General Update #91

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 paper, which Joyce said she could probably do. 

Dusty reviewed his day with Joyce, and re-reviewed portions of it after she inquired about it again (not recalling what has already been said). Visit concluded as Joyce's dinner was delivered.

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Dusty and Jess called Joyce to check in with her in the evening around 8:40 p.m. 

Joyce asked if there was any news about her new discharge date and Dusty relayed that the first week of August is still the current plan as far as he has been told by the Aspen Park team. 

Dusty asked how the hair clips were working for Joyce and she stated that she was having difficulty in working them. Jess and Dusty attempted to walk her through their use and ultimately suggested that Joyce consider asking the staff for help with getting them into place.

Joyce switched the conversation to confusion over her location. She thought that she was at the farmhouse but wanted to know what was going on from Jess and Dusty as things had "been re-arranged" in her home and people she did not know were coming and going into her house. Dusty and Jess assured her that she was just in Aspen Park and that nothing was out of order. Attempts were made to ease Joyce's mind about her location and her reason for being at Aspen Park. Joyce expressed concern that things had changed on her and that she was not where she thought she was (the farmhouse). Joyce was very confused about what was going on around her but calmed as things were talked through with Dusty and Jess. Joyce expressed that she wanted truth on her situation and not to be deceived. Jess and Dusty confirmed that she was not being deceived in anything and confirmed to Joyce they had previously promised not to hide anything from her, even if it was bad news. Joyce stated she was thankful for that and that she is willing to take any truth about her situation even if it is bad news. 

Joyce made statements about her mental state, recognizing that she is having some issues. She also made statements about how doctors might be misdiagnosing her and that she doesn't have dementia and Alzheimer's. Jess and Dusty acknowledged her statements and re-confirmed with Joyce that she has dementia and Alzheimer's and that she has been taking medication to slow the effects for some time now. Joyce changed her statements about the misdiagnosis from confrontational to more generalized statements about misdiagnosis done by medical professionals overall. 

Joyce confirmed that she remembered falling down the stairs at the farmhouse as the reason she ended up in Aspen Park.

Dusty and Jess wished Joyce a goodnight as she ended the call.

Participant Observation:
Extreme paranoia and confusion might be due to continuing onset of dementia and Alzheimer's as this seems to match case examples listed in The 36-Hour Day book. Dusty plans to call Aspen Park tomorrow to visit with Joyce's nurse about this evening's phone call with Joyce and to obtain update on Joyce's condition. 


07/24/2020

Dusty called Aspen Park and spoke with Joyce's nurse, Andrea, who had just returned to work (following her 2 days time off). Dusty relayed summary of phone call he and Jess had with Joyce last night: Joyce's confusion over her location (and blending of farmhouse and Aspen Park) and "who all the strangers were coming and going in her house," her paranoia about being deceived, and how differently she behaved over last night's phone call than previous phone calls. Dusty requested that Joyce be checked for another UTI or that someone review if something had been changed/missed in her medication.

Andrea stated that according to the reports from yesterday's day shift Joyce was functioning fine at her baselines during and after her therapy sessions, meals, etc. All of Joyce's vitals and blood glucose levels were also showing as fine during day shift.

The night shift nurse from last night (Maggie) reported to Andrea at the shift change meeting that Joyce had gotten herself up and "went looking" for Dusty around the facility twice last night and had to be returned to her room. There was no time stamp that Andrea could provide, so could possibly have occurred before or after Dusty and Jess' phone call was made at 8:40 p.m.

Andrea stated that as of this morning, Joyce is functioning fine at her baselines following therapy and meals, and all of her vitals are likewise showing as fine following testing. This has caused Andrea confusion as to what could have happened to cause the issues Dusty and Jess and the Aspen Park night shift encountered in Joyce's behaviors last night. Andrea will be working today, Saturday and Sunday and will be watching Joyce closely. Joyce is currently not exhibiting any signs of a urinary tract infection but Andrea will request testing be initiated if needed as she goes through her checks throughout the day on Joyce. Andrea will contact Dusty if Joyce starts exhibiting any continued deviance from her normal baseline behaviors. Joyce's blood work is showing as okay and Joyce is currently alert and going through her day normally with no abnormalities noticed.

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