General Update #216 - Sunday, November 15, 2020

Dusty arrived to farmhouse ~8:45 a.m. after purchasing supplies for farmhouse in town (diaper pad inserts, blood glucose testing strips, disposable chair/bed pads) finding Joyce awake in her recliner with her oxygen line out of position. Dusty asked if Carol had been in to see Joyce and Joyce laughed, confirming Carol had just been inside to see her a few minutes earlier. Joyce was confused how Dusty knew that Carol had been in and asked how Dusty knew, thinking he had seen her outside or if he had seen her driving off down the road. Dusty said he could smell her perfume in the entryway when he came into the farmhouse. Bathroom trip declined. Evidence Joyce had taken herself to the bathroom at least once since Dusty departed farmhouse last night. Joyce did not recall the time of when she went to the bathroom.

9 a.m.- Bathroom trip declined. BP 147/84, pulse 77. BGL @ 119.

9:23 a.m. - Breakfast (5 mini pancakes with peanut butter, banana slices, and syrup). Earl Grey tea.

9:50 a.m. - Morning medication (Carvedilol, metformin, Mucus DM, multivitamin, 2 Tylenol, potassium, iron) given with nutritional shake. 

10 a.m. - Bathroom trip declined. Joyce requested to be allowed to nap.

10:17 a.m. - Derik arrived to do laundry. Dusty informed him the washer and dryer were already in use. Derik asked if the laundry machines in the basement worked. Dusty confirmed they did not. Dusty informed Derik that the laundromats in Moscow were open 24/7 and had quarter dispensers.

10:30 a.m. - Dishwasher emptied and reloaded, trash bins emptied, counters sanitized, bathroom sanitized, kitchen floors swept and swiffer mopped. Dusty beginning kitchen cupboard clean up project (tossing rancid/expired food, restacking shelves, etc.) and Joyce's bedroom organization (washing sweatshirts and old office clothes for Joyce to sort through for donation, organization of dresser drawers with Joyce's guidance). 

11 a.m. - Bathroom trip declined. Joyce resumed napping. Joyce's portable diaper kit (brown bag with teal handles) restocked, hand soap dispensers refilled. 

11:30 a.m. - Joyce startled awake by Dusty cleaning the portable table in her kitchen. Dusty calmed her and let her know he was just cleaning. Joyce became concerned about what Dusty was up to in the kitchen and Dusty reviewed what he has done.

11:45 a.m. - Bathroom trip. Urinary incontinence, diaper and diaper pad replaced. Remainder of urine passed. Joyce refused showering, Dusty informed her it will be happening today. Joyce requested it to occur this afternoon when she is "more awake." Joyce protested needing a shower, stating that she had not soiled herself and therefore did not need a shower. Dusty informed Joyce she should at least be showered every other day to help keep her healthy and in good hygiene. Joyce stated that she does not do enough to warrant showering every other day and became belligerent. Dusty worked at calming her. Joyce declined PT walk, citing she could not focus enough and wanted to sit down. Dusty asked if she was dizzy but Joyce said that she was just sleepy.

12:05 p.m. - Carol and Craig stopped by to visit, departing ~12:32 p.m. Joyce asked Dusty to clarify everything that had been relayed to her in conversation as she did not understand what was said to her. Dusty reviewed information and Joyce seemed to comprehend but then asked to repeat what was discussed twice more.

1 p.m. - Lunch declined, Joyce requested to nap.

2:05 p.m. - Bathroom trip without incident. Joyce refused shower, becoming irritated at the suggestion it needed to be done. PT walk. Dusty suggested that they work on sorting through her dresser drawers to make room to put away her clothes that have been stacked in the living room. Joyce said she was too tired to do that right now but would like to do it later in the afternoon or as an evening job. Joyce was returned to chair by 2:18 p.m. Lunch declined, Joyce requested to be allowed to sleep.

3:30 p.m. - Bathroom trip declined. Joyce resumed sleeping.

3:53 p.m. - Bathroom trip declined. Lancet cartridge replaced.

4:30 p.m. - Bathroom trip declined. 

4:38 p.m. - Bathroom trip without incident. Urine passed. Joyce declined showering, rising to panic levels of concern. Dusty managed to calm her and said that they would shower tomorrow when he arrives to the farmhouse. Joyce asked when Jess would come to visit her again and Dusty said it would be tomorrow and every morning this coming week. Joyce asked why Jess was coming out every morning this week and Dusty reviewed Joyce's care plan and scheduled visits by family care providers. Joyce was shocked, stating that she did not know that this was occurring. She asked who all was coming tomorrow and Dusty provided the information. Joyce became embarrassed that people were coming to take care of her. Dusty assured her it was for her safety and not to shame her. Discussions and reviews of Joyce's mental health deterioration as well as her physical injuries in 2020 were reviewed. Joyce stated she understood and confirmed she wanted to take a PT walk to living room and back to kitchen. PT walk taken returning Joyce to recliner by 4:49 p.m.  Joyce declined offer to start the sorting project with her dresser drawers. Joyce having difficulty focusing mentally. Dusty departing to town to pickup dinner ~4:40 p.m.

~5:25 p.m. - Dinner (Zip's cheeseburger and fries). Dinner finished ~6:15 p.m., Joyce consumed all food she was given.

6:16 p.m. - Evening medication administered (Carvedilol, metformin, 2 Tylenol) with nutritional shake. Joyce complained about quantity of pills being given to her and what the nutritional shake contained. Joyce was suspicious that she was being drugged. Conversations with Joyce ranged from coherent reflections on her divorce and adoption of Dusty to incoherent discussions of things that didn't quite make sense to either Joyce or Dusty. Joyce spent time holding the two plush animals Jess had made for her, talking to them and holding them, as they watched Star Trek: Voyager on Netflix together. Joyce moved through moments of time where she did not know who Dusty was, asking him if he "would be leaving soon because her son Dusty wasn't out today" so he would miss him if he was waiting for him. 

Joyce slept from ~7:45 p.m. to ~10 p.m., Joyce was difficult to rouse throughout this period of time. Joyce declined all requests for bathroom use, citing extreme fatigue. 

10:26 p.m. - Bathroom trip without incident. Urine passed. Joyce extremely incoherent and unstable, most likely due to fatigue, struggling to walk and focus on toileting. Returned to recliner ~10:40 p.m.

Joyce settled down for bed after struggling with Dusty to keep her oxygen line in place ~11:10 p.m. Joyce kept insisting that it does not need to be on her and should be no where near her. Dusty worked on breathing exercises to try and get Joyce coherent.

Dusty departing farmhouse ~11:25 p.m.

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