General Update #249 - Friday, December 18, 2020

8:45 a.m. - Jess arrived to farmhouse, finding Joyce awake with oxygen line in place and watching a movie. Jess brought out the tins and containers for cookies that she picked up in town yesterday for making Joyce's Christmas gifts for the family. Joyce's mind seemed eased and she was excited to make cookies with Jess and Dusty tomorrow.

9:10 a.m. - Bathroom trip. Urinary incontinence. New diaper and diaper pad insert. Remaining urine passed. Barrier cream applied.

9:20 a.m. - BP 180/95, pulse 76. BGL @ 141.

9:50 a.m. - Breakfast (egg in toast with syrup). Breakfast finished by 10:15 a.m.

10:20 a.m. - Bathroom trip. Urinary incontinence. New diaper and diaper pad insert. Remainder of urine passed.

10:30 a.m. - Joyce stretched out for nap in her recliner. 

12:45 p.m. - Dusty arrived to farmhouse to find Joyce awake in her recliner without oxygen, "tired from cleaning." Joyce informed Dusty that she had been "cleaning up around the house" this morning but all she could recall doing was taking the pillows that were out in the kitchen back to her bedroom. Joyce lamented that Dusty was unable to tell what she had done for cleaning around the house, but she could not remember what she had done besides move pillows. Joyce spent a length of time lamenting about all the work she did and it was not noticeable to Dusty.

12:57 p.m. - BP 141/75, pulse 71. BGL @ 166.

1:03 p.m. - Lunch (1 slice whole wheat bread with peanut butter and honey, 1/2 banana, nutritional shake). 2 Tylenol. Lunch finished by 1:27 p.m. Joyce began napping. Joyce expressed concerns over the bubbles in her nutritional shake, thinking that Dusty had put medication or "something else" into it. Dusty assured her that it was just from him shaking the bottle it came in before pouring it into her mug.

Dusty set dishwasher running, tossed old food from the refrigerator that had spoiled, and emptied garbage from kitchen and bathroom.

2:14 p.m. - Joyce woke herself from napping and sat herself up in the recliner. Dusty asked if she was ready to go to the bathroom and she indicated that she was getting herself ready to go "in a few minutes."

2:17 p.m. - Joyce got herself up from the recliner and began gathering up additional pillows and blankets from the kitchen. When questioned, Joyce expressed that she was very concerned about the state of her house and that she was not ready for Christmas. Joyce was extremely agitated, concerned over "not doing enough" to get her home ready for family to visit. Dusty was unable to get Joyce to articulate what it was that was agitating her. Joyce returned to commenting about how the house is not ready but could not express what she wanted done. Joyce unable to provide Dusty with a list of tasks to perform or items to take care of to set her at ease. 

Joyce took several pillows (Dusty stopped her from taking her blankets) back to her bedroom and heaped them up with the others that had been taken there earlier in the day. Dusty found evidence that Joyce had gotten into the two hallway decoration boxes that were left to be processed. Joyce insisted that she had not moved them, only removing the lids. Joyce expressed concerns over the "mess" in the living room. Dusty assured Joyce that he and Jess would have it cleaned up tomorrow. Joyce was finally convinced to quit flitting about the living room and rummaging in her bedroom and go to the bathroom.

2:28 p.m. - Bathroom trip. Urinary incontinence. Joyce released her bladder early while moving to sit onto the toilet seat riser. Diaper and diaper pad replaced. Joyce continued to fret over farmhouse's state while passing remaining urine. Dusty confirmed with Joyce that Christmas was not tomorrow. Joyce confirmed that she did not think that it was, but she was still worried that her house would not be ready for family to arrive in time. Dusty explained to Joyce that he and Jess were going to be out all day tomorrow and finish up what they started last week. Joyce became upset about not being able to get gifts for family members. Dusty reminded her that he and Jess would help bake cookies and prep gift tins tomorrow. Joyce semi-placated. Joyce cleaned up and fresh barrier cream applied. Bathroom floor, sink, and toilet seat riser sanitized. PT walk to living room. Joyce returned to recliner by 2:37 p.m. Dusty attempted to work with Joyce on identifying what specifically was causing her distress about her home and Christmas prep to help set her at ease. Joyce had difficulty in articulating what was bothering her.

3 p.m. - Dusty returning to his office on campus to complete processing reports, returning later in the afternoon to provide evening care for Joyce.

Dusty returned to farmhouse ~7 p.m., finding Joyce asleep in her recliner without oxygen line in place. Evidence that she had taken herself to the bathroom at least twice since he departed at 3 p.m. Joyce had gotten the Cream of Wheat box off the counter "to read" to see if she could make it for herself. Dusty began making dinner. 

7:17 p.m. - BP 166/83, pulse 69. BGL @ 112. Joyce was very excited that the blood was able to be collected on the first attempt. 

7:30 p.m. - Dinner (prosciutto and cheese ravioli). Evening medication. Dinner finished by 8 p.m.

8:20 p.m. - Bathroom trip. Urinary incontinence. Diaper pad insert changed. Remainder of urine passed. PT walk to living room before returning to recliner. Began napping.

9 p.m. - Bathroom trip declined. Joyce resumed napping.

10:30 p.m. - Bathroom trip declined.

10:40 p.m. - Bathroom trip without incident. Urine passed. Fresh barrier cream applied. Joyce returned to her recliner and made ready for bed.

Dusty departing ~11 p.m. from farmhouse, returning tomorrow with Jess to provide all-day care for Joyce.

+++

Joyce experienced frequent instability in sitting/standing from toilet seat riser. Recommending that family members continue close assistance for Joyce in her toileting. Joyce having difficulty aligning herself with toilet seat riser when moving to sit down, loses balance while pulling diaper down/up, and nearly lost balance and fell twice where Jess and Dusty had to catch her. 

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