BV Guide

General

• BV can only communicate yes/no without his communication device.  Raising eyes and looking up is “yes”, looking down and blinking is “no”
• BV showers in the evening after dinner and GTube and before bed.  He should shower every other day. 
• BV does not like the word "diapers", refer to incontinence briefs as "briefs" or "underpants".

Morning

• Wake up around 9am. 
• Wake him and give him his morning meds. 
• Give him 20 minutes to wake up and have a bowel movement. 
• Check every 20 minutes until he is done.
• When he has gone, then change his underpants and clean him up. 
• If he is particularly messy offer a sponge bath or shower.
• Transfer him to his chair.  Make sure his leg cannot hit the communication device.
• Tilt chairback, and pull him up by the waist of his pants.
  • ​Make sure his pants are all the way up and covered by his shirt, he does not like his briefs or abdomen showing.
    
• Buckle belt below the GTube port, making sure that the belt does not touch and rub the port.
• Place bar for communication device on the hole on the right side of his chair.
• Fold bar out and mount communication device. 

Watch video on setting up communication device HERE.

Communication Device

• BV communication device is VERY important to him and is necessary to his ability to email, text, control his TV etc. 
• It is vital that staff be VERY careful mounting and removing it as to not drop/damage it.  It is also very important that he is placed in his chair so that his legs do are not able to kick the device and damage it. 
• Always run the power cord straight down from the device in such a way that it does not go anywhere along the side and near his right arm. 
• Remember that he has spasticity he is no able to control and can damage the device by kicking it or a connected power cord.  Make sure that the device is secure on it’s mount when setting it up.
• The device mounts on a pole that goes into a hole on the right (from his perspective) side of his chair.

Evening

• After he eats dinner, give him a G-Tube feeding.  At least 1 can of Jevity, 2 if he has not eaten a lot or none.
• If it is a shower day, give him a shower in between GTube feeding and bed.
• Undress him, transfer him onto shower chair in bathroom.
• Clean him using soap, wash hair, rinse.
• Dry him off and transfer him back into chair, then bed.
• Shower or no, put fresh incontinence briefs and pajamas, make sure bed rail is up

GTube Feeding

• Place bag on the IV stand, behind his chair. 
• Pour Jevity mix with 2 parts Jevity to 1 part water.  2 cans Jevity to 1 can water or 1 can Jecity to ½ can water) into bag and allow it to flow to the end of the tube (this prevents too much air from going into his stomach which is uncomfortable.  Clamp it.
• Open the GTube port on his abdomen.  Close the clamp on the G-Tube tube and place the end with writing into the feeding port on his abdomen, lining up the arrow with the slot in the port.  Turn it clockwise ¼ turn.
• Connect other end of the tube to the tube from the bag on the IV stand, make sure it is secure and tight.
• Open the clamp on the tube coming from the port first, then the one on the tube coming from the bag.
• When all the mixture is done and bag is empty, disconnect the tube coming from the port from the tube coming from the bag.
• Use the syringe to run water SLOWLY through the tube into the port until it is clear.  This prevents the Jevity from caking around the port.
• Close port.
• Take the tube that goes into the port and syringe and clean it by running water through it using syringe until it is clear.  Place tube in ziplock bag.
• Bag and tube from bag are disposable and can be thrown away. 

Watch GTube feeding videos HERE and HERE. 

Bag

Tube from Bag Clamp

Tube Going to Port

Tube to Port

Clamp on Tube to Port

Syringe

Eating

• BV can eat any food, except hard candies. 
• All food must be cut up smaller than the tip of a pinkie finger past the last knuckle.
• Meat must be well cooked, preferably ground meat.
• Feed him using a shallow spoon made of plastic, do not use metal spoon.
• Hold his chin in one hand holding a washcloth under his chin to collect spillage.  Spoon food with other hand in small bites and allow him time to swallow food.
• Eating is a very slow process for him and requires a lot of time and patience.