General Update #189 - October 17 & 18, 2020

October 17, 2020

Jess provided care all day (Dusty joining her after his training event for Scouts concluded in the afternoon). 

8:25 a.m. - Jess arrive to farmhouse finding Joyce awake without her oxygen line in place. Joyce informed Jess that she had just returned from using the bathroom.

8:33 a.m. - Vitals taken. BP 184/108, pulse 78. BGL @105.

8:35 a.m. - 1/2 nutritional shake and morning medication (Carvedilol, Metformin, 2 Tylenol, multivitamin, iron, potassium).

8:40 a.m. - Breakfast (Rosauers cinnamon roll with all frosting removed by Joyce - 80% eaten, remainder of nutritional shake). Breakfast finished ~9:04 a.m.

9:10 a.m. - Bathroom trip without incident. Urine passed. PT walk halfway across blue livingroom and then back to her chair.

9:24 a.m. - Earl Grey tea.

9:27 a.m. - Lidocaine patch applied to Joyce's back, Tiger Balm patch applied to Joyce's left knee.

10:26 a.m. - Bathroom trip without incident. Urine and Type 6 bowel movement passed. 

11:05 a.m. - Pillow on recliner adjusted to opposite side as part of preventing pressure sores. Joyce setup for enrichment activity (coloring) after Jess noticed Joyce becoming fidgety and shifting about in her recliner. 

11:16 a.m. - Coloring ceased as Joyce was dozing off. Coloring tray removed and Joyce allowed to nap.

1:24 p.m. - Bathroom trip. Dry, but diaper pad insert replaced. Urine passed. Tiger Balm patch removed from left knee as its adhesive was failing.

1:35 p.m. - Lunch (mug of Nally chili, corn bread muffin). 2 Tylenol for pain relief. Lunch finished ~2:20 p.m., leaving only 2 bites of chili in her mug.

2:25 p.m. - Joyce requested a second cup of Earl Grey tea. Joyce had Jess put away the artificial gladiola flowers on the fireplace (bagged and moved to storage), then had Jess move the portable oxygen bottles out of her line of sight as they were bothering her. Portable oxygen bottles are now stored in front of fireplace seating area behind the green recliner so Joyce cannot see them but so they are still readily accessible. Joyce went through her newspapers.

3 p.m. - Coloring, then napping.

5:15 p.m. - Bathroom trip. Dry. Diaper was noticeably sagging (elastic stretched out). New diaper and diaper pad insert. Urine passed.

5:30 p.m. - Apple Dumpling Gang movie put in for Joyce to watch, followed by its sequel The Apple Dumpling Gang Rides Again. Joyce expressed she was unhappy with the clutter beside her chair. Joyce lost interest in working on it quickly while Jess was preparing low sodium meatloaf. Bathroom cupboard dusted, track greased, old chemicals pulled out to take to household waste day drop-off, shelves cleaned, and clean bath towels, hand towels, wash cloths put away. Sanitizing wipes and supplies placed in left-hand side of cabinet, closer to door, to assist caregivers with ease of reach. Hand soap refill bottle and wet wipe packages placed into bottom door of bathroom stand below diaper and diaper pad insert baskets. Toilet cleaned.

7:05 p.m. - Bathroom trip. Minor urinary incontinence. Joyce reviewed cleaning/organizing of bathroom cupboard and approved of work done.

8:19 p.m. - BGL @ 111

8:25 p.m. - Dinner (Leftover baked potato from Wendy's, 1 slice low sodium meatloaf). Evening medication (2 Tylenol, metformin, carvedilol). Dinner finished ~8:45 p.m.

9:40 p.m. - Bathroom trip without incident. Urine passed.

10 p.m. - Ready for bed.

Kitchen hand towel drawers emptied and sanitized after mice had gotten into them. Kitchen hand towels sanitized. Sanitization of canning supplies continues in preparation for making grape juice.

Internet service outage at farmhouse ~8:50 p.m., Dusty contacted First Step and issue was corrected ~9:51 p.m. via online help ticket.

+++

October 18, 2020

Dusty arrived to farmhouse ~8:07 a.m. finding Joyce sitting upright in her recliner without her oxygen line in place and house smelling of bowel movement. Joyce in a semi-coherent state. Joyce said that she was working on waking herself up to go to the bathroom but only got so far as taking off her blankets and then had "gone back to sleep." Joyce had soiled herself and at some point before Dusty's arrival had "checked herself" by putting her hands down her backside. Fecal matter spread over all nearby surfaces, blankets, shirt, recliner arms, back rest of recliner, etc. as she touched items and stuffed Kleenex down the rear of her diaper. Dusty cleaned Joyce's face and worked on breathing exercises with Joyce to get her oxygenated as she had difficulty focusing. Joyce asked why Dusty was at the farmhouse. Dusty explained that he was scheduled to care for Joyce today. Joyce stated she was worried there was some sort of emergency as to why he was present, she insisted that she had not fallen down (thinking the LifeAlert had summoned Dusty). Joyce eventually remembered that she had family members caring for her regularly. Joyce said she did not know why she soiled herself or why she made such a mess. Joyce became emotional and Dusty talked through her feelings about soiling herself, assuring her that he was not mad at her and she was not in trouble. Joyce wanted Dusty to know she did not do it on purpose and Dusty confirmed he knew that and everything was cleanable. Dusty replaced Joyce's oxygen cannula, sanitized the oxygen line exterior, eyeglasses, walker's handles, and walker's seat (which Joyce had piled soiled Kleenex onto) while waiting for Joyce to wake enough to stand up.

8:13 a.m. - Vitals taken while Joyce waking up after her hands and arms were cleaned up. BP 164/95. Blood glucose level @ 125. 

~8:42 a.m. - Joyce roused enough to stand and have soiled clothing removed. Joyce cleaned and taken to bathroom where she passed urine and minor amount of Type 5/6 bowel movement. Dusty stripped recliner of pillows (soiled) and prepared green recliner for Joyce to use for today as he needs to shampoo the powered recliner (disposable pads had been twisted and flipped by Joyce as she was attempting to clean herself due to poor motor control issues, fecal matter spread under and past them as she was stuffing Kleenex up her shirt, down her skirt, down her diaper and most likely accidentally folded the disposable pad into her diaper at some point while attempting to clean herself before untucking and smoothing its soiled surface out against the chair padding). Chair arms and side of chair smeared with fecal matter as Joyce wiped hands across them on purpose or by accident. 

Joyce refused to shower initially, seating herself onto toilet in protest and stating that she would just "nap in [the bathroom]!" Joyce stated she did not want to shower naked but did not want to be showered clothed either. Joyce was eventually calmed and showered, then put into fresh clothes. Joyce moved to green recliner under her own power ~10:05 a.m. Bathroom toilet riser, sink, and floor sanitized. Joyce informed Dusty she had never sat in the green recliner before in her life. Powered recliner left in extended position to aid in drying.

~10:11 a.m. - Epsom salt footbath setup for Joyce. Joyce would not allow Dusty to clean her feet while showering and so feet were cleaned as part of preparation for foot soak. Dusty set soiled clothing and blankets to run in washing machine on sanitize settings. Joyce given nutritional shake and morning medication (Carvedilol, metformin, multivitamin, iron, potassium, 2 Tylenol). 

10:15 a.m. - Joyce given fresh blankets and consented to eating half of a Rosauers cinnamon roll for breakfast after refusing initial offers of breakfast. Joyce only ate half of the half of cinnamon roll, asking remainder be saran wrapped and saved for her to have as a snack later. Joyce watched Dusty clean the recliner, put away canning jars, wash dishes, and vacuum kitchen carpet and rug. 

Noon - Compression stockings put onto Joyce's feet along with her new shoes Connie had bought her.

12:15 p.m. - Bathroom trip. Joyce dry until her bladder released early as she moved to sit on toilet riser, requiring replacement of diaper and diaper pad insert. Floor sanitized. Joyce returned to kitchen ~12:40 p.m. Joyce chose to sit in glider rocker instead of green recliner, citing it was better for her back and would likely be easier to get out of later on. Joyce requested to continue watching Star Trek Deep Space 9.

Dusty departing farmhouse ~1:15 p.m. to work at UI Theatre Archives. Dusty returning to farmhouse tomorrow ~8 a.m.

Connie arriving to provide afternoon and evening care for Joyce.

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