The Official Joyce Update Blog

Dusty and Jess called to check in with Joyce on the evenings of June 28 and 29 but did not get posts created due to schedule conflicts. Joyce reported that she was doing well on both occasions and was feeling better on pain levels overall with most pain spikes occurring during initial movement from resting position to standing or transitioning back into her room's recliner following physical activities such as walking and physical therapy exercises with staff. She is continuing her cognitive exercises. She misses being out at the farm but still understands why she has to remain at Aspen Park. She's started reading her Redwall book. Her pain levels are low and only spike up when she initially rises up from her recliner chair to go walk or use the bathroom, then numb back down, only to spike up again when she re-seats herself or shifts too much or too quickly in her chair. She is still sleeping in the recliner overnight. She did not see the thunderstorm on the 28th or the double ...

Dusty and Jess called to check in with Joyce around 8:30 p.m. Joyce reported that she had a delightful time visiting with Connie, Phil, and Zac who reserved time to sit outside and visit with her at Aspen Park's outdoor area this morning. The sitting area that Aspen Park is quite nice, said Joyce. Dusty updated Joyce on her flowers and plants at the farm, having transferred them out onto the patio this afternoon. He also let her know that Zac and Connie have been doing a marvelous job keeping the lawn and border grasses under control. Dusty confirmed he is still working through Joyce's laundry so everything is nice and fresh for her return home.  She asked to confirm why she was at Aspen Park, if it had something to do with some sort of an injury. Dusty and Jess reviewed her fall which caused two rib fractures and a fractured vertebrae. She then recalled what had happened. Joyce reviewed the mail and cards she'd received so far and was most thankful for all that has come to...

Dusty called Joyce at 8:20 a.m. but due to nurse being in the room the phone call was ended.  Dusty attempted to call again before Joyce's lunch hour but there was no answer. Dusty called and connected with Joyce at 3 p.m. She reported that they have been having her walk the hallways throughout the morning and early afternoon. They usually have a wheelchair follow along behind Joyce as she walks so she has a ready place to rest if needed as she goes along. Additionally they had her do more resistance training and movement exercises. She said that the therapist wanted to "keep it light since it was Friday."  For lunch today the cook made hamburgers and came into the room to speak with Joyce to see what she wanted to make them special for each resident. The cook said that corn on the cob was going to be the side, but switched Joyce's side to potato salad at her request. Joyce said that she feels spoiled as they are taking such good care of her at Aspen Park.  Joyce repo...

NOTE:  Joyce has been moved out of the quarantine hall and is now in Room 208. Her new phone number is now 208-892-5855. --- Joyce had her teleconference with her primary care provider (Dr. Collins) today, which happened to occur as Dusty was calling Moscow Medical around 12:15 p.m.  Dusty spoke with staff member Wendy at Moscow Medical (unaware Joyce was concurrently meeting with Dr. Collins at that time) about the discharge summary notes Gritman had setup for Joyce about her potential spinal cancer. Dr. Dickinson was listed as the radiation oncologist Joyce was to have follow up. Dusty inquired if that appointment had been scheduled. Moscow Medical staff was unable to determine from Gritman documents if the oncologist appointment had been scheduled but took down Dusty's phone number to call him back with updates once Dr. Collins finished with Joyce's teleconference. Wendy anticipated that Dr. Collins would most likely arrange the oncology appointment with Dr. Dickinson given...

Dusty called Aspen Park to obtain report on Joyce's appointment with Dr. Keizur earlier in the day. Sue, head of nursing care team, stated that Dr. Keizur reported that the stint was removed successfully and he has listed "encouraged fluid intake increase" on the care notes for Joyce. No additional antibiotics were deemed needed as the previously diagnosed UTI appears to have cleared up. Dr. Keizur provided Joyce with some informational paperwork detailing how to avoid kidney stone development.   Sue noted that if Joyce reports hallucinations in the future to the family then they should have her tested for a UTI as it is most likely the cause.  Dusty inquired about the follow up with the cancer center and if a review of Joyce's spinal imaging had been scheduled. Sue stated that she had not knowledge related to that at this time. Sue suggested that the upcoming appointment with Joyce's primary care provider, Dr. Collins, might be where that information is reviewed/...

Dusty and Jess called Joyce this evening around 7:50 p.m. She was having her blood sugar levels checked, with a reading of 256 ("too high"). The nurse excused herself while the phone call continued and returned with insulin. Joyce was thankful that the needles for blood testing and insulin injections were so small. Tramadol was administered to Joyce for pain control.  Joyce reported her pain level was around a 2 out of 10 at the time of the phone call. Joyce claimed that she did not have physical therapy today, believing that the staff might've been too busy to get her on the schedule today. She said that tomorrow she will begin a new regimen with a therapist assigned to her to work on some specific and new exercises. Joyce has continued to sleep in her recliner for comfort but is considering attempting to try sleeping in the bed in the coming days. She stated she will discuss that option with the day nurses as they are more knowledgeable about what she should and should ...

Dusty called Joyce twice yesterday but the overall timing was bad for both phone calls (Joyce had extreme drowsiness from napping and then nurses' arrival into the room truncated both conversations down to less that 5 minutes each with not much information gleaned).  Dusty called late morning today to check in with Joyce. Breakfast for today was scrambled eggs, sausage, and french toast. Joyce was so excited about the french toast that she had forgotten to request apple juice. "It's a nice change from the usual buttered toast." Pain levels today were not too bad, hovering around 3-4 out of 10.  Joyce initially stated that she had not yet had physical therapy when Dusty asked and then later corrected herself as conversation went on, recalling that she had indeed had PT this morning. Most of it was done while Joyce was seated in her recliner but toward the end Joyce was walked down the hallway and introduced to an equipment room and parallel bars. "It was a good wo...

Dusty and Jess stopped by to visit Joyce at Aspen Park around 2 p.m., apparently just missing Carol by a few moments who had just visited Joyce as well. Joyce had a slice of meat (beef? maybe meatloaf), mashed potatoes, and veggies for her lunch. She said that after a few days the meals all start to blend together in her mind.   Joyce hasn't had physical therapy today, leading everyone to guess that maybe the PT team does not work over the weekend. Joyce stated that today her pain levels had been very low and so she had been able to nap comfortably through most of the morning post-breakfast. Joyce has not been reading her Redwall book, nor writing anything as yet. Joyce stated that there was "weird stuff" on television, but then admitted that she hasn't really been working hard enough to look for something good across all the channels. Dusty and Jess answered Joyce's questions about why she needs to remain at Aspen Park for so long and she agreed that it was proba...

Dusty stopped by around 2:30 p.m. to visit Joyce on his lunch hour through her window. She was resting comfortably with her pain levels around 4 out of 10 at the time of his arrival. Joyce reported that the pain medicine seemed to be working fine today. She had gone for a walk earlier in the morning with the physical therapists and was looking forward to going again for a walk with them later in the afternoon or early evening when they said they would come back by to see her again. "I'm going to get up and go for a walk if they ask, even if I am hurting, because I want to improve and get back to the farmhouse," she said. Joyce said that lunch today was two slices of pizza and a small can of soda pop which she enjoyed. The nursing staff has been giving Joyce ice water to help keep her cool. Dusty explained that the fan he procured for Joyce to have in her room was not permitted due to COVID-19 safety protocols at Aspen Park and Joyce understood but lamented it could not be...

Dusty called to check in with Joyce at 11 a.m. Joyce reported that breakfast today was scrambled eggs, sausage, and a chocolate chip muffin. "It was very good today."  Joyce stated that she has never made chocolate chip muffins and would need to make them when she returns home. Plain white muffins she specified, as she had previously added chocolate chips to her other muffin varieties. Joyce stated that she would like to be back at 1048 Estes Road.  Joyce stated that she has not yet received the two letters Dusty has mailed direct to her at Aspen Park. She confirmed again that she has received the three letters/cards that Dusty dropped off last night from Glenda, Frank and Linda, and the Estes Club. Joyce has not yet received the blue box fan that Dusty dropped off last night. Dusty said that he would call and follow up with the front desk team at Aspen Park about its whereabouts and timeline for delivery as Joyce stated her room gets quite warm now with the sun out. Joyce as...

Andrea of Aspen Park called Dusty to provide an update on Joyce's condition around 4:30 p.m. this afternoon. It was confirmed through urine sample collected yesterday that Joyce does have a urinary tract infection. Dr. Collins was contacted and after reviewing information from Aspen Park lab she is starting Joyce on antibiotics this evening with first dose to be administered with diner this evening. Antibiotic course will be 2/day over 7 days administered with meals by the Aspen Park staff. The UTI will not affect or delay the June 24 appointment with Dr. Keizur to have the stint removed. Dr. Keizur has been updated by Dr. Collins and is up to date on Joyce's situation in regard to the UTI. Andrea reported that Joyce was much better today than yesterday. She has seen no hallucinatory images, has kept her oxygen hose in place, and has not been wandering the hallway in disorientation. The nursing staff has strategically placed Joyce's purple walker farther from her recliner c...

Andrea (nurse at Aspen Park) attempted to call Dusty earlier in the evening to update Dusty on Joyce's condition. Unable to reach Dusty (who was in a troop committee meeting at the time), Andrea contacted Craig to provide the update. Dusty returned Andrea's call and she repeated the information provided to Craig. Andrea, the floor nurse, reported that Joyce was found coming down the down hallway earlier in the day with no oxygen line in use, and was looking for room and could not find her room to return to it. This was a huge red flag to the nursing staff that Joyce may be suffering from effects of a urinary tract infection (UTI) as she was self transferring without notification, was out of her room in hallway by herself, and had no oxygen line on her person. Joyce was escorted back to her room and made comfortable.  Joyce is continuing to have hallucinations about the little boy and girl, but they are still non-distressing in nature. Andrea also noted that Joyce is having more...

Sue (Doctor of Nursing Science) and Rachel (administrator) at Aspen Park contacted Dusty via phone around 12:10 p.m. with an update on Joyce, reporting that Joyce was experiencing hallucinations.  Joyce informed a nurse today that she has been seeing a little boy and a little girl in her room while she sat in her chair. The nurse asked Joyce to elaborate on what she was seeing and Joyce reported that for the last 2-3 days she would see the children playing and moving through the room in front of her, then lay down on the floor to rest. Joyce also reported that they would occasionally move behind her chair and kick her chair or move it as they played behind it. The nurse assured Joyce there were not children in the room, and that the entire facility was not open to visitors at this time due to COVID-19 safety protocols. When presented with this information Joyce asked to confirm if the children she had been seeing in the room were real and the nurse confirmed they were not. Sue and ...

Dusty followed up with Jennifer at Aspen Park today via email about information on Joyce's follow up appointments that were to be arranged per Gritman orders. Aspen Park will transport Joyce to her appointment with Dr. Keizur on June 24. Appointment is at 1:30 p.m. in his Pullman office. He will remove the temporary stint and follow up with Joyce about the kidney stone removal procedure. Dusty will be relayed information about appointment from Aspen Park nursing staff when available for disbursement to Joyce's family.  Joyce is scheduled to meet with her general practitioner, Dr. Deborah Collins, at noon via teleconference. Moscow Medical (Dr. Collins' office) uses a teleconference system which does not allow for multiple parties to attend their sessions so a family representative will not be able to join the call. There will be a nurse from Aspen Park present with Joyce during the call and information from this session will be relayed to Dusty for disbursement to Joyce...

Dusty received emailed communication from Libby, the social worker at Aspen Park, yesterday (June 15) about Joyce's discharge plan. After assessment on Joyce's capabilities and pain levels the therapists on site at Aspen Park have determined that Joyce should remain under skilled nursing care and PT for 4 weeks. The current goal date to have her back at the farmhouse will be July 15. Joyce expressed that she wants to go home sooner but that she understands that she needs to heal from her vertebrae and rib fractures, and she also needs to get her pain levels under control in order to make meaningful gains with therapy work. Dusty and Libby went through the recommended equipment that Joyce should have at home again and confirmed that nothing new should be added to what was already obtained or installed for her use. Only point of concern raised by Libby was if a ramp needed to be installed for Joyce to make ingress and egress out of the farmhouse via back patio. Joyce indicated th...

Joyce reported that her pain was finally brought under control and she had an easier evening. She's resting comfortably and awaiting the nurses to come and prep her for sleep. She recognizes now about when she needs to be requesting pain medication to keep her from going too far into suffering. Burritos, salad, and refried beans were had for supper. Joyce asked Dusty if he knew when she could go home. Dusty confirmed that no new information has been provided yet on a timeline. Dr. Collins still needs to have a telehealth conference with the Aspen Park staff to set some initial benchmarks and goals. That appointment was to be scheduled by Aspen Park staff and information on it will be relayed to Dusty when available. Jennifer and other Aspen Park administrators don't work over the weekend, nor does Joyce's primary care physician, and so no new information was expected until Monday or Wednesday of the coming week. Joyce seemed to be okay with this, though slightly disappointe...

Joyce was feeling miserable today. At the time Dusty called to check in with her mid afternoon she had requested more pain medicine. Joyce asked the nurses to take her for a walk. As she wasn't feeling too well, she didn't walk far. Joyce reports that she is being treated well. Joyce is doing better about asking the nurses to bring her pain medication and water when she needs it. Breakfast was biscuits with sausage gravy and scrambled eggs. Apple juice for a beverage. Lunch today was pork chops and brussels sprouts with a rice and nut mixture as a side.  Joyce wasn't certain if she could eat pork chops with the state of her teeth and so they changed her meal to cottage cheese. It was kind of a grey day so the views out the window for Joyce were a little dour. That said, there is a house's roof line in her field of view which had a conglomeration of blackbirds prancing about it. They were eating something up there and were quite active for a while which was entertaining ...

Joyce wanted to thank everyone who reached out to her today on her birthday. Jess and Dusty stopped by to visit with her through her window via phone call around 5:20 p.m. J oyce appeared well and in good spirits. She received phone calls throughout the day and was very happy to visit with folks. Breakfast was scrambled eggs, bacon and toast. Lunch was chicken marinara pasta. Her dinner this evening was a burrito and potato salad. The latter made her especially happy as she loves potato salad. As it rained all day long her views out of her window were pretty grey, but she still enjoyed them. She did not have PT today that she could recall. Perhaps a birthday gift from the facility, Dusty hypothesized.  Dusty reminded her to ask the nurses for water when she needs it. Joyce also learned today that her orders for pain medication are administered by request and not on a scheduled regimen. This was good to learn as Joyce was very uncomfortable due to pain. So now Joyce will be sure to ...

Dusty and Jess called mom to check in with her about her day. A nurse arrived during phone call and took mom's blood sugar levels, reading came up as 216 at ~8:45 p.m. Joyce received one unit of insulin shortly afterward. Nurse was so good at administering the insulin the only thing Joyce felt was the wetness from the alcohol wipe. Joyce reported that 216 was the lowest reading it was so far today.  Joyce enjoyed her meals today. She stated that they give her too much food at each meal and her stomach revolts at the idea of eating everything that they bring her. Joyce reported that she doesn't feel she was getting enough water. Dusty reminded Joyce that she needs to ask the nurses for assistance in refilling her water bottle as there aren't the same number of nurse's aides present at Aspen Park as there were at Gritman. Joyce said that her Chicken strips and french fries for dinner were quite good. Joyce shared that Carol called her earlier in the day and that they had ...

Dusty received a phone call around 12:55 p.m. from Rachel (Aspen Park's executive director) who wanted to provide updates about the Phase 4 reopening plan. At this time, due to proximity to Whitman County (who just added two new COVID-19 cases to their total) and frequency of inter-county travel, Aspen Park will remain on their previously listed outdoor only visitation plan for residents at this time.  Outdoor meetings with residents will be limited to 30-minutes in duration (reserved at least 24-hours in advance) with a limit of 4 visitors at one time, monitored by Aspen Park staff to ensure social distancing is maintained and that masks are worn at all times. Additionally, no one under the age of 14 will be permitted at outdoor meetings with residents. Aspen Park's COVID-19 visitor policy and protocols will be re-evaluated in 2 weeks' time for potential update. Families will be notified as to whether visitation policies remain the same as currently listed or will be softe...

Dusty called Joyce to check in on her for the evening. She reports she is doing well and has been appreciating her room window. She likes seeing the clouds change throughout the day (when the blinds are open).  Joyce had tomato soup and toasted cheese sandwich for dinner. They did a good job on it, Joyce reports.  PT was done today. "Just about more than I could do," she said. They had Joyce walk down the halls, and then had Joyce get up and down from her walker's chair ten times. "That was a bit much when your body's not cooperating." But Joyce did it, knowing it was good for her. She "put a smile on her face and did it!"  Joyce commented that she is confusing her days, owing to no calendar in her room. She requested a notepad and ballpoint pen. Dusty said that he would try to see if that could be provided when he calls Jennifer tomorrow. Joyce reports that her glasses were finally cleaned.  Joyce says that the spot in her back still hurts her. Sh...

Libby from Aspen Park, who oversees discharge planning at the facility, contacted Dusty before noon to follow up about Joyce. She and the care giving team had their conference about Joyce today.  Libby wanted to verify with Dusty about what kind of durable medical equipment/supplies that Joyce might need at her home for assistance in returning to her daily life. Dusty confirmed that Joyce has a wheelchair, walker, blood glucose meter, oxygen concentrator and lines. Libby said that Joyce confirmed she had a wheelchair at home but that she might want to look at getting a newer one. Libby said that if Joyce has not purchased any medical equipment using her Meidcare benefits within the last 5 years then Medicare would cover the cost of a new wheelchair (Aspen Park therapists and Joyce's primary care physician, Dr. Deborah Collins would provide the necessary documentation).  Libby interviewed Joyce about her home situation. Joyce reported that she lives and moves about on the prima...

Dusty called Joyce to check in on how she was feeling this morning.  She stated that she slept okay through the night in her recliner. Joyce reported that her right shoulder and arm was hurting her this morning. The nurses stated that she has a lot of bruises all over her body. Pain medication should be delivered later on by the nursing staff when they come to pick up Joyce's food tray. Neck and back also in "noticeable" pain according to Joyce. Joyce's breakfast today was sausage patties, a chocolate chip muffin, apple juice, oatmeal, and scrambled eggs. Joyce stated that she didn't have her dentures in for eating breakfast. She wasn't sure where her dentures were initially this morning but the breakfast was all soft enough she could do fine with what was brought. She reassured Dusty the staff did not toss out her dentures later on as she saw that the denture container was across from where she was seated on the room counter so they were probably in there and...