see cars coming the other
051086 - way around hairpin curves with no room to pull off the road to let
051087 - anyone past.  That is pretty stressful.
051088 -
051089 -      [On 020706 report that Ron's tenants moved because they had an
051090 -      autombile accident while trying to leave the property and get
051091 -      onto highway 17. ref SDS 33 MO6H
051092 - ..
051093 - Ron cried a bit struggling to remember things, and said he
051094 - expects to get better,  but it is not any fun going through his
051095 - predicament.  He said it is shocking to realize he cannot remember
051096 - simple little things he should be able to remember going along
051097 - day-to-day.
051098 - ..
051099 - I related the shock we felt when Millie was diagnosed with
051100 - cancer, and commented that we are all in training for a continuing
051101 - sequence of ills as we get older.  I have been staying with Millie to
051102 - help her through treatment.  Her memory is not affected like Ron, but
051103 - the physical and emotional toll of the experience makes it hard to
051104 - concentrate and remember about taking medicine and doing other routine
051105 - daily things, so she needs someone with her.
051106 -
051107 -
051108 -  ..
051109 - Family Very Helpful for Ron's Recovery; Needs Assistance Remembering
051110 -
051111 - Ron said he is very grateful for the support of his family; everyone
051112 - has pitched in as best they can in light of all the circumstances.  He
051113 - said that Kurt living nearby has been a blessing, because Ron can get
051114 - help when the need arises.
051115 - ..
051116 - I asked how Kurt can be alerted to help, during those times when
051117 - Ron may not remember things that give rise to a need for action, like
051118 - taking medicine, calling the doctor and so forth?
051119 -
051120 - Ron feels he is doing pretty well on these things.
051121 -
051122 - I asked if he has kept in touch with Donna, and mentioned we had a
051123 - good conversation in December when Karol passed away. ref SDS 24 QT5K
051124 -
051125 - Ron said Donna has been supportive and helpful.  He was glad she was
051126 - there when Karol became ill and needed someone to care for her.
051127 -
051128 - Ron noticed my face was getting red sitting in the sun.  I explained
051129 - that a little sun is okay, but I can't stay out for very long, so we
051130 - walked back down the hill to the house.
051131 - ..
051132 - Ron asked how Millie is doing in her recovery?
051133 -
051134 - I explained recent good news where a cancer marker has dropped
051135 - dramatically that gives us all hope. ref SDS 30 0001  Millie has to
051136 - take medication regularly in order to get better, so I help her
051137 - remember by keeping a spreadsheet chart and checking off each time
051138 - when medicine is taken during the day, so we can make sure not to
051139 - forget.
051140 -
051141 - I remind her about eating, help fix meals and take care of things.  I
051142 - think just having someone there to be attentive about details, so she
051143 - is not dealing with her situation alone is a big help.
051144 -
051145 - We talked about how this experience might relate to Ron, and that he
051146 - could benefit from having a family member or even a nurse stay with
051147 - him to help through this period while he adjusts and recovers.
051148 - ..
051149 - Ron indicated a checklist could be helpful for him because he
051150 - cannot remember things he decides to do.
051151 -
051152 -     [...see ideas below. ref SDS 0 VQ6L
051153 -
051154 -
051155 -  ..
051156 - Ron Feels Medication Not Helping, Needs Refill on Mevacor
051157 -
051158 - Back in the house, we were in the living room and I asked Ron if he is
051159 - taking any medication?
051160 -
051161 - He said that some of it is not doing any good, and everybody
051162 - understands his decision on that, indicating he has been encouraged by
051163 - family and friends to take medication, but is resisting.
051164 - ..
051165 - We discussed this a bit more.  Ron is discouraged that he is not
051166 - recovering faster.  He was insistent that the medication is not
051167 - working and so he is not taking it.
051168 -
051169 -     [On 020705 taking medication may still be an issue. ref SDS 32
051170 -     VL92
051171 - ..
051172 - Ron then asked me to look at his medication.
051173 -
051174 - We walked from the living room into the adjacent kitchen area.  On the
051175 - counter next to the sink there were three bottles that called for
051176 - daily use.  One bottle had one pill left, and the other two looked to
051177 - have at least a week or so supply.
051178 - ..
051179 - I drew a glass of water for Ron, and he took the three pills.
051180 -
051181 - I asked who orders re-supply on the empty prescription bottle?
051182 -
051183 - Ron said he is not sure.  Ron said he could do it, and asked if I
051184 - would help.
051185 -
051186 - The bottle says there are "0" refills remaining, which nominally means
051187 - the doctor has to authorize additional refills.
051188 -
051189 -
051190 -
051191 -  ..
051192 - Cognitive Therapist Arrived for Treatment
051193 -
051194 -
0512 -
0513 -
0514 - 1215
0515 -
051501 - About this time Ron's therapist arrived.  Ron introduced us.  Her
051502 - name is Dawn.
051503 -
051504 - We needed Ron's Kaiser account number to order a refill on his
051505 - medication.  Ron remembered it so Dawn wrote it down for me to make
051506 - the call to Kaiser while she and Ron were doing his therapy.
051507 -
051511 -
051512 -
051513 -
051514 -  ..
051515 - Medication Refill Ordered for Mevacor; Need Follow Up on Delivery
051516 -
051517 -
0516 -
0517 -
0518 - 1220
0519 -
051901 - Called Kaiser at the number on the prescription bottle....
051902 -
051903 -                         408 236 5295
051904 -
051905 - The phone is answered by an automated system that asks questions and
051906 - gives instructions, so there is not an opportunity to ask about
051907 - getting the prescription renewed.
051908 - ..
051909 - Gave Ron's Kaiser number.
051910 - ..
051911 - Placed order for:
051912 -
051913 -                       412674018
051914 -
051915 -                       Mevacor
051916 -
051917 -
051918 - Kaiser asked for the address to mail the prescription, gave the
051919 - address on the bottle.
051920 -
051921 - There was no request for payment, so did not have to give a credit
051922 - card.
051923 -
051924 -     [On 020705 Ron received prescription refill. ref SDS 32 VL92
051925 - ..
051926 - There was no feedback from the system indicating the
051927 - prescription could not be filled because the refills have expired.
051928 -       ..
051929 -       Millie later said that the pharmacy takes care of this.
051930 -       When a prescription has expired the pharmacist calls and gets
051931 -       okay from the doctor to extend the refills.
051932 - ..
051933 - The transaction was concluded with a message saying the
051934 - prescription will be mailed within two (2) working days.
051935 -
051936 - This means Ron will be without medication for at least two (2) days
051937 - which he is prescribed to take daily.  Who though is checking the mail
051938 - to ensure delivery?
051939 -
051940 -     This presents an issue of medical management of how to order
051941 -     medication in time to avoid disruption of treatment.
051942 -
051943 - Need follow up to ensure medication is received and taken.
051944 -
051945 -     Experience with Kaiser shows that, like other big organizations,
051946 -     even though the order is placed, things get lost in the shuffle,
051947 -     and so the order has to be be placed again. See for example on
051948 -     010103. ref SDS 23 0001  Previously, pattern of difficulty getting
051949 -     prescriptions filled was reported on 000308. ref SDS 22 0001
051950 -
051951 -   [On 020621 Ron said he will look for this medicine today, and follow
051952 -   up with Kaiser, if the medication is not delivered. ref SDS 31 0001
051953 -
051954 -
051955 -
051956 -  ..
051957 - Relaxation and Instructional Therapy for Ron
051958 -
051959 -
0520 -
0521 -
0522 - 1320
0523 -
052301 - Ron and Dawn came into the house.  Ron said that Dawn wants to do the
052302 - next 30 minutes of therapy with me in the room.
052303 -
052304 - Ron laid on his back, using the large footstool in front of his chair
052305 - and put his feet in the chair, so he was comfortable.  Dawn sat on
052306 - the floor and massaged his head.  She asked if he remembered the
052307 - instructions she gave for breathing.  Dawn helped Ron remember this
052308 - information.
052309 - ..
052310 - Dawn explained her work involves cognitive speech therapy, and
052311 - asked if I am familiar with cognitive science?  She said that
052312 - cognitive science is a relatively new field, and so is not commonly
052313 - understood, which aligns with the record on 971024. ref SDS 13 8288
052314 - ..
052315 - I reviewed my work helping important executives like Ron and
052316 - others at PG&E, the Corps of Engineers, Microsoft, IBM, etc, remember
052317 - accurately by not commingling disparate events, which all of do when
052318 - there is a lot going on, commonly called information overload, as
052319 - explained in NWO. ref OF 1 4077
052320 -
052321 -
052322 -  ..
052323 - Narrative Therapy Aids Patient's Memory, Demonstrates Progress
052324 -
052325 - I asked Dawn if she is familiar with narrative therapy?
052326 -
052327 - Dawn said that is a new idea in her practice and asked how it works?
052328 -
052329 - We reviewed the record working with Doctor Maynard Busman on 951117 who
052330 - correlated Welch work using "thinking through writing" with SDS to
052331 - methods being tried for helping patients improve memory. ref SDS 3
052332 - 4341
052333 -
052334 - Doctor Busman called this narrative therapy. ref SDS 3 9624
052335 - ..
052336 - Dawn commented that she can see how using the hands to write
052337 - could help the mind remember.  She told Ron she would like him to try
052338 - this; that his homework is to try to write a few paragraphs explaining
052339 - the days session.  Dawn said this would help her see Ron's progress on
052340 - therapy and recovery.
052341 - ..
052342 - Ron said he would try.
052343 -
052344 -     [On 020621 Ron said he has written up this report. ref SDS 31 0001
052345 -
052346 - The rest of the therapy was performed with Ron simply lying still (he
052347 - fell asleep), and Dawn doing slow meditating massage to his head and
052348 - shoulders.  For about 20 minutes she held her hands under Ron's head,
052349 - near his ears and neck, holding it in a slightly elevated position
052350 - like a pillow, and just being silent.
052351 -
052352 -
052353 -
052354 -  ..
052355 - Therapist Advises that Ron Needs Someone with Him
052356 - Family Needs Professional Advice to Aid Decisions on Helping Ron
052357 -
052358 -
0524 -
0525 -
0526 - 1349
0527 -
052701 - Dawn removed her hands from under Ron's head, and placed them on the
052702 - sides of his head for a few minutes, then removed them and stood up.
052703 - ..
052704 - This completed the therapy treatment.
052705 -
052706 - While Ron was still resting, Dawn whispered that she feels Ron should
052707 - have someone staying with him to help him remember to take medication
052708 - and just manage daily affairs, e.g., remember instructions from the
052709 - doctor during examinations, and follow through on implementation.
052710 -
052711 -      [On 020705 discussed arrangements on this matter with Ron.
052712 -      ref SDS 32 SG5O and ref SDS 32 OR6L and also concerning Donna.
052713 -      ref SDS 32 I25O
052714 -
052715 -      [On 020706 Krista is worried her dad is losing weight because he
052716 -      is forgetting to eat. ref SDS 33 RH9O
052717 -
052718 - I asked if she is preparing a report on these therapy sessions, and
052719 - explaining her professional opinion about Ron's progress and that at
052720 - this stage she recommends full-time companion or some kind of nurse
052721 - to help Ron remember to take his medicine, order re-fills, and so on?
052722 - ..
052723 - Dawn said she prepares reports.  She has told the family
052724 - verbally that someone should be staying with their father, but has not
052725 - put this recommendation in her written reports, because the written
052726 - reports do not go to Ron's doctor.  This presents a considerable
052727 - hurdle for Ron and the family to obtain timely, independent and
052728 - professional opinion on Ron's condition.
052729 - ..
052730 - We reviewed the idea that since Dawn is a professional therapist
052731 - seeing Ron on a regular basis, she can help Ron and the family work
052732 - through the challenge of his recovery by providing independent
052733 - observations of his progress that help everyone decide the level of
052734 - support needed to meet the current circumstances.
052735 - ..
052736 - For example, Dawn asked Ron to prepare a written report on the
052737 - therapy session today, writing down what they discussed he should be
052738 - doing to aid recovery. ref SDS 0 HW3H  On her next visit, she can
052739 - review what Ron has written and include that in her report to
052740 - demonstrate progress on cognitive recovery.  If Ron does not remember
052741 - to write the report, that failure shows the level of support he needs
052742 - for handling daily affairs, including trips to the doctor.  For
052743 - example, on 020606 his son Kurt said he has been going to the doctor
052744 - with his dad to help implement instructions from the doctor.
052745 - ref SDS 28 RH7K  However, this may not be enough, if Ron is not taking
052746 - his medication, and other matters of personal care are being
052747 - neglected, because Ron cannot remember, per above. ref SDS 0 V55M
052748 - ..
052749 - A professional report would give Ron, the doctor and the family
052750 - key information that guides treatment.
052751 -
052752 -      [On 020705 Ron concerned about not being able to remember well
052753 -      enough to pass a written test. ref SDS 32 MX8G
052754 - ..
052755 - Dawn agreed.  She will consider this further in preparing a
052756 - useful report on her observations from these treatment sessions.
052757 - ..
052758 - Ron remained laying down for about 5 or 10 minutes, then he woke
052759 - up. Dawn helped him sit up slowly.  She said he should get a drink of
052760 - water.
052761 -
052762 - The next therapy session is on Monday, 020624 between 1400 - 1500.
052763 -
052764 - She and Ron walked down the hill to Ron's office that is a small
052765 - building outside the house.  Dawn wrote the session date on Ron's
052766 - calendar, and commented that family and friends can help by keeping a
052767 - list to remind Ron of things to do.
052768 -
052769 -    [...below, action item to keep a list. ref SDS 0 VQ6L
052770 -
052771 -
052772 -  ..
052773 - Excursion to Sco