General Update #110

08/10/2020

Rachael (social worker at Aspen Park) contacted Dusty via email ~3:30 p.m. to confirm that the discharge plan for Joyce was on hold while Dr. Collins and the Aspen Park team worked to determine what was occurring with Joyce. Rachael confirmed she knew that Dusty had already been in contact with Maggie, Rachael has updated home health and Lincare contacts about the delay to Joyce's return home. 

Joyce was confirmed to be working with occupational therapy today.

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Dusty called Joyce on his walk home from work around 4:45 p.m. She was alert and coherent. She could not recall what she had eaten for lunch but thinks it was some kind of tomato pasta.  

Dusty asked about Joyce's therapy work today and she said that they took her for a walk and while they did go into the weight room they did not have her lift weights but rode a stationary bike for a few minutes. They both agreed that was good for her.

Joyce asked about if Dusty knew when she would get to go home and he confirmed that was still going to happen, just that the process had been suspended as the Aspen Park team and Joyce's doctor needed to determine what was occurring with Joyce in regard to the mystery illness that caused the swing in Joyce's mental state and energy levels. Joyce thought that made sense but that the medical staff should hurry up. 

Joyce briefly went into a borderline nonsensical rant about how she thinks that the staff are making things up about her condition but quickly recovered when Dusty reviewed what had occurred to her the previous week (there was a memory lapse that Joyce did not recall) and that appeared to placate Joyce.

Joyce confirmed that she was still taking antibiotics, but that she thought she could do that (as well as the therapy work) from home and didn't really need to be in Aspen Park any longer.

Dusty reviewed his day with her and she reviewed what she could recall of her day with him as a subject change. 

Dusty asked if people had been keeping in touch with her via phone and Joyce said that she thinks Carol had called her earlier in the day to check on her, but maybe that had been yesterday. Joyce stated that Carol usually calls after she has gotten to her office in the mornings to check in with her. Carol said that Craig had started harvesting and so Joyce thought that Craig would most likely not have time to call as he would be very busy through the rest of the month.

Joyce ended the phone call early, citing need to use the bathroom.

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Dusty called Joyce around 9:35 p.m. to check in and wish her a goodnight. 

Joyce was initially conversant, if a little sleepy. She could not recall what she had for dinner. Dusty apologized for calling so late, citing inconsiderate apartment complex members delaying the normally quick access to washers and dryers in the communal laundry room. 

Joyce asked if Dusty knew when she would get to go home. Dusty reviewed her recent downturn from a baseline normal condition, citing the potential ongoing mystery infection/condition, and that the medical team was trying to deduce what the cause was and treat it before discharging her home. Dusty reviewed the bacterial infection from the first UTI and reminded Joyce they had just done a second one on her recently that gave no indication of a second UTI but that the antibiotics Joyce was taking had cleared something up. Joyce then became agitated and stated that she felt the hospital staff was making things up about her. Dusty asked for clarification about what Joyce meant and Joyce went onto state that the doctors don't know what kind of infections she has and trailed off into muttering. Dusty asked for clarification and Joyce went on, citing that there is no way the doctors could know what kind of infections and bacteria Joyce has, no way they could know what kind of infections and stuff she has out there as they don't go into her home and test her there and so there is no way to know what kind of infections and bacteria she grows at home - so she should be allowed to go home and take care of it herself there. After some continued probing questions, Dusty finally comprehended that Joyce had misinterpreted the phrases he used in conversation ("bacterial infection" and "clear up") and had instead interpreted that to mean she was prevented in going home not because of something affecting her biologically but that she thought Dusty had meant that she could not go home until her farmhouse had been "cleared up." Dusty assuming lateness of hour and possible oxygen deprivation were at play, and confirmed that the Aspen Park staff were not meaning she couldn't go home because of potential uncleanliness of the farmhouse but within her own body. After repeated re-working of the dialogue and more conversation engagement, Joyce's suspicion about the Aspen Park staff reduced as did her hostility and restored her to a calmer demeanor. 

Joyce stated that she was thankful for everything the family is doing for her in her condition, that she appreciates the phone calls and visits when they occur, and she cannot wait to see everyone out at the farmhouse again and get hugs again. She misses hugs very much. She would appreciate going home and Dusty confirmed that he would not hide information from her, keeping her updated as soon as he knew what the new discharge plan was going to be when available. 

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