General Update #188 - October 16, 2020
October 15, 2020 Addendum
Dusty visited with Connie when she arrived to farmhouse as he was packing up to leave. They discussed dates for next family meeting to plan for November, December, January care for Joyce when Dusty is required to end remote work and return to working at his campus office.
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October 16, 2020
Dusty arrived to farmhouse ~8:50 a.m. after picking up the replacement basket for Joyce's walker from Northwest Respiratory and stopping by post office. Joyce found awake and sitting upright in her recliner. Joyce stated she had already taken herself to the bathroom but could not recall when. Yesterday's clothes were draped over her walker, Joyce having traveled into family room to get herself fresh clothes at some point before Dusty arrived (fresh skirt, 3 long sleeve shirts). Dusty inspected Joyce's clothes from yesterday and did not discover any evidence of soiling or urinary incontinence.
9:15 a.m. - Vitals taken, BP 168/107. BGL @ 124. Joyce given nutritional shake and morning medication (Carvedilol, Metformin, 2 Tylenol, potassium, iron, multivitamin). Dusty asked Joyce what she would like for breakfast but she would not state what she felt like when presented with options. Joyce proceeded to complain about the quantity of pills she had been given and asked if it was really necessary for her to take them or "if some of them were just fakes [the doctor] told her to take." Dusty assured her that they were all necessary.
9:20 a.m. - Breakfast (1 slice whole wheat toast with butter, 1 hard boiled egg with Mrs. Dash seasoning, 1/2 banana). Joyce refused he breakfast after her tray was set in her lap, saying that she did not feel like eating. Dusty asked why and Joyce said it was not what she would have made for herself. Dusty asked what Joyce wanted and he would make it. Joyce refused to answer, shrinking into her recliner and avoiding eye contact. When Dusty asked Joyce why she wasn't talking to him she said that she did not want the people who were taking care of her "getting in trouble if [she] didn't eat what they put in front of her." Joyce stated that she was being watched. Dusty asked for an explanation and Joyce said "they've got cameras here at this facility and they are watching what I do and if I don't eat what they give me the people taking care of me will get in trouble." Dusty assured Joyce there were no cameras and that he was the person taking care of her today and would not get in trouble. Dusty offered to make Joyce whatever she felt like having for breakfast instead of what he prepared. Joyce remained silent for a while before looking around the room and leaning close to Dusty to whisper "cinnamon sugar toast." Dusty confirmed he could make that and did so (using Equal and cinnamon from the spice cupboard) while Joyce directed him how to make it from her recliner while he was in the kitchen. Joyce relaxed once this change was made and began eating her breakfast without further resistance.
10:15 a.m. - Scam phone call to farmhouse landline intercepted by Dusty, individual posing as Medicare/Medicare associate wanting Joyce to provide payment over phone for their service in scheduling a genetic test for cancers.
10:16 a.m. - Life Alert test occurred from base unit in kitchen. Dusty assisted Joyce with following directions by pressing the button on her necklace. Call put through to operator and signal and volume was confirmed strong and well received. System reset and working fine.
10:30 a.m. - Joyce declined bathroom trip, stated she wanted to nap.
11 a.m. - Joyce woke herself up from her nap. Dusty asked if she would like to use the bathroom. Joyce declined bathroom trip, stating she was too tired and resumed napping.
11:28 a.m. - Dusty notified Connie he was able to remain on-site at farmhouse due to a schedule change and that she could arrive later in afternoon around usual time instead of ~1 p.m. today.
11:50 a.m. - Joyce woke herself up and exclaimed "It's coming out!" and soiled herself. Joyce rose from recliner and managed to travel to bathroom under her own power at surprisingly great speed, unwilling to allow Dusty to stop her and put down mat to permit changing out of soiled clothes in living room. Remainder of bowel movement (Type 6) and urine passed once Joyce was seated onto toilet riser. Dusty assisted with cleaning up Joyce and removing soiled clothing. Dusty discovered that Joyce had stuffed Kleenex into her slippers at some point (2 in one, 3 in the other) and asked her why she did that. Joyce stated that she did not know why. Joyce was showered and changed into fresh clothing. Bathroom floor, hallway floor, toilet riser, and bathroom sink sanitized. Joyce returned to her chair after walking with extreme difficulty using her walker (nearly falling backward twice, Dusty caught her) after declining to be sat onto it and wheeled out to kitchen ~12:40 p.m.
12:42 p.m. - Joyce struggled to get her oxygen line into place and required assistance. Dusty worked on deep breathing exercises with Joyce.
12:45 p.m. - A character on Star Trek Deep Space 9, Kai Winn Adami, appeared on screen and Joyce immediately stated that she hated her and wanted her removed. Dusty asked if she wanted the show stopped and changed and she said yes. Dusty changed Netflix to play Sugar High for Joyce instead. Joyce then asked how much Kleenex was left in the house. Dusty confirmed that there were still a few boxes on the laundry room storage shelf. Joyce became stuck in a mental loop, alternating between asking about how much Kleenex was left in the house, who was making her breakfast tomorrow (because she wanted them to bring her a cinnamon roll from Rosauers), who was caring for her this evening (Connie), who was caring for her the next day (Jess then Dusty), how nice the shower was but that she doesn't like taking them because they take longer when she has to wash her hair, and that she wanted a hamburger from Wendy's for lunch. The Sugar High episode had the contestant teams making sculptures and one appeared too close to a snake, which upset Joyce. Dusty talked through Joyce's feelings and explained that it was just a stylized tree that was being made. Joyce remained skeptical until the final sugar sculpture was revealed.
~3:20 p.m. - Joyce asked Dusty "what all this table stuff was for?" Dusty explained that Connie brought it for Joyce to use for eating, coloring, and so on. Joyce expressed concern that she could not move it on her own and so was trapped in her chair. Joyce expressed that she did not think this was a good idea because no one would be around to let her out when she wanted to get up. Dusty let Joyce know that the family caregivers would not leave her trapped under the table after she expressed concerns about not being able to handle the table on her own when she needs to get up in the middle of the night. Joyce pulled several Kleenex from her new box of tissues, stating she had a runny nose that needed blowing (which she did) and piled up the extra Kleenex on her shelves. When Dusty asked why she was pulling Kleenex from their box and piling them up Joyce stated she did not know why she was doing it.
~3:36 p.m. - Dusty noticed Joyce nearly flipped the table trying to push it away from herself while he was putting away sanitized canning jars and lids. Dusty moved to stop her, preventing her from dumping her lunch tray on the floor. Dusty asked Joyce what was the matter and she exclaimed "it was too much and [she does] not want it!" Dusty asked to clarify if she meant the food and Joyce indicated the table and then said that she did not want to eat as it was not supper time. Dusty pointed out that it was her lunch. Joyce pointed the time out to Dusty and Dusty reminded her she had been working at eating it for a little while as a late lunch. Joyce stated she did not want to eat at all and so Dusty moved to put the food away. Joyce became emotional and Dusty arrived to her side. Joyce was not able to articulate herself for a few moments but Dusty was able to work through her feelings. Joyce felt that Dusty had taken the food away from her and was writing reports on her not eating it and they would get in trouble "with the nurses" and "[she] would not get to live at the farm anymore because she is being difficult." Dusty asked why Joyce thought she was being difficult and Joyce could not explain. Dusty worked with Joyce, holding her hand, talking her through her thoughts and he kneeled beside her while discovered Joyce had a minor panic attack with the table in front of her (claustrophobia?) and felt that when she expressed her concerns to Dusty about having the table left in front of her he did not understand her discomfort with it and she "would get in trouble for not wanting it because that nurse (Connie) had brought it into her room special for her." She lost her appetite because of the panic. Dusty assured Joyce that the table wasn't an issue, Connie would understand if she was claustrophobic with it straddled over her and wanted to not use it, and that the food could be brought back to her by Connie if Joyce got hungry later. Joyce stated she didn't want to use that table for eating and Dusty confirmed she could continue eating off a food tray on her lap if she preferred. Joyce stated that she wasn't sure about using the table for coloring and Dusty said that she could continue coloring on the usual tray she's been using for art on her lap if she liked. Joyce stated that she was anxious about what Dusty was writing about her. Dusty asked to clarify what she meant and Joyce said that Dusty goes back to his laptop and writes things down all the time. Dusty reminded Joyce that he is working remote and doing work for the university, so that is why he keeps returning to his computer. Joyce stated that she felt like she was doing everything wrong and not feeling right today. Joyce concerned about her memory issues, recognizing that she was not able to think how she wanted to or talk about what she was thinking of because "it disappears." Joyce calmed some and stated that she thinks she needs to nap as it might help her relax. Dusty helped her stretch out in her recliner after her crying abated and returned to putting away her lunch (only 1/4 of sandwich and 1/8 of potato eaten). Joyce thanked Dusty for "understanding her."
4:07 p.m. - Joyce requested Sleepless in Seattle be put on for her.
4:17 p.m. - Connie returned, having traveled to Tri-State Outfitters in Moscow to get Joyce size 11 Merrell Hydro Moc shoes and some long wool socks as a gift. Connie put the new shoes on Joyce and got Joyce to stand up and try walking in them. Joyce did a PT walk to family room and back, walking at a fast pace there and to her recliner. Joyce did not feel the shoes were falling off her feet or ankles. Connie worked with Joyce in practicing how to put shoes on herself. Joyce got the Mocs on by herself and got up from her recliner, taking herself for a walk over to fireplace and then into kitchen before returning to recliner. Joyce was very pleased with the new shoes.
Dusty departing farmhouse ~5 p.m. after getting next load of canning jars into dishwasher, Joyce's laundry switched to the dryer, and Joyce's evening medications prepped for Connie to provide.
Jess arriving tomorrow to provide Saturday morning care for Joyce. Connie covering Saturday afternoon/evening care for Joyce.
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Joyce's nose was running nearly continuously today.
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