General Update #160

11:13 a.m. - Marshall from Kindred arrived to do initial evaluation with Joyce. Reviewed plans to improve strength, posture, and balance. Vitals taken (96% O2 Level; BP 130/80, pulse 78; normal temperature). Confirmed zero use of stairs in Joyce's daily life with Dusty. Confirmed family present with Joyce during daytime hours (8 a.m. - 8 p.m. at minimum). Marshall checked Joyce's legs. No pain reported in legs, slight swelling noted. Marshall asked of Joyce felt she tired easily, Joyce said that she did. Confirmed that she does not get short of breath in going to the bathroom. No cough, fever, or sore throat reported in last 14 days. Confirmed sore/rash/skin breakdown on buttocks and inner thigh and noted it was being treated by the family using barrier cream. Joyce reported no numbness in hands or feet. No sensations of pins/needles in her hands and feet. Confirmed fall down basement stairs in June 2020 and injuries sustained. Marshall tested Joyce's legs for range of movement, flexibility, and resistance tests - some pains reported by Joyce for some movements. Marshall checked Joyce's back and upper body for range of movement, flexibility, and resistance tests - cited good range of motion in upper body.

Marshall did some physical resistance exercises with Joyce for her back. Explained to her the importance of good posture for her as her back had experienced a fracture.

Marshall had Joyce perform some leg exercises (marching exercises, leg extensions) from a seated position. Marshal noted Joyce experienced some difficulty from movement exercises.

Marshall observed Joyce standing from recliner and walking around room. Marshall had Joyce stand still for a period of time, attempt to shift her hips right and left, stand without holding onto her walker, and stand still with her eyes closed (which made her extremely unbalanced but Marshall steadied her). Observed Joyce re-seating herself onto recliner.

Marshall will come out twice per week for four weeks. If progress is made, will reduce to once per week. If not, will just continue on with meeting with PT twice per week. Marshall submitting paperwork to Joyce's primary care physician, Dr. Collins, she will approve and process paperwork most likely today or tomorrow. PT to begin as soon as authorized. Marshall will coordinate with Dusty for scheduling.

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~11:54 p.m. Dusty discovered that Derik was the individual who was removing the toilet riser and not replacing it back onto the toilet. Dusty confronted him about the need to leave it in place to reduce wear and tear on the clamp and prevent him forgetting to put it back into place.

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Joyce given lunch ~12:40 p.m. (sweet potato with butter and honey, 1/3 of banana), finishing around 1 p.m. 

Joyce requested that she have a peanut butter sandwich for her dinner. Dusty said that she could request that later if she still felt like it, but suggested that she might be hungrier for something more substantial by this evening. Joyce stated that she was told there was no bread in the house for peanut butter sandwiches. Dusty assured her that there was and asked who told her there was no bread for sandwich making. Joyce stated that she "would have to think on that."

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