General Update #95

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 giving up on her. "It is like they don't want me to do the PT or they don't want to work with me." Dusty inquired if Joyce was tiring out while doing the PT, which she denied. Later in the conversation about her PT experience she said that "it's like they don't want a person to catch their breath or have water." Dusty explored that statement and determined that it may be as the report suggests that Joyce tires out while doing PT with the staff and requests a break. The breaks may exceed the scheduled time allotted to Joyce for PT. Dusty raised this point to Joyce, which she considered and accepted as possible why they wrote what they did on the reports Dusty read. Joyce asked if she should try forgoing breaks and requesting water while doing PT and Dusty stated that it was probably too late to try that as the telehealth conference with Dr. Collins is tomorrow and the Aspen Park PT staff have already determined that Joyce has reached the maximum they can accomplish with her at the facility. Dusty suggested that they could work on PT more productively at the farmhouse when Joyce isn't being asked to perform within a certain time frame. Joyce appreciated the idea that it could potentially be spread out. Joyce confirmed that she probably was becoming too tired and taking too long to recover for the Aspen Park PT team's time allotted her each day. 

Dusty reviewed the notes and information Rachael provided about her toileting and Joyce denied being afraid to use the bathroom by herself and requiring attendants. She reported that she uses the bathroom often without any supervision or call for aid. Joyce proposed that the reports about her needing assistance are when someone like a nurse or aid are in the room with her and they are "on standby" to help her on their own as they are there, not because she requested them to help her. Dusty asked how Joyce felt she was doing with her capabilities about toileting, cleaning herself up following accidents, etc. and Joyce stated that she had been doing just fine with those processes. She admitted that sometimes she doesn't always get her skirt on straight but she corrects it as she notices it out of alignment. 

Joyce stated that she would not let on that Dusty told her that she was going to have a telehealth conference with Dr. Collins tomorrow, just in case they are not wanting her to know for some reason. She expressed hope that Dr. Collins would write home care orders after the telehealth conference and is hoping that her next conversation with Dusty will be about a discharge date. 

Dusty asked about Joyce's overall dental health perspective in regard to her eating capabilities and if she was having any persistent pains or difficulty eating certain meals the Aspen Park team had been bringing her. She stated that she would need work done "eventually" if she were to eat more things, but there isn't enough persistent pain to keep her from eating in general. Some foods are more difficult for her to eat than others. She would most likely just need to coordinate with the family about what foods they can help her obtain and/or prepare which she can eat with the most comfort and ease. 

Dusty had to end the call to finish up his evening meal preparation and Joyce wished everyone a good night.

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