General Update #156

Connie arrived at 1:20 p.m. to the farmhouse, visiting with Joyce until arrival of Tracy from Kindred Home Health.

Tracy texted Dusty at 1:20 p.m. to let him know that she was running a few minutes late. 

Carol arrived and reviewed Joyce Care Calendar (JCC) with Connie and Dusty until Tracy Webster arrived ~1:50 p.m. 

Tracy went over medicare paperwork to ensure Joyce is covered (meets all criteria, reviewed Joyce's health history, household safety items and family care plan) for home health with Joyce, Carol, Connie, and Dusty. Care from Kindred will most likely be a temporary 60 day period, with the goal of keeping Joyce out of returning to hospital care. Physical therapy, occupational therapy, and nursing visits will be scheduled through Dusty. PT should be contacting Dusty tomorrow. It was requested that Dusty ensure that the different units don't schedule overlap onto each other, or stack on same day, to prevent Joyce from becoming worn out. Tracy provided 24/7 phone number (509-334-6016) to family for non-emergency medical contact. Reviewed Joyce's medications with the family and confirmed they are not in danger of administering current medications. 

PT will arrive twice per week to work with Joyce. Nurses will collect vitals on their visits and check on noted existing areas of concern on Joyce (currently only rash and sores on buttocks and inner thigh area the family is currently treating) and keep alert for anything that could develop that family might not catch.

Fire extinguisher and carbon monoxide detector replacements are needed for farmhouse. Dusty will work on procuring those with his next paycheck.

Tracy needs a copy of Joyce's advanced directive. Dusty working to locate, scan, and have copy ready before Tracy's next visit.

Tracy inquired what Joyce's goals were for their work together. Determined working on strength, balance, and stamina would be best for goals. 

Tracy conducted a cognitive reading exercise with Joyce. Joyce was able to read all the words (a few with some difficulty) except for "allergic." Overall good ability to read and comprehend. 

Joyce taken to the bathroom ~3 p.m. and passed urine. No accidental loss of bladder control during her transfer onto toilet riser. Old barrier cream was cleaned away so Tracy could inspect rash and sores on Joyce's buttocks and inner thigh area. Tracy inspected visually and confirmed they are healing, family doing correct steps for care. Connie observed Dusty's process of assisting Joyce with hygiene and application of barrier cream. Tracy stated that if family care providers let the Kindred staff know when the barrier cream they have on-hand runs low they can get more in about 2 days' time.

Tracy was asked if Kindred provides shower assistance as part of their services by Carol (via note through Connie, owing to Carol having to return to work). Tracy stated that they do have a "bath aide" and could look into scheduling that if the family would like. The current bath aide is in nursing school so availability has to be planned around that schedule.

Tracy collected vitals prior to departing farmhouse ~3:10 p.m. - Joyce's temperature normal, blood pressure 147/90 (high), pulse 74. Oxygen levels fine. Heart rate was noted to be irregular.

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Dusty fed Joyce late lunch ~3:20 p.m. (delayed from unanticipated length of visit from Tracy). 1 slice of meatloaf Jess made yesterday, 1 cup of potato salad, and last 1/3 of banana which was opened today. Joyce completed eating all of her food by 3:50 p.m. Joyce enjoyed the meatloaf, finding it quite delicious. Dusty teased Joyce, asking if it wasn't just her hunger that made it seem so delicious when really it was awful. Joyce laughed and said that was not the case, it was nice to have food that people who love her made her. Dusty asked if Joyce wanted anything else which Joyce declined, feeling better after her fast. Dusty checked Joyce's water and informed her he would take her to the bathroom one more time at 4:30 p.m. before he had to go into town for his evening meetings.

Dusty will depart for Moscow ~4:45p.m. - 5 p.m. once Joyce is resettled back into her chair post toileting. Dusty to return to farmhouse ~8 a.m. tomorrow.

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