General Update #201 - October 30, 2020

October 29, 2020 Addendum:

4 p.m. Joyce changed her mind about wanting to use the bathroom before Dusty departed for the day. Urine passed. Joyce was dry until she moved to seat herself on toilet riser and released her bladder early. Floor and toilet riser sanitized by Dusty and fresh diaper and diaper pad insert placed on Joyce. PT walk - Joyce attempted to "walk at speed" from living room to kitchen. Returned to blue chair ~4:13 p.m. with Joyce wanting to color. Dusty set her up with oxygen line, trash can, kleenex, and coloring kit before departing farmhouse ~4:20 p.m.

Dusty ran into Connie at Rosauers as he was leaving after purchasing some dinner before heading into his office on campus, providing update/summary of day with Joyce.

~5:16 p.m. - Jay (Kindred PT) called Dusty's cellphone. Dusty was in meeting with his director and could not answer. Jay left voicemail stating that he would be in to work with Joyce tomorrow around noon or 12:30 p.m.

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October 30, 2020

9 a.m. - Dusty arrived at farmhouse after stopping by campus, Latah Title Company, and pulling over to repair engine oil leak in his Jeep. Found Joyce asleep in her recliner without oxygen line in place. Dusty found note about Joyce wanting a 2021 calendar and he placed an order for one.

9:20 a.m. - Craig arrived to farmhouse to visit and read newspaper, having returned from Moscow (purchased bread, bananas). Updated Dusty that he had found mom in bathroom toileting when he arrived to farmhouse ahead of Dusty ~7:30 a.m. Joyce was able to return to kitchen under her own power.

9:24 a.m. - BP 145/80, pulse 83. BGL @ 128. 

9:37 a.m. - Craig departed. Bathroom trip. Urine and bowel movement (Type 5) passed. PT walk following toileting. Joyce praised the new shoes that Connie bought for her. Joyce asked what today's date was and then complained that she was only receiving old newspapers (she had October 28's newspaper on her walker). Dusty clarified that today's newspaper was out on the kitchen counter waiting for her. Joyce returned to kitchen with some difficulty. Joyce elected to sit in the blue chair instead of her recliner.

~10 a.m. - Breakfast (1 slice whole wheat toast with peanut butter and apricot jam saved from yesterday, 1/2 banana, nutritional shake). Morning medication (carvedilol, metformin, 2 Tylenol, iron, potassium, multivitamin). 

11:16 a.m. - Dusty chased off the wood pecker from the back patio wall. 

11:20 a.m. - Bathroom without incident. Urine and bowel movement (Type 5) passed. . Joyce weighed at 158 lbs. PT walk. 

11:45 a.m. - Dusty cleaned kitchen counter, started dishwasher, and emptied farmhouse trash bins. Joyce declined lunch.

11:59 a.m. - Jay (Kindred PT) called Dusty's cellphone and asked if it would be all right if he arrived earlier to work with Joyce today ahead of his original 12:30 p.m. arrival time. Dusty confirmed that would be fine.

12:15 p.m. - Jay (Kindred PT) arrived to work with Joyce. Jay asked Joyce about her Halloween plans and they discussed what his kids would be doing for Trick-or-Treating this year with COVID-19 precautions in effect changing things. Jay reviewed Joyce's condition since he last visited, reviewed log book, and asked about PT and OT routines. Joyce reported no pains when asked. Joyce confirmed that as long as she holds still her back does not hurt. Jay took Joyce's vitals. Joyce reported that she is sleeping well. Joyce told Jay that she has been eating well. Dusty shared that she has been losing weight and has had loss of appetite. Jay collected vitals from Joyce - BP 141/78. PT walk (x2 laps, ~120ft in total covered) from kitchen to living room and back. Jay praised Joyce on her speed, lack of stops, and overall endurance. Joyce was reminded to keep her walker closer to her and not push it out too far ahead of her when she reported that her arms were getting sore/tired. Joyce given 2 minute break before she was moved to the kitchen to perform lower body PT (toe raises, knee ups, leg kickbacks, ankle rotations, side leg extensions, etc.  - 15 repetitions per leg) and balance exercises. Jay switched Joyce to sitting PT exercises when Joyce became exhausted. Joyce asked if it would be good for her to do these PT exercises each day would be good for her. Jay confirmed that it would be good if Joyce could do them 2-3 times per day, but only if someone is present to help Joyce with the exercises to provide safety. Jay encouraged exercises to be done if Joyce is up for it. Jay has seen that Joyce is moving around better, is more lively, and that the small amount of PT work that Joyce has been doing is improving her time when Jay is present and working with her. Joyce returned to working on standing exercises with Jay once she'd recovered from the exertion of the first set of exercises. Jay commended Joyce on her improved ability to sit on her chair post-exercise routines (she is no longer flopping down hard on the chair but is now able to slowly seat herself in a controlled manner) as that indicates she is improving in her motor and muscle controls. Jay praised Joyce's family members for their care of Joyce as they have been doing much better than other family or commercial in-home care providers that he has seen in the last few years he has been providing services. Jay departed ~12:50 p.m. 

Joyce visited with Dusty after Jay departed about the state of her life, her concerns over her remaining days, and informed him that she would like him to have her recipe collection and got his promise that he would keep the sourdough starter going "for the family" after she was gone. Dusty worked on guiding Joyce to cheerier subjects. Dusty and Joyce made plans to work together on this coming Sunday to get the sourdough starter refreshed. Dusty asked Joyce if she would like him to take down the office workstation in the kitchen and setup another blue chair that faces the patio window so she could watch him working on winterization of the planters and she thought that might be nice. 

1:34 p.m. - Bathroom trip, minor urinary incontinence requiring diaper pad insert replacement. Urine passed. PT walk following toileting. 

1:45 p.m. - Lunch (sweet potato with butter and honey). 2 Tylenol for pain relief. Lunch finished ~2:30 p.m. Joyce began coloring. Dusty worked on repairing Jeep.

3:36 p.m. - Robocall to farmhouse intercepted by Dusty. Dishwasher emptied. 

~4:09 p.m. - Bathroom. Minor urinary incontinence. Joyce released her bladder early as she moved to sit on toilet riser. Diaper and diaper pad insert replaced. Toilet seat riser and floor sanitized. PT walk following toileting.

Dusty departing ~4:30 p.m. to work at his office on campus. Carol arriving ~5:30 p.m. to provide evening care for Joyce.

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Connie providing care for Joyce tomorrow morning (October 30) before spending Halloween with her grandchildren. Carol covering afternoon/evening care for Joyce. Dusty returning to farmhouse Sunday, November 1 to provide all day care for Joyce. 

Dusty setup morning, afternoon, and evening medications for Saturday on the kitchen counter by the toaster.

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