General Update #218 - Tuesday, November 17, 2020

9 a.m. - Jess arrived to farmhouse finding Joyce awake without oxygen line in place (she had pulled it down and was wearing it like a chin strap). 

9:11 a.m. - BP 163/92, pulse 84. BGL @ 118. Jess replaced the lancet cartridge.

9:25 a.m. - Carole (Kindred nurse) called Dusty to let him know she needs to adjust her schedule, now planning to arrive around 2 p.m. to 2:30 p.m. today instead of 12:30 p.m. Dusty contacted his director and received permission to do remote work at farmhouse this afternoon so he can be onsite for nurse's visit.

9:45 a.m. - Breakfast (Egg in toast), morning medication administered. Breakfast finished by 10:14 a.m.

10:30 a.m. - Bathroom trip without incident. Urine and small bowel movement passed. PT walk to living room and then back to recliner.

10:50 a.m. - Joyce hopped up from recliner to use bathroom, narrowly avoiding soiling herself. Type 6 bowel movement passed. Returned to recliner ~11:07 a.m.

11:12 a.m. - Joyce settled down to nap until Dusty arrives.

12:58 p.m. - Dusty arrived to farmhouse after picking up lunch for Joyce and Craig at Humble Burger. Joyce awake in her recliner, stretched out and playing with the stuffed animals Jess made her. Joyce was having a conversation about Dusty with the stuffed animals, commenting on how late he was in arriving today and how she didn't think anyone would be out to see her. Craig, Dusty, and Joyce visited over lunch. Craig departed ~1:37 p.m. 

1:10 p.m. - Lunch (1/4 hamburger and 1/3 French fries). 

2:15 p.m. - Carole (Kindred Nurse) arrived to check on Joyce. Vitals taken. Oxygen level at 97%, pulse 81. BP 140/82. No headaches, neck pain, or dizziness reported by when asked. Health log reviewed with Dusty - blood glucose levels and bowel movements looking good. Noted swelling in legs but family caregivers were confirmed to still be using leg elevation and compression stockings on Joyce. Dusty updated nurse on use of decongestant for Joyce's cough per guidance received from previous visit. Joyce told nurse it was very seldom that she coughs up anything. Joyce's breathing and stomach were checked with stethoscope - no fluid heard in lungs which is good. Confirmed Joyce is not using insulin. Carole reviewed BGL ranges for Joyce with Dusty, low BGLs are the concern. If her BGLs are low (below 90) Joyce should be given fruit juice to help bring it up. Family reminded to monitor weight on Joyce, being vigilant for rapid weight gain. Joyce's new open pressure sore was inspected and family directed to continue with treatment (wound wash and barrier cream application) to promote healing and prevent infection. Confirmed PT visits have now terminated and Kindred will contact Dusty to schedule nurse visit for next week. Carole departed ~2:48 p.m.

2:51 p.m. - Bathroom trip without incident. Urine and bowel movement (Type 6) passed. Wound on right butt cheek cleaned, barrier cream applied. PT walk to living room, returning to recliner ~3:15 p.m.

3:18 p.m. - Epsom salt foot bath. Shoes sterilized by Dusty.

Dusty departing farmhouse ~4:15 p.m.

Connie arriving to provide evening care for Joyce.

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