General Update #155

Joyce abandoned working on her kleenex box project and coloring book shortly after getting setup with them, citing a desire to sleep. Joyce slept in recliner in upright position until alarm sounded to take Joyce to the bathroom.

Dusty roused Joyce and took her to the bathroom ~11 a.m. During process of getting her up, Dusty asked what she would like for lunch when she got hungry. Joyce stated that she skipped breakfast earlier today. Dusty corrected her, reminding her that she had toast and 1/4 of a banana. Joyce refused use of the recliner's powered assist feature to stand.

Phone call occurred to the farm's mainline simultaneously but both wireless units had not been seated on the base units correctly so call went unanswered due to this when Joyce attempted to answer them. Dusty went scrounging later for hard line phones to swap out for use in kitchen and place near Joyce's chair recliner later.

Joyce had some difficulty in moving but made it to bathroom under her own power and with no assistance. Joyce has started backing her walker into the bathroom, having a few moments of instability, before transferring handholds to sink and toilet riser grips. Slight amount of urinary incontinence that diaper absorbed, but no involuntary discharge of urine as Joyce seated herself onto toilet riser. Joyce passed urine and bowel movement (Type 6). Joyce managed to perform cursory cleaning of herself post-toileting and stood up under her own power without assistance. Dusty finished cleaning Joyce's buttocks and applied fresh barrier cream before providing Joyce with new diaper which she was able to step into and pull up with assistance from Dusty (as she was already in a standing position). Joyce commented while washing her hands that she wanted to go sit back down, citing her legs not wanting her to be upright. Joyce was returned to her recliner ~11:20 a.m. and accepted being put back into a reclined position after refusing to use remote to raise recliner up for assisting in sitting down. Joyce resumed napping intermittently. Joyce roused herself around 12:40 p.m. and resumed working on her kleenex box.

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12:35 p.m. - Rachael at Aspen Park returned Dusty's phone call from earlier in the day. She confirmed that Dusty will need to schedule the 2-week follow-up appointment with Moscow Medical for Joyce to see Dr. Collins where she will review Joyce's insulin stoppage and also follow up on Joyce's medication refills.

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Dusty called Moscow Medical ~12:38 p.m. and scheduled the 2-week follow up appointment for Joyce with Dr. Collins, working with Tanya. Dusty will plan to take Joyce in on October 1 at 11:20 a.m. using her Subaru to this appointment. Joyce Care Calendar (JCC) has updated with this appointment.

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12:45 p.m. - Dusty informed Joyce that it was time for her to get up and use the bathroom. Joyce initially refused, becoming irritated at the idea that a schedule had been set for her to use the bathroom on such a basis. Joyce stated that she had not been informed that this was how things were going to be. Dusty reminded Joyce that Carol had her on this schedule yesterday afternoon and evening and that it seemed to be working and so they should continue on with it. Joyce asked, "This is factual? You can document this? Is this an actual prognosis?" Dusty asked for clarification and Joyce asked if this 1.5 hour schedule was something the doctors prescribed or if it was something foisted on her by Dusty. Dusty explained that Carol's friend suggested it as a way to help Joyce avoid incontinence or involuntary bowel discharges if she was placed on such a schedule. Joyce remained irritated for a few minutes before finally stating "it is terrible getting old and you cannot rely on yourself!" Joyce eventually calmed and got up to use the bathroom.

Joyce continues to have difficulty in remembering to set her brakes on her walker when parking it and moving/pushing off of it. Joyce was able to seat herself onto the toilet riser and clean herself with minimal aid. No need to change diaper as it was clean aside from barrier cream transfer. Joyce passed urine only. Dusty applied fresh barrier cream to her sore areas, which are looking less irritated today, most likely due to increased hygiene practices and cream use. Joyce expressed that the one sore on her inner butt cheek is still tender to the touch. 

Joyce was returned to her recliner ~1:03 p.m. Joyce responded favorably to the idea of meatloaf and tea for lunch but decided to only take 1/3 of a banana as the Kindred Home Health, Carol, and Connie were soon to arrive around 1:30 p.m. Joyce asked if that would be okay and if she could eat the meatloaf after everyone leaves and Dusty confirmed that should be fine. Joyce ate her banana and took in a cup of water.

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