General Update #87

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:
  1. 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 pocket costs would vary depending on agency engaged to provide service. Most likely this would be temporary until Joyce can function independently. Libby will provide contact information of local home care providers that can be contacted to obtain rates, etc.

  2. Extend Joyce's stay at Aspen Park facility for additional time. This would be covered by Medicare according to Libby. To pursue this route, family would need to notify Libby and then Libby would contact Joyce's primary care provider, Dr. Collins, to change the discharge date. Aspen Park would then work with Dr. Collins to set a new discharge date and continue working with Joyce on her recovery and building her independence. 
Libby believes that if the home care option is to be pursued, it would be temporary, as there is belief that Joyce will eventually be able to regain independence with her daily tasks. This might just not happen before the current July 15 discharge date.

If Joyce's stay at Aspen Park is extended, she will most likely remain for 2 more weeks at current estimate of her progress being made. Aspen Park team thinks that the recovery work at their facility might be best option (preventing out of pocket costs for home care, strain on family members to provide support to Joyce, etc.). 

Dusty informed Libby that he would need to discuss this information with the family and get back to her.
Libby confirmed and reminded Dusty that she is available to answer questions.

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Dusty called Joyce to check in with her about the information Libby provided around 2 p.m. 

Dusty relayed what Libby shared. Joyce was quite mentally alert and comprehended the information presented through entire duration of phone call.

Joyce expressed that she would be disappointed if she could not ho home on the 15th but stated that if the Aspen Park team thought it best for her to remain under their care and have 2 more weeks of physical therapy she would be open to it, provided that it does not rack up uncovered fees. Dusty said that Libby stayed Joyce should still be covered by Medicare if it was decided she should remain for 2 more weeks. 

Joyce wanted to clarify she is dressing herself, is walking fine, getting up and down from the chair and toilet fine and that she doesn't think she is doing bad with her recovery progress.

Dusty confirmed to Joyce that the nursing staff and therapists were not punishing her or giving her bad reports to the family, only recommendations based on what they were witnessing as they work with her daily.

Joyce was informed that the family would visit about the information Libby provided and Dusty assured Joyce that she would be kept up to date on what was decided for her discharge plan as it comes together. Joyce stated that she would be okay with remaining at Aspen Park for two more weeks if that was what the therapists were recommending. Dusty provided reassurance that the family will take Joyce's concerns and desires into consideration where her care is concerned. Dusty assured Joyce that her family loves her and will take all action with her best interests and care in mind. 

Joyce and Dusty discussed Alice and June's mental deterioration and discussed parallels in her life now and Joyce's desire not to be a burden to the family.

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Kim, Joyce's evening nurse, called Dusty around 7:15 p.m. to inform him that the nursing staff has noticed Joyce is suffering from diaper rash. They have begun treating her with a barrier cream and will plan to make more frequent checks on Joyce's incontinence and diapers going forward.

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Jess and Dusty called Joyce to check in and say goodnight for the day around 8:40 p.m. Joyce was still fairly mentally alert. 

Jess shared information about her work day and Joyce discussed her rash and treatment cream (which she takes with her to prevent it from being accidentally tossed out by an orderly). Adoption Day banana splits, 4th of July hot dogs, watermelon, and other foods that were missed out on enjoying together during her absence from the farm were discussed and scheduled to enjoy at later dates.

She is still reading her Redwall book but only at brief stretches before she becomes sleepy and starts to doze off.

She wishes everyone a goodnight and sends her love out. 

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