General Update #183 - October 9 Through October 11, 2020

October 9, 2020

[Connie and Carol provided care for Joyce.]

8:10 a.m. - Joyce found awake without her oxygen line in place, having just returned from the bathroom.

8:25 a.m. - Bathroom trip. Breakfast (blueberry waffles, coffee, grape juice). Morning medication (Carvedilol, Metformin, 2 Tylenol, Multivitamin, Iron, Potassium). 

Joyce napped from ~9:41 a.m. to 10:30 a.m.

10:57 - Bathroom trip, Joyce needed to be wheeled out to her recliner with assistance from Derik to get back into recliner. 2 Tylenol given for pain relief.

11:10 a.m. - Enrichment activity (coloring). 

Noon - Diarrhea, cleaned and showered. Craig remained onsite as standby to provide support.

12:40 p.m. - Joyce napped for ~10 minutes.

12:50 p.m. - Coloring.

1:20 p.m. - Lunch (1 chocolate ensure, graham cracker with peanut butter and honey).

3 p.m. - Bathroom. 

3:20 p.m. to 4 p.m. - Joyce napped in recliner.

Connie departed ~5 p.m.

6 p.m. - Dinner (Hamburger patty with cheese, tomato, cottage cheese). Evening medication (Carvedilol, Metformin, 2 Tylenol).

9 p.m. - Bedtime.

+++

October 10, 2020

Jess provided care for Joyce all day while Dusty participated in the San Diego Imperial Council's 2020 Commissioner Conference until he joined them at the farmhouse ~7 p.m.

8:16 a.m. - Bathroom. Minor urinary incontinence. New diaper and diaper pad insert. Joyce had doubled her diaper pad inserts overnight. Joyce returned to her recliner ~8:23 a.m.

8:25 a.m. - Half of vanilla Ensure given to Joyce while Jess prepared breakfast.

8:55 a.m. - Blood pressure 152/86, pulse 87, BGL at 162.

8:57 a.m. - Breakfast (Cream of Wheat with 2 packets of Equal, other half of vanilla Ensure). Morning medications (Carvedilol, Metformin, 2 Tylenol, Multivitamin, Potassium, Iron). Breakfast finished ~9:20 a.m.

11:46 a.m. - Bathroom. Urinary incontinence, diaper and diaper pad insert changed. Urine and minor bowel movement passed. 

12:10 p.m. - Joyce returned to recliner and Tiger Balm patch applied to left knee. Joyce given decaffeinated Earl Grey tea.

1:15 p.m. - Lunch (Chicken pot pie). 2 Tylenol for pain relief.

1:45 p.m. - Lunch finished, Joyce ate all of the interior of her pie and ~50% of the crust. Joyce declined bathroom trip.

3:48 p.m. - Zac, Nichole & baby MJ arrived to visit.

4:30 p.m. - Zac, Nichole & baby MJ departed, Craig arrived to visit. Swamp cooler removed from living room window by Craig and Jess.

5 p.m. - Bathroom. Urinary incontinence, diaper and diaper pad insert changed. 

Enrichment activity (coloring) for Joyce while Jess continued work on her art commissions.

 

7:04 p.m. - BGL at 110. Dinner (Wendy's hamburger, fries). Evening medication (Carvedilol, Metformin, 2 Tylenol). 

7:50 p.m. - Bathroom trip without incident. Urine passed.

9:55 p.m. - Bathroom trip without incident. Urine passed.

10:05 p.m. - Bedtime.  

+++

October 11, 2020

Dusty arrived to farmhouse ~8:23 a.m. finding Joyce slumped over the right side of her recliner without her oxygen line in place. Joyce was lethargic and incoherent when able to be roused. Dusty got her oxygen line back into place and worked through some breathing exercises. Joyce remained disoriented until about 8:35 a.m., asking what Dusty was doing at her place (not initially recognizing him as Dusty) and how "it was funny that they both ran into one another here." Joyce made some out of context comments as though she were finishing a conversation with another person before finally acknowledging that Dusty was her son and was able to say his name. Joyce had taken herself to the bathroom sometime after Jess and Dusty had departed last night.

Joyce was able to be roused enough to go to the bathroom at ~8:50 a.m. Joyce stopped Dusty as he asked her if she needed help standing. She waved him off then waved him back, stating that she was "still confused and [she] does not know how to go to the bathroom." Dusty provided directions to her as he walked her to the bathroom with some difficulty. Joyce stated she did not recognize where she was going. Joyce grunted with pain as she walked to bathroom but managed to traverse the distance without additional assistance. Joyce was able to seat herself on the toilet riser without assistance. Minor urinary incontinence requiring diaper pad replacement and disposable pad on recliner replaced.. Joyce passed urine and small bowel movement (Type 5). Returned to recliner ~9:15 a.m.

Tiger balm patch applied to left knee ~9:20 a.m.

Vitals taken at 9:27 a.m. - Blood pressure 148/79, pulse 83, BGL 126. Breakfast served (1 slice whole wheat toast, 1 hard boiled egg with Mrs. Dash seasoning, 1/2 banana, 1 cup Earl Grey tea). Morning medication (Carvedilol, Metformin, 2 Tylenol, Multivitamin, Iron, Potassium). Joyce complained about amount of pills she had to take saying that "seven pills [was] too much." Dusty pointed out that there were actually eight pills in her cup and Joyce lamented the correction.   

9:38 a.m. - Derik arrived to use bathroom and say 'hello.' Departed shortly afterward.

Breakfast finished ~10 a.m., coughing fit with mucous expelled.

10:09 a.m. - Woodpecker chased off from pecking on the back patio wall.

Joyce napped until Noon. Lunch declined. Bathroom trip declined. Joyce resumed sleeping until woken at 1 p.m. when bathroom trip offered and declined. 

2:16 p.m. - Lunch (Zucchini, black olive, garlic, onion omelet). 2 Tylenol.

2:18 p.m. - Phone call from another individual attempting to contact Gritman about scheduling surgery and COVID-19 pre-testing.

Lunch finished ~2:45 p.m., Joyce attempted to covertly remove her lidocaine patch from her back and Tiger Balm patch from her left knee. Dusty asked her why she didn't want to leave them in place and Joyce stated that they "just came off by themselves" (while tugging them off her skin in front of Dusty). Joyce removed both patches and threw them into the trash next to her recliner. Dusty asked if she did not like them and Joyce asked "Like what?" Joyce had no memory of removing patches after removing them. Joyce agreed that she must have removed them herself and put them into the trash as "they don't come off by themselves."

2:54 p.m. - Bathroom. Urinary incontinence requiring diaper pad insert replacement. Urine passed. Joyce returned to recliner ~3:11 p.m., stretching out to sleep.

~3:20 p.m. Dusty departed farmhouse to travel into Moscow for supplies (blood glucose test strips from Walgreens; refilled two 5-gallon water dispenser jugs at Rosauers; nutritional shakes, bananas, Tiger Balm patches, 5 oz Dixie Cups, Tylenol, Potassium, Cream of Wheat from Wal-Mart). Dusty returned and found Joyce still sleeping in her recliner where he had left her. Dusty began process of waking Joyce up for a bathroom trip.

5:23 p.m. - Jay (Kindred PT) called Dusty's cellphone to schedule visit with Joyce tomorrow between 10 a.m. - 10:15 a.m.

6 p.m. - Vitals taken. 169/88, pulse 82. BGL @ 116. Dinner declined.

7:51 p.m. - Able to get Joyce roused and mobile for bathroom trip. Minor urinary incontinence requiring diaper pad insert replacement. Urine and Type 5 bowel movement passed. Joyce stood easily post-toileting using the hand rails on the toilet riser. Returned to recliner ~8:08 p.m.

8:13 p.m. - Dinner (baked potato with butter and sour cream, leftover omelet from lunch, chocolate Equate nutritional shake). Joyce commented that she liked the taste of the Equate brand of nutritional shake versus the Ensure brand she had been drinking when Dusty gave her half while he was heating her dinner. Joyce more awake and alert while she ate, talking about her ideas for projects she wants to try doing for the week and during the fall. Joyce requested salt for her potato ~8:23 p.m. stating it was "tasteless." Dusty negotiated adding a small amount of salt along with some onion and garlic powder for seasoning. Dinner finished ~9:15 p.m. 

Joyce declined bathroom trip at 9:30 p.m., 10 p.m. and 10:30 p.m. Joyce fell asleep in her recliner while Dusty was loading his car and was difficult to rouse. 

~11:08 p.m. - Bathroom trip. Minor urinary incontinence, diaper pad changed. Urine passed. Joyce returned to recliner ~11:20 p.m. Oxygen line set into place, though Joyce kept attempting to remove it.

Dusty departing farmhouse ~11:30 p.m., returning tomorrow at ~8 a.m.

Addendum: Dusty discovered that Joyce had hidden her morning pills on the shelves beside her recliner as he was collecting her tea mug, refilling her water cup, and setting her dentures to soak in the evening before leaving. Joyce apparently had switched an empty Dixie cup she had access to from a previous day with the one that had morning medications in it while Dusty was cleaning up breakfast prep materials, setting the dishwasher to run, and bringing in his kit from the car and so Dusty did not realize that she had not taken them until this discovery. Dusty will watch Joyce take her pills going forward before moving onto other tasks.