General Update #184 - October 12, 2020

Dusty arrived to farmhouse ~8:15 a.m. finding Joyce awake in her recliner without oxygen line in place. Farmhouse smelled of bowel movement. Dusty investigated and discovered Joyce had soiled herself at some point before his arrival and had attempted to clean up the mess she had made in the bathroom by herself.

8:23 a.m. - Nutritional shake and morning medication (Carvedilol, Metformin, 2 Tylenol, Multivitamin, Iron, Potassium). given to Joyce. Joyce voiced appreciation on the Equate brand of nutritional shake, stating she liked it better than the other versions she has been receiving with breakfast and dinner. Joyce asked if it has been raining outside and Dusty confirmed it had and was also quite windy. Dusty informed Joyce the county's graders were out leveling the east/west leg of Estes Road when he was arriving and caused him delay in reaching her as they were traveling in a line abreast formation and that prevented him from getting around them. Joyce asked how he was able to get to the farmhouse if they were blocking the road and Dusty explained that he just backed into a driveway until they had passed by and then was able to continue onward. Dusty set to work sterilizing bathroom floor, toilet riser, and sink.

8:48 a.m. - Vitals taken. 132/69, pulse 84. BGL @ 162. Joyce asked what was on the agenda for today and Dusty informed her that she has Jay (Kindred PT) arriving to work with her ~10 a.m. today and that was all he knew about so far. Joyce asked if she had to shower before Jay arrived and Dusty said he would take her to the bathroom after breakfast to help clean her up and ensure she has clean clothes.

8:58 a.m. - Breakfast (omelet with cheese and onion powder, 1/2 cup cottage cheese, 1/2 banana). Breakfast completed while Dusty was out of room on video call.

9:56 a.m. - Jay (Kindred PT) arrived to farmhouse to work with Joyce. Joyce reported that she was experiencing no pain currently when asked. Vitals taken. BP 131/82 (after eating it elevates a little bit, Jay noted). Oxygen levels at 77%. Temperature 98.6 degrees. Jay notified Dusty that Marshall might be out later this week or next week to do a reassessment on Joyce. 

Joyce went on a PT walk through the kitchen and into the family room area before returning to kitchen/living room. Joyce reported that she was walking good with little pain. Jay asked Joyce about the family photographs on the wall in the family room and Joyce said that they were all her grandchildren. Jay noted the boarded up stairwell doorframe and Joyce informed him that was for her safety as she had fallen down the stairs "a month and a half ago." Jay noted that Joyce's activity tolerance was quite high today. When Joyce asked what Jay meant by that Jay explained that usually she tells him she has had enough by now. Joyce stated "well I do but I'm keeping my mouth shut right now." Joyce returned to recliner ~10:11 a.m. for a break and use of oxygen line. Joyce was taken to kitchen following the short break for balance and lower extremity exercises (steps, lateral leg extensions, rear leg extensions). Joyce reported left leg was easier to do repetitions than with the right.

Jay departed farmhouse ~10:30 a.m. after informing Joyce that he would see her next week after Marshall does the assessment on her. Joyce asked Dusty if he had watched and learned what she needed to do today. Dusty confirmed he had and that Jay discussed how to do the exercises with him. Joyce stated that they were not fun for her but she would like to learn how to do them. Dusty confirmed he could do the PT and OT exercises with her but reminded her that often she declines doing them citing fatigue or she cannot stand or move to do them. 

Joyce requested shoes that support her feet and ankles to wear instead of slippers as she thought that would make her perform better and help her with walking. Dusty confirmed and stated he would get her some in a larger size. Dusty told Joyce that he thinks that size 10, which is the size she had been buying for herself, is too small for her feet and that a larger size would feel better on her toes and heels. Joyce concurred. Joyce asked Dusty if he had meetings scheduled for this evening. Dusty confirmed he had a Kenworthy Board of Directors meeting and a Troop 344 meeting scheduled for this evening. Joyce asked Dusty when he would be able to purchase her some shoes. Dusty stated he would buy some for her when he gets paid on Friday. Joyce became irritated and told Dusty that she has money and will buy them herself. Dusty attempted to redirect Joyce onto the magazines that Dusty and Jess purchased for her to read with limited success.

10:40 a.m. - Joyce declined bathroom trip.

10:41 a.m. - Potential scam call intercepted. Someone called farm landline asking for Joyce but would not identify themselves. 

Joyce proceeded to empty her purse and repack it three times starting around 10:45 a.m. Dusty asked what she was doing and Joyce said she was "seeing what she had in there." 

Derik arrived to use the farmhouse bathroom ~11:19 a.m., departing ~11:27 a.m.

Joyce declined bathroom trip at 11:45 a.m. and 12:15 p.m. before Dusty had to get onto a video call for work.

Vitals taken at 1 p.m. once Dusty was off his video call for work. Blood pressure 153/87, pulse 77. BGL @ 127. 

Joyce initially declined eating lunch but Dusty negotiated giving Joyce 1 hard boiled egg with Mrs. Dash seasoning, Jell-O gelatin cup, and 1/2 banana at 1:09 p.m. Derik arrived to use bathroom again while lunch tray was being given to Joyce by Dusty. Joyce asked who that was who just passed through the house. Dusty informed her it was Derik (Joyce stated she thought it was Zac). Derik departed ~1:13 p.m. Joyce started laughing after Derik departed. Dusty asked what was so funny. Joyce stated that she had not been able to read the text printed on her pills and so had dumped them from her cup to her hand to her other hand and was about to ask Dusty what the word on her pills said when suddenly she could read "Tylenol" on her pills and it made her happy. Dusty asked if she could not read her pills because the font of the text was so small and Joyce stated "no, it was that [she hasn't] been able to read for some time, and now suddenly [she] can comprehend what printed words say. "So, what's next?" Joyce asked, very pleased with herself that she can read again and wondered what other things would "switch on" for her today that had been "switched off" before.

Dusty noticed that Joyce was not eating ~1:29 p.m. and asked what was wrong. Joyce said that she wouldn't eat unless Dusty was eating his lunch with her. Dusty paused his remote work to have lunch with Joyce. Lunch finished ~2:15 p.m.

2:21 p.m. - Bathroom. Urinary incontinence and some fecal matter expelled with flatus requiring diaper and diaper pad insert replacement. Urine and Type 5/6 bowel movement passed. Dusty assisted with cleanup and Joyce returned to recliner ~2:43 p.m.

Joyce asked about Jess and how long she has to work at her job and Dusty provided rough timelines for her to get off work and arrive to the apartment by each work night. 

Joyce declined bathroom trip when offered at 3:30 p.m. and 4 p.m. after Dusty returned from running out trash to garbage can and loading recycling into his Jeep.

Dusty departing farmhouse ~4:15 p.m., Carol arriving ~5:30 p.m. to provide evening care. 

Dusty returning to farmhouse tomorrow morning around 8:45 a.m. after completing COVID-19 testing (was randomly selected from staff roster).


 


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