General Update #45

11 a.m. - Room service arrived to take Joyce's order. Joyce had been napping and was much slower to respond to the hostess in providing her order.

11:08 a.m. - Nurse's aide, Dean, arrived to check Joyce's vitals. Blood pressure was 106/70. Dusty asked if Joyce could have a fresh lidocaine patch applied as this had not occurred yet since his arrival. Dean stated he would check with Jackie for approval and make that happen.

11:36 a.m. - Stocker arrived to check on Joyce. Jackie arrived simultaneously to see if Joyce ready for the new lidocaine patch and Joyce confirmed that she was. Jackie applied the lidocaine patch. Joyce told Jackie that she has been sleeping in the chair off and on so her pain levels must not be too bad. Jackie informed Joyce that she is still waiting for the timeline to be provided for Joyce's transfer to Good Samaritan. Jackie will let Joyce know as soon as she hears what the plan will be.

11:56 a.m. - Dean arrived to check Joyce's blood sugar level. Reading was 234.

12:01 p.m. - Joyce's lunch arrived. Penne pasta with meat sauce and side of steamed broccoli florets and steamed diced carrots. Joyce was slow to eat food, stating that she was not feeling hungry. She started picking at the pasta and carrots, stating that what they brought her was "a lot of food." Dusty encouraged her to eat what she could.

12:08 p.m. - Joyce asked Dusty to tell her what they are going to do her as she states she does not remember anyone talking to her about what is going to happen. Dusty informed Joyce that she is to be transferred to Good Samaritan later today and will be there for four weeks or so for PT and skilled nursing care. Once those four weeks are up and if she has done acceptably in PT she should be cleared to return to the farm. Joyce stated that she did not remember being told that.

12:09 p.m. - Jackie arrived to administer insulin to Joyce. 

Dusty inquired about Joyce's memory issues and concerns about moving her to Good Samaritan, where she will be under quarantine and family cannot be with her through a majority of the daytime, that she will not have an advocate and her care will suffer (example, the staff will not remember that she has memory issues and not be alert to her morphing responses to their questions through a single day or that Good Samaritan caregivers might provide Joyce with information about her health and expect her to relay that to family). Jackie assured Dusty that the note about Joyce's memory issues has been included with the packet to be sent to Good Samaritan for her care instructions. Jackie stated she will follow up with the Good Samaritan coordinator when Jackie calls later today to confirm that their staff know about Joyce's inconsistent memory. 

Dusty asked Jackie about the potential issues with Good Samaritan and COVID-19 quarantine since Joyce is scheduled to arrive there today, will be in quarantine, and then be sent to see Dr. Keizur so soon after being placed in Good Samaritan's quarantine period. Would Joyce then have to start her Good Samaritan quarantine period over again after seeing Dr. Keizur? Jackie indicated that Dana, Joyce's case worker, might be the better person to ask that question to but Jackie will ask the Good Samaritan coordinator she talks to about that when they arrange Joyce's transfer and discuss the scheduled appointment to see Keizur.

12:14 p.m. - Dusty repeated plan for Joyce at her request. At conclusion of the repeat of plan for transfer to Good Samaritan, Joyce nodded slowly and stated that the reason she asked again so soon "Just so I make sure I understand." Joyce then expressed that she wasn't too hungry for lunch, her stomach "says it doesn't have room for all this food." Dusty agreed that she has been eating more than she has been used to doing over the last few days but should keep trying to eat. 

Dusty realized Joyce did not have her dentures in so provided them to Joyce in case that would to facilitate eating around 12:34 p.m. Dusty said that Joyce should try to hurry up and get more food into her before people come to interrupt her lunch. Joyce asked, "Why, am I going somewhere?" Dusty asked Joyce if she remembered she was going to be leaving Gritman for Good Samaritan today and Joyce indicated that she did not remember that. Joyce states she does not want to eat shortly after this, lifting a hand to her clavicle level of her chest and stated "It's like I'm full clear up to here." Dusty told Joyce then she should probably stop eating. Joyce then started eating again. Dusty asked why she was eating if she said she was so full. Joyce responded that she thought she should take a few bites. Joyce asked if she had clothes. Dusty confirmed that he brought in clothes for her from the farmhouse. They will go with her over to the Good Samaritan. Joyce apologized to Dusty for being a pain. Dusty reassured Joyce she was not being a pain, that he was just worried about her mental state.

Joyce has eaten 1-2 broccoli florets, a tiny amount of diced carrots, and 4-5 small bites of pasta after about 42 minutes. Joyce stated she was done eating lunch ~12:45 p.m.

Message(s) from Joyce:
Tell the family that I love them.

Current location:
Gritman Medical Center, Room 202.

Current pain level:
7 out 10 (at 12:47 p.m.)

Visiting information:
No change from previous post:
Currently only 1 visitor per day for Joyce, no exceptions. Once current visitor departs Joyce's room, no further visits for the rest of the day. No swapping out visitors (example, Dusty cannot remain on hospital grounds while Craig goes to sit with Joyce for an hour and then Dusty returns to room).

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