General Update #48
Dana returned to give Dusty the summary of conversations she had with Good Samaritan and Aspen Park regarding oncology issue raised by Good Samaritan. Text related to that can be found below between the "---" dividers.
3:46 p.m. - Joyce asked if something serious is wrong with her after listening to conversations Dusty was having with Aspen Park and Dana. Dusty explained the doctor's concerns about a potential spinal cancer and how that concern means she will need to see the cancer center to determine if there is an active cancer or if it was just the damage caused by a previously undetected spinal cancer that was wiped out when she had chemotherapy for the colon cancer she had in 2016. Dusty explained they were going to keep Joyce in Gritman one more night and try to get her over to Aspen Park tomorrow as Good Samaritan didn't want her at this point. Dusty attempted to talk up Aspen Park's more open visitation policy to lift Joyce's spirits and this seemed to help as did the reassurance that she would not remain at Aspen Park longer than she would have done at Good Samaritan.
3:48 p.m. - Joyce summoned nurse's aide, Stocker, for bathroom trip. Joyce expressed that she felt a little light-headed. Stocker asked Joyce to let him know if the sensation of being lightheaded gets any worse while they are moving around.
4 p.m. - Room service arrived to take Joyce's dinner order while Dusty making phone calls.
4:20 p.m. - Dusty realizes that oxygen tubing and oxygen meter were not reconnected to Joyce when Joyce pointed out disconnected oxygen sensor hanging from her finger. Dusty reconnected both. Oxygen level had been at 74% according to meter reading but quickly raised to 94% as Dusty walked Joyce through breathing exercises.
4:24 p.m. - Stocker arrived to refresh Joyce's water. Dusty asked for assistance in fixing Joyce's oxygen line (it wasn't sitting right). Stocker apologized about forgetting that and helped Dusty learn how to properly setup oxygen line. Dusty will make use of that training in helping Joyce when she is back home. Stocker checked Joyce's oxygen levels (97%, pulse 76). Stocker will ask nurse if a spirometer might be useful for Joyce to use in improving her breathing as Dusty mentioned that one was issued to her years ago to use (about the same time she was put onto home oxygen use).
5:04 p.m. - Jackie arrived to check on Joyce and confirmed that Dana had provided an update to Dusty. Blood sugar checked, reading was 147. Joyce reported her pain levels "were there, but I'm tolerating it."
5:07 p.m. - Joyce's dinner was delivered. Turkey with gravy, mashed sweet potatoes, apple juice for a beverage, and berry crisp for dessert. Joyce reported that this looked like the best food she had seen so far.
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Summary of conversations Dana had with Good Samaritan and Aspen Park provided below:
Good Samaritan - Cassandra (SW- social worker) and Denise (RN)
Facility is hesitant to accept Joyce at this time because of need for oncology follow-up and potential they might they may be responsible for treatment cost. Medicare pays a daily rate for skilled stay at facility, they have to cover all of Joyce's costs from that rate (room/board, medications, therapies, treatments). Dana explained that no plan for treatment is in place and would not be until Joyce has the follow-up appointment at the cancer center, then Joyce and her family would explore what options are and whether they do or do not want to pursue. Good Samaritan does not want to proceed with placement of Joyce into their care until they talk to Cancer Center.
Aspen Park - Jennifer (admission coordinator), Rachel (administrator), Sue (DNS)
Aspen Park has already accepted Joyce for placement last Friday (6/5/2020) and they will look at the updated referral Dana faxed them today to determine if they can still take her. If they take her, they would coordinate follow-up at cancer center for Joyce and then have conversation with Joyce and her family about options after those have been determined.
Addendum:
Jennifer and Sue contacted Dusty via phone shortly after Dana stopped by to drop off above summary of conversations with Good Samaritan and Aspen Park. They asked to verify family's goals for Joyce while she is in their care. Dusty relayed that the family wanted to follow Gritman's recommendation on 3-4 week skilled nursing care and PT for Joyce with goal of getting Joyce fit enough to return to living at her home. Confirmed that long-term care was not planned. Jennifer and Sue confirmed that they can facilitate follow up appointments at cancer center where Good Samaritan would not.
Dusty asked about quarantine protocols currently in place at Aspen Park. Jennifer confirmed that their current visitor policy is permitting scheduled visits with family members in their outdoor seating area, with masks and social distance maintained. Visits are supervised by Aspen Park staff. As Idaho moves into later stages of quarantine and reopening their procedures and protocols will be reviewed and adjusted. These are still being developed but revised protocols would be provided to families as soon as they are put into place.
Dusty expressed concerns about Joyce's memory issues to Jennifer and Sue. Sue stated that anytime a person is on pain medication memory and cognitive functions are affected. Sue suspects that once Joyce comes off of pain medication there should be a noticeable improvement to her mental faculties. Sue could see about also having Joyce do speech therapy and cognitive therapies while she is at Aspen Park so the current level of cognitive function does not become the new baseline. To be explored. Dusty also brought up Joyce's breathing difficulties and that Joyce has not been doing her breathing exercises at home pre-accident. Dusty noted Joyce's incontinence issues. These are in Joyce's packet of information from Gritman and would be covered when Joyce moved into Aspen Park, especially breathing to avoid concerns for any potential pneumonia developing.
Family is welcome to contact Jennifer with any questions they may have at 208-882-4576 or by routing them through Dusty who was identified as point of contact.
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Message(s) from Joyce:
None.
Current location:
Gritman Medical Center, Room 202.
Current pain level:
Unknown.
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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