General Update #232 - Tuesday, December 1, 2020

 8:30 a.m. - Jess arrived to farmhouse, finding Joyce asleep in he recliner without her oxygen line in place. Joyce was feeling "very fuzzy."

8:50 a.m. - Bathroom. Urinary incontinence, remainder of urine passed. New diaper and diaper pad insert.

8:56 a.m. - BP 168/97, pulse 79. BGL @ 98.

9:25 a.m. - Morning medication with nutritional shake.

9:30 a.m. - Breakfast (5 small pancakes, butter, and syrup). Breakfast finished by 9:45 a.m. Dusty arrived to help prep Joyce for her morning appointment in Moscow.

10 a.m. - Bathroom. Joyce was dry but released her bladder early while sitting down onto toilet riser. Bathroom cleaned. 

10:15 a.m. - Jess changed Joyce's clothes.

10:30 a.m. - Jess departed farmhouse, Dusty began loading Joyce into Subaru for trip into Moscow.

11 a.m. - Joyce's appointment with Dr. Capawana at Palouse Foot & Ankle Clinic in Moscow. Toes inspected, toe nails trimmed. No ingrown toenails, Joyce's feet doing good. Praise for new shoes that Connie purchased given by nurse, much easier getting them on/off Joyce now that she is wearing the correct size.

11:45 a.m. - Joyce returned to farmhouse after Dusty took her to Dutch Bros. for some tea (following Jess' past rituals for a treat post foot care appointments when she was taking Joyce to them). Bathroom trip without incident. Urine passed. Wound cleaned and fresh barrier cream applied. PT walk to living room and then Joyce declined lunch and went down for a nap.

Fuel oil delivered to farmhouse.

2:42 p.m. - Joyce woken for bathroom trip and to ready for visit from Kindred Home Health nurse. Urinary incontinence, remainder of urine passed. Diaper and diaper pad insert replaced. Wound cleaned, fresh barrier cream applied. PT walk to living room. Joyce declined lunch.

3:03 p.m. - Carole (Kindred nurse) arrived to visit Joyce. Temperature taken, 98.1 degrees Fahrenheit. BP 130/70 (deemed good), pulse, 75. O2 level at 93% (without oxygen line in place). Dusty relayed Joyce's complaints of chest pain on Sunday, November 29 (Joyce did not recall that she had complained of chest pain, having told Carole she "hasn't had any pain at all" since her last visit when asked). No pains and no dizziness was self reported by Joyce. Pressure sore was still present but healing, family noted to be continuing treatment. Noted addition of nasal saline for Joyce's nose comfort - confirmed this was all right. Joyce confirmed she has not been having leg cramps. Joyce confirmed no new falls since June. Carole noted some leg swelling. Dusty confirmed that compression stockings and elevation of legs were being done for Joyce by family care givers. Discussed sputum output with Joyce's cough. Carole asked if family was monitoring its coloration and Dusty stated they were not. Caroled recommended adding that to what is being output from Joyce. Carole noted 2 days of sore throat reported by Joyce on November 25 and 26 but no other symptoms. Carole confirmed upcoming appointment for Joyce with Dr. Collins on December 16, recommended that family discusses Joyce's continued loose stool and ask about possible metformin alternatives as that is still an ongoing issue. Most likely Joyce can be moved to a metformin alternative that will not irritate her bowels. Joyce became irritable with Dusty as Carole was asking her the questions but Dusty was answering for her (as Joyce was giving incorrect information or stalling out or taking too long of pauses in replying). Carole confirmed continuation of Kindred visits through the end of December 2020, with continuation of visits dependent on Dr. Collins' orders post 12/16 appointment. Carole departed farmhouse ~3:25 p.m.

Joyce declined lunch, Dusty departed farmhouse to return to his office on campus ~4 p.m.

4:30 p.m. - Connie arrived to provide evening care for Joyce. Joyce was hungry.

5 p.m. - Dinner (Tuna Helper - huge bowl - and 1 slice of toast). Joyce ate everything.

6 p.m. - Bathroom.

6:30 p.m. - Enrichment activity (coloring). 

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