General Update #150

Joyce requested to be taken to the bathroom ~8 p.m. Dusty and Jess assisted her in raising up from the recliner using her remote control. Joyce was fine (no incontinence or soiling of her diaper or waterproof chair mat). Upon reaching bathroom and attempting to sit on toilet riser Joyce lost control of bladder. Dusty cleaned up mess and Joyce continued on with urine and bowel evacuation (Type 6-7 on Bristol Chart). Joyce was able to stand up under her own power and Dusty assisted with cleaning her. Jess applied barrier cream she purchased from Walgreens (Calmoseptine Ointment) to Joyce's inner thighs and buttocks. Jess and Dusty placed new type of diaper onto Joyce (side closure style, high absorbency) to reduce chance of leaks and soiling of garments/chairs/floors. 

Swelling in Joyce's legs has been reduced (through use of compression stockings and elevating her legs).

Jess is going to arrange a new appointment for Joyce with Palouse Foot and Ankle clinic (Dr. Capawana's office) to have Joyce's sensitive toenails trimmed.

Joyce was returned to her recliner and oxygen hose re-seated to proper alignment. Chair extended into a prone position as tolerated by Joyce. Dusty applied Lidocaine patch to Joyce's back ~8:38 p.m., will need to be removed 12-hours later around 8:30 a.m. to follow 12-hours on/12-hours off directive on packaging.

Dusty and Jess attempted to feed Joyce peanut butter sandwich for dinner as a treat, Joyce not hungry (citing large, late lunch at which all of her food was consumed). Joyce attempted to eat 1/4 of the sandwich but could not do so. Dusty and Jess wrapped up sandwich for Joyce to have for a meal tomorrow.

Joyce reporting pain level at 3 to 4 (on scale of 1-10). 

Joyce's blood pressure was 133/61, with pulse of 91 at 9:10 p.m.

Joyce was given evening pill complement (Carvedilol, Metformin, and 2 Tylenol tablets for pain relief). 

Dusty and Jess leaving farmhouse for the night, planning to depart ~9:30 p.m.

Dusty will plan to return to farmhouse in the morning ~8 a.m., Jess will obtain some additional groceries tomorrow and drop them off at the farm later in the afternoon. Carol planning to spend afternoon with Joyce. Dusty will be gone to a Scouting event at Camp Grizzly in the evening.

Participant Observation: Joyce was not taking much fluids in today due to frequent, long naps. Will attempt to push more water intake tomorrow to prevent dehydration.

Participant Observation: Joyce requesting more assistance with post-toileting self-cleaning. Jess has obtained disinfectant wipes for cleaning of soiled surfaces due to unintentional bladder or bowel release.Additional disposable gloves are located in laundry room and in kitchen/living room area. Recommending that family members working with Joyce on toileting and personal hygiene use positive words of encouragement with Joyce, and exercise patience as sometimes she needs to sit for several minutes on the toilet (~20 minutes per trip appearing to be average).

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