General Update #98

07/31/2020

Dusty did not call Joyce in the evening hours to check in before bedtime due to schedule conflict with other appointments.

08/01/2020

Dusty and Jess called Joyce from the farmhouse to check in, reported on work they were doing to get the place ready for her return. Bedroom dusted, laundry room cleared of clutter and organized, laundry completed, and finished washing bedding. Trees were trimmed along driveway with Craig's assistance to aid in farm truck passage and reduce grain contamination from leaf and branch debris.

Joyce was asked if she enjoyed her lunch from 7/31 (BBQ, watermelon, and potato salad) and she confirmed it was great. She was looking forward to returning to the farmhouse in a few days. Craig joined the call briefly as he was getting ready to return to his home at the end of the day. 

08/02/2020

Aspen Park staff attempted to call Dusty around 4:30 p.m. this afternoon. Joyce was not doing well mentally and they were hoping that talking to Dusty would help calm Joyce down as it did previously. Dusty did not answer as he was working on projects at the farmhouse. Dusty returned the call when he noticed a voicemail had been left.

Joyce had left the voicemail, indicating that she was "in captivity" and did not know who she was, where she was, and if Dusty could call her back (or the Aspen Park staff) it would be appreciated.

Dusty called the Aspen Park front desk line to ask about the odd voicemail Joyce left and was told that he would be transferred to Joyce's nurse after he identified himself and that Joyce has called him asking to be called back. Nurse's portable phone was taken to Joyce direct and left with her. Dusty and Jess proceeded to speak with Joyce to suss out the reason for the panicked and confusing voicemail left on Dusty's cell phone. 

Joyce was confused to where she was, believing she was in an office at a store and did not know why she could not go home. She was worried that they would not let her stay there overnight. After being told where she was at and why, Joyce repeatedly attempted to negotiate a return to the farmhouse, forgetting that she was being discharged from Aspen Park next week. Joyce did not indicate knowledge that she was in a care facility, nor how she arrived there, or who the staff were or why they were coming and going into the space she was sitting in. Dusty asked Joyce if she had simply had a nightmare, or bad dream, and Joyce stated after some confusion that she had a nightmare (she did not know what "nightmares" were at first). Dusty and Jess talked with Joyce in an attempt to calm her, with limited success. Attempts were made to distract Joyce as well with other topics and avenues of discussion. Limited success achieved. Joyce stated again she just wanted to go home. Dusty and Jess worked with Joyce verbally over the phone to try and set her at ease. Joyce asked Jess and Dusty if they wanted to talk to someone (as though Aspen Park staff were in the room with her), Dusty affirmed that would be good. Joyce proceeded to yell out for someone to come to her (staff had previously taken Joyce their phone and left it with her, so were not actually in the room at time of this call) and CNA Alex arrived. Joyce gave portable phone to Alex. Dusty and Jess spoke with Alex, asking about what was going on with Joyce. Alex relayed that Joyce was having some panic and confusion and the nursing staff suggested that having Joyce call and talk to Dusty would help as it did the last time it occurred. Alex stated the nursing staff was aware that she was panicked and confused at that moment and he was going to talk with Joyce for a bit after he hung up with Jess and Dusty.

Dusty and Jess ended the phone call, to free up the portable nurses' phone and planned to call Joyce's room phone back shortly thereafter.

Dusty and Jess called Joyce back a few minutes later using her room's land line. Joyce informed them that her dinner had arrived and she should eat it (hard tacos, beans, fruit). Joyce was still noticeably upset and still slightly confused. Dusty and Jess, wanting to assure her that everything was fine, attempted to provide verbal reassurance to Joyce and that the Aspen Park staff were there to help her and look out for her best interests. Joyce asked repeatedly to return home. Joyce continued to question why she could not go home immediately, and why she was being forced to stay at Aspen Park. She continually asked where she was, needing to be reminded, throughout the call. Joyce, frustrated, accepted she could not return home in a petulant manner. Joyce stated that she thought she would be fine, but would need "to just sit and cry for a bit," she said. Dusty and Jess assured her that she would feel better with food in her tummy and a good night's rest. They promised to call her like normal later on in the night. Joyce accepted this and ended the call. Joyce was done talking to Jess and Dusty at this point.

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Dusty and Jess called Joyce around 8:40 p.m. to check in and wish her a good night. Initially Joyce appeared to be back to baseline normal, was positive, and conversant.

Joyce then reported that she had an overnight guest staying with her at the farmhouse. Dusty and Jess explored this information and discovered that Joyce thought that her nurse was a guest staying with her for some reason, and was not currently in the room to talk or ask questions to as she was "upstairs getting a bed ready." Joyce was worried that the guest would need help finding everything needed to make the upstairs bed ready to sleep in. Joyce remembered that she could not go upstairs to help as she had promised the family that she would not go up or down stairs at the farmhouse anymore, and that she was worried about her guest not having any help making the bed. Dusty and Jess assured Joyce that "the guest" was there to take care of Joyce and that Dusty and Jess had cleaned all the bedding and so there was no need to worry about "the guest" needing any help to make her guest bed upstairs. 

Joyce then stated that she had someone looking into her window from the patio outside. She thought it was Craig at first. Dusty suspected it was a hallucination and so asked Joyce to expand on what she was seeing. Joyce stated that it looked like Craig was outside the kitchen window. Dusty, playing along to help keep Joyce calm (and hopefully move past the hallucination or keep her at ease and in a happy place given the tone of the phone conversation from earlier in the day) suggested that "Craig" was probably out watering her flowers on the patio. Dusty and Jess asked if Joyce had her oxygen lines in place. She said, "no," in an exasperated manner. When asked why, she stated that she had just gotten up a few times to go look out the window "at the people out the window." She seemed to accept this idea of Craig watering her flowers out on the patio but before the conversation could be steered elsewhere, Joyce stated that someone else was now outside of her window, possibly "a neighbor." Dusty asked for details on why she would say that, and who she was seeing besides "Craig" and Joyce said it was some old lady with grey hair. Dusty suspected that Joyce was seeing her own reflection at that point (and not recognizing herself) and suggested such to Joyce. Joyce insisted that it was not her reflection, but was someone outside her window. Dusty and Jess attempted to get Joyce to wave or move in such a way that Joyce could confirm it was only her reflection she was seeing. Joyce was unable/unwilling to accept the little woman with white hair was her reflection, Joyce stated that it looked like her mother that she was seeing in the window, not herself. Joyce asked Jess and Dusty if they thought she was crazy. Dusty and Jess assured her that they did not, they told her that this happens and Jess related a story from her lived experience about being startled by reflections at her workplace. Joyce was able to move on from conversations about "the people" outside her window after that point. 

Joyce went back to talking about "her guest" who was staying with her overnight upstairs, and her concern that she was doing okay in getting the guest bed setup. Dusty and Jess assured Joyce that her guest was probably settling nicely.

Dusty and Jess attempted to get Joyce to start planning on reclining her chair back and sleeping for the night. Joyce stated that she did not know how to operate the powered recliner and that she has not been looking for its remote when asked by Jess and Dusty as to its location. Jess suggested that Joyce's "guest" could probably help her get the chair remote and show Joyce how to work it when the "guest" returned from upstairs. Joyce thought that was a good idea. Joyce circled back to "the guest" being in her house. Jess assured Joyce the "guest" was there to help Joyce.

Joyce was ready to say "goodnight" at that point and the call ended after Jess and Dusty assured Joyce that her "guest" would check on her. 

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Dusty and Jess called the front desk at Aspen Park to notify the staff that Joyce was potentially hallucinating, may need her oxygen line put back into place, and that she may be preparing to get up from her chair and go wandering "to look for her 'guest.'" Staff assured Dusty they would go check on Joyce, immediately dispatching an orderly down the hall before the phone call ended.

Dusty will call the Aspen Park staff tomorrow morning for an update on Joyce's condition and ideas as to what might've led to such a bad day for Joyce today.