General Update #211 - Tuesday, November 11, 2020

November 9, 2020 - Addendum

6:30 p.m. - Lasagna soup, 1/2 breadstick. Evening medication.

9 p.m. - Ready for bed.

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November 10, 2020

8:54 a.m. - Jess arrived to farmhouse, finding Joyce awake without oxygen line in place. Joyce was very alert and had managed to get Netflix going (something she usually cannot do on her own). 

9 a.m. - Bathroom. Urinary incontinence, required change of diaper and diaper pad. Urine passed. Returned to recliner by 9:12 a.m.

9:17 a.m. - Vitals taken, BP 137/76, pulse 84, BGL @ 118.

9:41 a.m. - Breakfast (3 small pancakes with syrup and butter). Finished breakfast by 10:04 a.m.

10:10 a.m. - Morning medication and 1/2 nutritional shake. 

10:30 a.m. - Dr. Collins' office contacted Dusty via Debra (Kindred nurse) who called Dusty's cellphone. Dr. Collins does not want to place Joyce on a diuretic due to her mental state (confusion). Family caregivers are directed to continue use of compression stockings, elevation of legs, and walking PT exercises of at least 2-3 times per day to help reduce swelling in Joyce's legs. Based on current BGL data collected, Dr. Collins is ordering Joyce's extended-release Metformin dosage to be decreased to 500mg 2 times per day (instead of current 1000mg 2 times per day). Kindred nurse records about this change to Joyce's Metformin medication have been updated according to Debra. Dr. Collins will review changes in Joyce via Kindred nursing staff as well at Joyce's December 16 follow up appointment with Dr. Collins at Moscow Medical. 

10:35 a.m. - Bathroom trip without incident. Urine and small bowel movement passed (loose stool). PT walk to living room and back to kitchen. 

10:44 a.m. - Jess notified by Dusty via phone about Metformin medication change. Jess confirmed she had already given Joyce 1000mg Metformin this morning with her breakfast but that she would reduce the evening Metformin dose already in the Dixie cup and tomorrow's breakfast Dixie cup contents to 500 mg dose. Jess will note Metformin medication change in health log book. 

10:49 a.m. - Lidocaine patch applied to back, Tiger Balm patch applied to left knee.

10:52 a.m. - Nutritional shake finished.

11 a.m. - Joyce settled in to nap until Dusty arrives to farmhouse.

~12:20 p.m. - Dusty arrived to farmhouse to find Joyce in bathroom attempting to clean herself up from soiling herself (Type 6 bowel movement) in her recliner. Dusty assisted with cleanup, removing lidocaine and Tiger Balm patches in process, talking Joyce through her feelings and distress at soiling herself. Dusty assisted Joyce with showering and changed into fresh clothes. Washing machine started. Toilet riser, toilet, garbage can, bathroom floor, and sink sanitized. Joyce weighed in at 156.4 lbs. post showering. Returned to recliner ~1:27 p.m.

1:30 p.m. - Joyce declined lunch, Dusty worked at negotiating food. Dishwasher emptied, kitchen counter cleaned.

1:45 p.m. - Lunch (1/2 peanut butter and honey sandwich, 1/2 banana). Joyce declined to eat it, moving the tray to the walker and starting to sort the contents of her purse.

1:50 p.m. - Craig arrived to visit, brining loaf of bread. 

2:05 p.m. - Dusty departed farmhouse. Joyce still not eating, stated that she would eat when she felt hungry and that "the food had not been there that long." Joyce switched to looking at the calendar that Carol brought and cuddling the plushie that Jess made for her.



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Joyce forgot who Jess was today.

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