General Update #143

Joyce utilized the bathroom shortly after Derrick and Craig departed for the evening.

The toilet riser Dusty procured seems to have helped, with Joyce able to rise up under her own power after some effort with minimal assistance from Dusty. Urination output only this trip. Joyce had slight loss of control of her bladder as she began lowering herself onto the toilet riser. Dusty stopped her from lowering herself down until he could clean up the riser and Joyce continued on shortly afterward. Joyce was excited that the toilet riser appears to be providing her with what she needs to get up/down in a more controlled fashion.

Participant Observation: Dusty recommends that family member on duty with Joyce still accompany Joyce to the bathroom to provide standby-assistance for toileting routine. Joyce still becomes somewhat unstable at times and was observed making some maneuvers that had the potential to turn bad should she lose grip on a hand hold or her overall balance. Joyce still working on her seated maneuvering for post-urine/bowel evacuation phase of bathroom trip. Joyce will need to have assistance with hand washing.  

Joyce struggles with diaper removal, not always able to tear the sides apart. Dusty attempted to provide verbal coaching and guidance as Joyce wanted to remain independent in the activity. 

Participant Observation: Dusty recommends other family members remain on-site in the bathroom as standby-assistance for Joyce as she sometimes gets the diaper looped around her foot/shoe and struggles to make progress to getting it into position for final pull-up move post-toileting. 

Dusty returned Joyce to her recliner, working with her to remember how to use the remote control to lower the chair down (she became momentarily frustrated as she was only working the "up" button and not the "down" button, unable to process the difference and was complaining about discomfort of her staged position on the edge of the chair when it wasn't lowering). Dusty reviewed need for proper use of walker (Joyce did not set the hand brakes prior to releasing/pushing off from it to sit in the recliner and it shifted out from under her) and provided guidance for resetting oxygen tubing into position on herself. Joyce continues to get distracted easily by sensory input (conversation, television, items seen in line of sight nearby that catch her interest, things she decides need to be cleaned or organized or picked up and inspected) and loses focus on initial tasks set to accomplish. 

Dusty removed Joyce's lidocaine patch the Aspen Park nursing staff applied to Joyce earlier in the day. 

Dusty moved Joyce's medication box away from her chair shelving and to the counter, confirming with Joyce that she is not to take anything from it until he has a chance to confirm what is inside each compartment and clean/reload it for her current prescriptions. Joyce confirmed that she would not access it and knew what was to be taken would come from Dusty tomorrow when he returns for the morning medications.

Dusty prepared 2 over-easy eggs for Joyce's dinner, promising to obtain better fare for her tomorrow when he returns to the farmhouse with Jess in the morning for her low-sodium diet plan. Joyce insisted that she was not hungry and did not fully eat either egg (spitting out some portions into napkins) but made a good effort as Dusty explained she needed to eat something to take her medicine as he didn't want her to take them on an empty stomach. Joyce consented. Joyce informed Dusty she said that she would prefer a peanut butter sandwich. Dusty told Joyce he would try to locate appropriate peanut butter and bread which would be permissible with a low-sodium diet (farmhouse currently has not bread and the peanut butter Joyce has in her inventory might not be compatible).  

Dusty administered Joyce's evening doses of Metformin (diabetes control) and Carvedilol (hypertension/high blood pressure control) ~9:36 p.m. ahead of providing her with her dinner.   

Joyce frequently leans/curls forward in her chair into a ball-like hunch. Joyce states that she is personally comfortable in that position and apologized for causing any concern for frequently returning to it. Joyce reports that she is not in any pain and so Dusty did not administer any Tramadol.

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10:12 p.m. - BP Reading: 131/72 - Pulse 79

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Dusty began updating Joyce's paperwork/trackers provided in the Aspen Park discharge packet. Will complete tomorrow when he returns to the farmhouse. 

Dusty will create separate current medications list for Joyce to reference for family care providers on separate blog post with tag of "Medications List" for ease of use. 

Dusty restarted Finding Nemo film for Joyce to watch as she didn't get to finish it due to visitors.

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