The Official Joyce Update Blog

07/28/2020 Dusty called Joyce to visit during his walk home and reviewed his day with her. Joyce inquired if Dusty knew when she was getting out of Aspen Park and back to the farmhouse. Dusty relayed that it was Thursday or Friday that she would be released, then had to clarify NEXT Thursday or Friday after Joyce became excited about potentially being released on July 30 or 31. While slightly let down, she did understand that it would be next week. He promised that he would let her know as soon as it had been arranged by the Aspen Park staff, and assured her that she would be going home by the first week of August. Joyce was glad that she would be able to get back to the farm and still have some summer left to enjoy out there. Dusty reviewed her therapy work for the day and Joyce said that it consisted of her doing her standing/sitting exercise for her lower body and working through the occupational therapists checklists on processes and procedures related to daily living as an indepen...

Dusty called Aspen Park to follow up on Joyce's telehealth conference with Dr. Collins around 3 p.m. Jennifer transferred Dusty to Rachael as Maggie had left for the day. Rachael apologized that Dusty had not been updated before Maggie left at end of her shift but assured him she had been given the information from Joyce's appointment to update Dusty with, she just hadn't gotten to calling Dusty direct yet. Joyce has been cleared to return to the farmhouse. Dr. Collins will write up the home health orders and Aspen Park should receive them from Dr. Collins' office along with her notes in the next 2-3 business days. In the meantime Rachel will coordinate with the Aspen Park staff to prepare the discharge packet, confirm timelines and close out anything pending for Joyce. Rachael will also coordinate with Lincare and home health to ensure services are aligned with discharge plan for Joyce. Rachael said that the nurses will go over Joyce's medications list and dosage t...

07/27/2020 Dusty called Joyce to check in and wish her a good night while he was preparing dinner for Jess. Joyce was alert and quite talkative. Dusty reviewed the plan for the telehealth appointment scheduled for tomorrow and Joyce stated that no one had told her that was occurring. Dusty suggested to Joyce that they were going to visit with her tomorrow morning ahead of the appointment based on what Rachael had told him and Joyce concurred. Dusty questioned Joyce about her decline of participating in the urinary incontinence therapy as well as her reported lack of performance with physical therapy. Joyce stated that she had been looking forward to the urinary incontinence therapy work but according to her they only spoke to her once about it and then never again approached her about it.  Joyce felt like they don't do enough PT with her even though she wants to do more PT. She cited today that they only had her walk back and forth using parallel bars for a few minutes before givin...

Rachael Kimble followed up with Dusty's previous emailed request for communication. Joyce has a telehealth appointment tomorrow at 10:45 a.m. Aspen Park's RCM (Maggie) will check in with Dr. Collins prior to the appointment to help with the appointment. Progress, discharge and overall health of Joyce will be discussed.  Abby noticed that Joyce is self-limiting herself with therapy (not doing all that she is being asked). Dusty asked for clarification on if Joyce is refusing to do the work (attitude), cannot comprehend mentally what is being asked of her (mental faculties issue), or other issue occurring.  Abby would like Joyce to do the UI program to help with incontinence and skin issues, which is something that Dusty might be able to talk to her about doing therapy. Dusty was confused at this as he thought this was already underway from previous communications with Aspen Park staff and so asked for clarification.  Currently Joyce's goal for discharge is slated for next ...

07/26/2020 Dusty called Joyce to check in with her around 7 p.m. He informed her that he had completed cleaning her refrigerator, worked on catching up on her laundry, watered her flowers and continued cleaning other areas of the farmhouse. Dusty confirmed that the sourdough starter was still fine and safe but would most likely need to be refreshed once Joyce was home. Joyce was alert and talkative. She had not yet had dinner delivered but stated that was normal to have it later on the weekends, she assumed due to lower staff available to trundle the cart around the various wings of the building.  Joyce asked if there was any update to when she would be allowed to go home. Dusty said that as far as he knew the first week of August was the estimated timeline and that Libby would most likely be following up with him about it this week. Dusty assured Joyce he would keep her updated as soon as he was given a set date. Joyce stated that she would call her doctor to see about getting a d...

07/24/2020 Dusty missed calling Joyce due to personal schedule conflicts. 07/25/2020 Dusty called in to check with Joyce at 1 p.m. following a training session he attended for Scouts BSA. Lunch today was spaghetti "with a delicious meat sauce," a side of veggies and dessert was vanilla pudding. Joyce confessed that she might not have remembered it had the tray not still been sitting beside her with the remnants of the meal. She had today off from physical therapy but did have speech/mental therapy. She said that some of the questions that the speech therapists ask her are "laughable" because they ask her if she has lived in rural areas and then ask her about what she thinks living in the rural areas are like after already verifying she lives in the country. Dusty suggested that the therapists are trying to use something basic, like knowledge of Joyce living in the country, to then ask questions about living in the country to see how Joyce recalls information or rela...

07/22/2020 Dusty was not able to contact Joyce today due to his schedule. 07/23/2020 Dusty called Joyce to check in during his walk home from work ~4:40 p.m. She could not recall her meals, nor what exactly she had done for therapy during the morning and early afternoon but did agree that she probably did something. Joyce said that Craig had called her yesterday to visit. She lamented not having anything to write with in her room. Dusty reminded her that the Aspen Park staff had given her a pen and some paper previously. Joyce stated that they had not. Dusty reminded Joyce that she had told him they had given it to her, and also some coloring pencils and a coloring book, previously and that Joyce said they were stored "in a drawer" in her room. Joyce said that possibly could be true and that she would need to get up later and go look in the drawer. Later on she said that staff had provided her a pencil to write with, but no paper. Dusty suggested that she ask the staff for pa...

07/16/2020 Dusty and Jess called to check in with Joyce in the evening. She reported that she was doing well, but was a little sad that she did not get to return home on the 15th. She stated that she was glad that she is being well cared for at Aspen Park and understands that the delay is really for her overall benefit and wellness. She asked if a new discharge date had been established for her yet. Dusty relayed that a new discharge date is still being worked out among the therapy team at Aspen Park. Joyce reported that her diaper rash is still healing and barrier cream continues to be used for treatment. 07/17/2020 Rachael Kimble followed up on Dusty's request via email for notes on how Joyce's therapy is progressing. Rachael stated that she visited with Abby, who relayed: "I would maybe talk with [Joyce] about encouraging her to participate more in her own care and wanting to do more with therapy." Current therapy work note:  Transitioning from stand by assist (SBA...

Jennifer Trout (administrator) followed up with Dusty via email about hair barrette options for Joyce and said that as long as he brought in easy to sanitize clips they could be dropped off at the main desk (preferably during business hours) and then delivered to Joyce. They do have some in their inventory at Aspen Park. Dusty will let Joyce know that she can ask the staff to see if any of those would work for her and if they do not then he can pursue bringing in a pattern which works for her. --- Dusty called Joyce at 8:10 p.m. to check in and wish her a good night. She was in the midst of having her blood glucose levels checked and insulin administered. Joyce blamed her levels being off on the chocolate cake they served her at dinner time. Joyce could not recall any of or meals served today, but the chocolate cake was memorable. She said she could smell it in the hallway even before they brought her a piece. She has been reading The Daily Chronicle , a two sided newsletter the Aspen ...

July 10: Rachael Kimble, Libby's counterpart, followed up with Dusty via email and telephone about Joyce's discharge plan and Aspen Park's recommendations to see if the family had reached a decision. Rachael followed up with Joyce and visited about the potential that she would remain at Aspen Park beyond the originally planned July 15 discharge date.  Aspen Park's occupational therapy team will begin working on a bladder control program with Joyce to help with some of her incontinence and toileting since she has been having so much help with activities of daily living (ADLs) and toileting. Rachael noted that as the physical therapy team members noticed the skin breakdown on Joyce's buttocks from incontinence (which the Aspen Park wound nurse is treating) it is important for Joyce to have bladder training and wound treatment. The incontinence treatment would last 2-4 weeks according to Rachael. Rachael stated that the current projection for wound healing and incontin...

Dusty received a phone call at 12:49 p.m. from Libby, Joyce's social worker at Aspen Park, with an update on Joyce's overall progress and discharge plan.  Currently the goal for Joyce's discharge from Aspen Park is set for her to return to living at the farmhouse on July 15. Libby reported that Joyce is still requiring help with daily tasks (using the bathroom, cleaning herself up from bodily fluid accidents, getting dressed, getting up/down from seated positions, and so on).  Joyce gets tired while doing physical therapy, with Libby stating Joyce "burns out fast." Based on above information, Libby recommends that Joyce and the family consider one of two options in regard to upcoming discharge date: If the July 15 discharge date wants to be kept, the family should consider hiring a temporary home care professional to be with Joyce while family is not able to be present to provide care-giving assistance. This service would not be covered by Medicare and out of pock...

Dusty called to check in with Joyce at 7:09 p.m. on July 5. Joyce reported that dinner was arriving late today and so the phone call was abbreviated. She said that she did not nap much this afternoon. She said that she was planning an escape from the Aspen Park facility, jokingly of course. Joyce said that she did not do any other physical exercises today, her guess is because it is Sunday and that the caregivers are understaffed due to the holiday weekend and the fact it is Sunday. --- Dusty called Joyce during his walk home from work on July 7 around 4:45 p.m. She had just been seated in her recliner by the physical therapists who had taken her for "a very long walk." She was not able to recall what she had for breakfast or lunch but did remember they had her do some upper body physical therapy work in the morning. She said that she was getting a good amount of sunlight through her room window but lamented that she was unable to see well out of it given the height of the bu...

Dusty and Jess called Joyce in the evening on July 4 to wish her a happy Independence Day.  Joyce reported that her pain levels were fairly low, even after doing upper body physical therapy work earlier in the day. She was a little disappointed with her meals served. She had been hoping that they would serve hot dogs and potato salad for lunch or dinner but none were to be had. Joyce could not recall what she ate for any of her three meals she was served. At the time of the phone call Joyce had not seen any fireworks out her north facing window but she could hear several concussive blasts of fireworks being set off near Dusty and Jess' apartment.  Joyce said that she did not see or hear the Let Freedom Ring Tour (a B-25 Mitchell, a F-7F Tigercat, a P-47 Thunderbolt, a P40N Warhawk, and a P51D Mustang), which was sponsored by Hangar180 , fly overhead around 5:45 p.m. but she might've missed it most likely owing to having been napping at the time. She stated that she was excited...

Dusty called Joyce at 3:35 p.m. She reported that she had upper body physical therapy earlier in the day (but then later on in the conversation reported that she had not had any therapy today). She was not feeling too fatigued from the PT today. She is suspecting that they will arrive to take her for a walk around the facility before dinner this evening. Lunch today was a piece of chicken, potato salad, and a slice of watermelon which was enjoyed. She thought that it might have been "picnic" themed for the holiday.  Joyce says that the facility has been providing a copy of the Moscow-Pullman Daily News for her to read, as it seems to do for all residents. She built up a small collection of newspapers through the week, bundled them, and packed them into her trashcan to make the orderlies' pass through her room easier. She claims to have run out of reading material, at which Dusty reminded her that she has her Redwall book to read. Joyce then stated that she cannot reach it...

Dusty attempted to call Joyce around 10:30 a.m. but a nurse was in the room working with Joyce and so the call was aborted.  --- Dusty received an email from Libby Sheffler, social service assistant at Aspen Park, at 10:35 a.m. with an update on the current discharge plan for Joyce. Libby confirmed that Joyce was still on target to be discharged from Aspen Park on July 15. It was reiterated that is subject to Joyce's primary care physician, Dr. Collins, approval for discharge. Libby confirmed that she will keep Dusty updated on Joyce's progress. Joyce is working well with the therapy but is still needing some help with daily tasks such as toileting, dressing and showering. The hope is that the Aspen Park team can get her stronger and back home in the next two weeks. Libby welcomes any questions, comments or concerns from Joyce's family. --- Dusty called Joyce at 11 a.m. and made a successful connection. She just had completed cognitive therapy. Joyce said to Dusty that she ...