The Official Joyce Update Blog

7:05 a.m. - Craig noted that Joyce was making her first bathroom trip of the day. Joyce appears to be in a much better state of mind (less general confusion). Returned to recliner by 7:15 a.m. 7:58 a.m. - Jess arrived to farmhouse. Joyce found dozing in her recliner without oxygen line in place. 7:59 a.m. - BP 159/83, pulse77. BGL @ 145. 8:30 a.m. - Nutritional shake and morning medication. 8:35 p.m. - Breakfast (1 slice egg in toast with banana). Breakfast finished by 9:07 a.m. Joyce very tired. Joyce informed Jess she was "gone" one of the two days Jess was not at the farmhouse. Jess asked for clarification. Joyce took some time to articulate her meaning with prompting from Jess - Joyce was trying to say that she was not "there mentally." 9:30 a.m. - Bathroom trip. Urinary incontinence. New diaper and diaper pad insert. Remainder of urine passed. Barrier cream applied. Scab has formed on her right butt cheek. Returned to recliner by 9:40 a.m. Joyce given fresh bla...

7:45 a.m. - Craig arrived to farmhouse to cover Jess' morning shift as she was getting her teeth repaired at the dentist. Joyce informed Craig that she had already been to the bathroom. 8:48 a.m. - BP 146/77, pulse 78. 9 a.m. - Morning medication administered. Bathroom trip. 9:30 a.m. - Breakfast (banana, 1 piece of toast with jam, baby bell cheese wheel). Joyce informed Craig she was not particularly hungry. 11:02 a.m. - Joyce was returning from using the bathroom as Craig re-entered the farmhouse. Joyce informed Craig that she had a bowel movement. 11:25 a.m. - Dusty arrived to farmhouse. Found Joyce in her recliner, awake, without oxygen line in place struggling with the television remote - she had loaded some sort of Spanish dubbed video onto the television and was frustrated she could not get it to stop or change back to Netflix. House smelled of bowel movement. Evidence of type 6 bowel movement in bathroom - floor, toilet seat riser, sink were sanitized. Evidence found Joyce ...

Dusty arrived to farmhouse to cover Jess' morning shift of care for Joyce due to Jess being out of action with a migraine.  Joyce found awake in her recliner without oxygen line in place, struggling with television remote. Joyce disliked the western film Craig had setup to play and requested assistance in returning NCIS  to play again. Dusty discovered that Craig had left entry in logbook stating that Joyce had informed him she had taken herself to the bathroom prior to his arrival on-site at farmhouse. Evidence found that Joyce had taken herself to the bathroom at least three times on her own since 8:30 p.m. last night. Joyce expressed concern to Dusty about large envelope on counter that she could "just barely see." Dusty informed her that it (envelope addressed to Derik) was not for her and she should leave it alone.  PT walk to living room. Joyce expressed concern over piles of clothing in living room. Dusty explained those were what Joyce had sorted out for donation ...

8:05 a.m. - Craig entered into logbook that Joyce had taken herself to the bathroom and "was successful."  8:13 a.m. - Jess arrived to farmhouse and found Joyce awake in her recliner with her oxygen line in place. Joyce informed Jess that she had just set herself back into the recliner before Jess arrived. 8:15 a.m. - BP 148/81, pulse 72. BGL @ 162. 8:36 a.m. - Wendy called Dusty's cellphone to follow up about Joyce's confusion and pain mitigation - curious if Tramadol has helped or hindered Joyce with daily living. Dusty confirmed that the remaining doses of Tramadol were given to Joyce with each meal and there seems to have been improvement on Joyce's ability to walk and reduction of pain overall - no increase in Joyce's confusion noted by family caregivers. Wendy confirmed that the anti-inflammatory medication must have exacerbated Joyce's dementia/confusion and noted for it not to be prescribed again. Wendy will report to Dr. Collins and have prescript...

Dusty arrived to farmhouse ~9:15 a.m. after running errands for Jess and purchasing supplies for farmhouse in Moscow.  Joyce found in kitchen, foraging for food and drink. Joyce informed Dusty she had just taken herself to bathroom. Joyce had gotten herself expired egg nog from main refrigerator and donut that Dusty had been saving for Craig. Joyce returned to recliner. Dusty dumped egg nog, gave Joyce cranberry juice in its place. 9:20 a.m. - BP 147/63, pulse 88. BGL @ 123. 9:25 a.m. - Morning medication. Breakfast (donut, cranberry juice, whole banana). Breakfast finished by ~10:20 a.m. Bathroom floor and toilet seat riser sanitized (evidence Joyce had early bladder release during last bathroom trip). Dishwasher emptied and reset to run again. Kitchen counters cleaned. Supplies purchased put away. Vacuumed kitchen, hall, living room carpets. Joyce slept heavily. 12:15 p.m. - Bathroom trip. Urinary incontinence, early bladder release. Urine puddled into shoes, shoes sanitized. Rem...

8:25 a.m. - Craig logged in Joyce's health log book that Joyce had just returned to her recliner from a solo successful bathroom trip. 9 a.m. - Dusty arrived to farmhouse, finding Joyce napping in her recliner without her oxygen line in place. Evidence found that Joyce had taken herself to the bathroom, had issue with early bladder release. Dusty cleaned floor and toilet riser. Found Craig's 8:25 a.m. note in log book. BP 168/77, pulse 71. BGL @ 140. 9:11 a.m. - Breakfast (donut from Rosauers, 1/2 can peaches, nutritional shake, Baby Bell cheese wheel). Morning medication administered. Breakfast finished by 10:12 a.m. 10:17 a.m. - Joyce stated to Dusty that she wanted to stretch out to nap when he asked her what she would like to do next for herself. Dusty setup Joyce to nap. Joyce remained stretched out in her recliner for only 1-2 minutes before she used her remote to raise herself up into sitting position and declared that she did not want to sleep but that she wanted a proj...

8:20 a.m. - Jess arrived, finding Joyce asleep with oxygen line in place. 8:24 a.m. - BP 143/75, pulse 72. BGL @ 114. 8:28 a.m. - Medication with nutritional shake. Jess applied Tiger Balm patch to Joyce's left knee. 8:30 a.m. - Bathroom trip. Urinary incontinence. Early bladder release. Remainder of urine passed. Barrier cream applied. Returned to recliner by 8:45 a.m. 8:20 a.m. - Breakfast (Sausage, egg, cheese biscuit, orange juice, and hash brown from McDonald's). Breakfast finished by 9:13 a.m. 9:25 a.m. - Enrichment activity (coloring).  9:50 a.m. - Bathroom trip without incident. Bowel movement (type 6) and urine passed. Joyce returned to her recliner by 10:20 a.m. 10:23 a.m. - Tiger Balm patch kept falling off. Jess replaced it with a lidocaine patch. 10:25 a.m. - Joyce returned to coloring for enrichment activity. 1:49 p.m. - Dusty arrived to farmhouse following meetings on campus, finding Joyce struggling to stand up from her recliner to travel to bathroom. Bathroom t...

8:13 a.m. - Jess arrived on-site to farmhouse and found Joyce awake in her recliner with oxygen line in place. She was confused over which remote worked the television and which worked the powered recliner. Television set was not working and Jess reset it. 8:17 a.m. - BP 141/78, pulse 75. BGL @ 150.  8:30 a.m. - Morning medication with nutritional shake. Jess noticed two Jell-O pudding cups in Joyce's trash - did she get them herself from the fridge in the middle of the night? 8:35 a.m. - Breakfast (Egg cup omelet with sausage, 1 slice of toast, 1/2 banana). Joyce had difficulty eating the omelet but ate everything else. 9 a.m. - Jess took omelet away from Joyce and gave her 1/2 can of peaches and additional 1/2 banana. Joyce kept zoning out while eating, requiring Jess to keep prompting her to eat so they could get in a trip to the bathroom before Jess had to leave the farmhouse. Breakfast finished by 9:29 a.m. 9:40 a.m. - Bathroom. Urinary incontinence. New disposable pad put ont...

8:05 a.m. - Jess arrived to farmhouse. Joyce asleep in recliner with oxygen line in place. 8:06 a.m. - BP 150/83, pulse 75. BGL @ 142. 8:30 a.m. - Morning medication with nutritional shake. 8:35 a.m. - Breakfast (Egg in toast with banana).  8:53 a.m. - Breakfast stopped for bathroom trip, Joyce expressing urgency. Joyce had difficulty standing - left knee not wanting to function. Jess used wheel chair to move Joyce to bathroom. Urinary incontinence (Joyce did not have a diaper pad insert in her diaper). New skirt. Joyce returned to recliner by 9:13 a.m. 9:33 a.m. - Breakfast finished. 9:55 a.m. - Bathroom trip. Joyce wheeled into bathroom on wheel chair. Jess noticed a discoloration on the lower front panel of the diaper leg - Joyce appears to have scratch marks over her right leg on her tummy in the crease where the skin folds over. Urine and type 6 bowel movement passed. Joyce reported that her buttocks was hurting and asked Jess to check for pressure sores. Hemorrhoidal cream an...

8:07 a.m. - Craig arrived to farmhouse. Joyce reported that she had just sat down on her recliner after taking herself to the bathroom on her own.  8:08 a.m. - Jess arrived to farmhouse, finding Craig on-site. Craig reported that Joyce reported she had a good night. 8:15 a.m. - While Jess was talking with Joyce about what to have for breakfast Joyce said that "it depended on what everyone else wanted." When Jess asked who else Joyce was referring to, Joyce said "all the others." Jess reminded Joyce that it was just the two of them (Jess and Joyce) as Craig already had his oatmeal. Joyce said "oh" and dropped it - Joyce may possibly be hallucinating again? 8:30 a.m. - Joyce was rocking forward and backward in her recliner every minute or so while Jess was preparing breakfast (usually a sign that Joyce has to go to the bathroom). Jess took Joyce to the bathroom - Joyce had removed her diaper pad insert at some point but did not replace it. Joyce was dry. Uri...

Jess and Dusty arrived to farmhouse ~8:50 a.m., found Joyce asleep in her recliner with oxygen line in place. Evidence that Joyce had taken herself to the bathroom at least once since Dusty departed last night after 11 p.m.  Joyce attempted to tell Jess and Dusty that she had visitors last night but could not articulate who they were - suspecting that she was dreaming/hallucinating as Dusty left so late in the night and nothing in the farmhouse showed evidence of being moved from how Dusty had left it.  Joyce had removed her t-shirt layer of clothing, evidence she had a nosebleed. Joyce could not remember removing the shirt or having a nosebleed. T-shirt replaced. 9:01 a.m. - BP 170/81, pulse 72. BGL @ 131. 9:11 a.m. - Bathroom trip. Urinary incontinence, early bladder release. Remainder of urine passed. Toilet seat riser and floor sanitized. Diaper and diaper pad insert replaced. Hemorrhoidal cream applied. Returned to recliner under her own power by 9:28 a.m. 9:20 a.m. - Mor...

9:10 a.m. - Dusty arrived to farmhouse finding Joyce awake in her recliner without her oxygen line in place. Joyce stated that she had just returned from the bathroom, passing only urine, could not recall if she had been incontinent - toilet tank fills slowly and was filled, so at least was 30 minutes prior to Dusty's arrival.  9:20 a.m. - BP 147/87, pulse 80. BGL @ 134. Morning medication administered with nutritional shake. 9:40 a.m. - Breakfast (6 mini pancakes with peanut butter and syrup, 1/2 can peaches). Breakfast finished by 10:40 a.m., Joyce began napping. 10:40 a.m. - Joyce soiled herself in recliner without warning (type 6). Joyce cleaned up and showered. Shoes sanitized. Bathroom sanitized. Returned to recliner by 12:05 p.m. under her own power. Weight 156 lbs. 12:05 p.m. - Enrichment activity (sorting clothing from her old office clothes for donation from her closet).  Joyce napped, citing fatigue.  1 p.m. - Bathroom trip declined. Napping resumed. 1:30 p.m. ...

9 a.m. - Dusty arrived to farmhouse, finding Craig already on-site in the kitchen and Joyce in the bathroom. Urinary incontinence, diaper and diaper pad insert replaced. Remainder of urine passed. Hemorrhoidal cream and barrier cream applied. Joyce had to be wheeled out on the walker by Dusty. Craig informed Dusty that Joyce had walked into the bathroom on her own. Joyce returned to recliner by 9:14 a.m. 9:17 a.m. - BP 161/96, pulse 76. BGL @ 119. 9:20 a.m. - Nutritional shake with morning medication. 9:30 a.m. - Breakfast (2 strawberry Eggo waffles with butter and syrup, banana). Breakfast finished by 10:15 a.m. 10:23 a.m. - Enrichment activity (laundry folding).  10:45 a.m. - Joyce soiled herself in her recliner without warning (type 6 bowel movement). Joyce showered. Joyce had difficulty following verbal directions. Large mess created in bathroom. Joyce's shoes sanitized. Bathroom sanitized. Returned to recliner by 12:10 p.m. Weight 156.8lbs. Joyce completed laundry folding, too...

8:15 a.m. - Jess arrived to provide morning care for Joyce. Craig on-site, having just arrived to farmhouse before Jess. Joyce found to be stretched out in her recliner with oxygen line in place. 8:19 a.m. - Bathroom trip. Urinary incontinence. Joyce able to walk very slowly into bathroom under her own power. Joyce reporting being in "a lot of pain" throughout trip. Joyce's shoes were sanitized. New disposable pad for recliner put into place. Skirt changed, diaper and diaper pad insert replaced. Jess had to assist Joyce in standing upright at the sink to wash her hands. Jess had to wheel Joyce out to kitchen on her walker as Joyce could not walk under her own power.  9:13 a.m. - Lidocaine patch applied to Joyce's left knee in attempt to relieve pain reported. 9:20 a.m. - Jess was able to get Joyce back onto her recliner.  9:25 a.m. - Morning medication administered with nutritional shake. Cup of Red Rose tea. 9:30 a.m. - Breakfast (1 slice of toast with butter and apr...

Craig providing morning care while Jess is at dental appointment. 9 a.m. - Craig gave Joyce her morning medication. 9:09 a.m. - Got Joyce to the bathroom. Joyce in pain. Joyce says that her leg would not move. 9:39 a.m. - Joyce returned from bathroom, no bowel movement. 9:50 a.m. - Breakfast (banana, baby bell cheese round, 2 slices of toast with jam).  10:51 a.m. - Craig checked back in on Joyce. Joyce had finished her entire breakfast 12:20 p.m. - Dusty arrived to farmhouse, found Joyce asleep, hunched over in her recliner without oxygen line in place. 12:21 p.m. - BP 153/93, pulse 73. BGL @ 216. 12:40 p.m. - Joyce soiled herself in her recliner (type 6 bowel movement) without warning. Recliner and wheel chair's disposable pads replaced. Joyce showered and given fresh clothes. Joyce's shoes sanitized. Bathroom sanitized. Hallway flooring sanitized. Returned to recliner by 1:50 p.m. 2 p.m. - Lunch (2 strawberry waffles with butter & syrup, 1/2 can of peaches, Earl Grey tea...

8 a.m. - Jess arrived to the farmhouse to find Craig visiting with Joyce. 8:10 a.m. - Joyce reporting pain in her left leg. Joyce could not give a number on the pain scale when asked. Jess attempted to use the visual pain guide chart on her phone instead of numbers to get a reading on Joyce's pain levels - Joyce said the pain was at ~8 out of 10. 8:12 a.m. - Tiger Balm patch applied to Joyce's left knee. 8:19 a.m. - BP 155/86, pulse 68. BGL @ 139. 8:30 a.m. - Morning medication administered with nutritional shake.  8:35 a.m. - Breakfast (1 slice toast with peanut butter and apricot jam, banana). Joyce stated she did not have much of an appetite due to pain levels being so high.  9:26 a.m. - Bathroom trip. Urinary incontinence. New diaper and diaper pad insert. Remainder of urine passed. Joyce gassy - expecting bowel movement soon. 9:50 a.m. - Urgent bathroom trip - Joyce suddenly panicky in chair stating "it's coming out!" as she soiled herself. Jess spoke calmly ...

7:31 a.m. - Bathroom trip with Craig, returned to recliner by 7:53 a.m. 8:10 a.m. - Jess arrived to farmhouse. Craig still on-site. Joyce awake without oxygen line in place. 8:12 a.m. - BP 173/70, pulse 69. BGL @ 155. 8:36 a.m. - Morning medication administered with nutritional shake. Joyce informed Jess she prefers the chocolate nutritional shakes versus the vanilla shakes but the vanilla ones were not bad. (Vanilla shakes were all that was in stock at time supplies for farmhouse were purchased by Dusty.) 8:40 a.m. - Breakfast (1 slice whole wheat toast with egg, banana). Breakfast finished by 9:10 .am. 9:33 a.m. - Bathroom. Urinary incontinence. Joyce only wearing a diaper and no pad. Disposable mat on recliner had evidence of previous accident occurring - Jess replaced it. Skirt changed. Remainder of urine and bowel movement (type 6) passed. Hemorrhoidal cream applied. Toilet seat riser and bathroom floor sanitized. Joyce returned to recliner by 10:10 a.m. 10:15 a.m. - Joyce stretch...

8:09 a.m. - Jess arrived to farmhouse to provide morning care for Joyce, finding Joyce in the bathroom. Urinary incontinence, Joyce had taken off her diaper and diaper pad insert. Remainder of urine passed. Jess assisted Joyce with cleanup. Hemorrhoidal cream applied. Joyce returned to recliner by 8:19 a.m. 8:23 a.m. - BP 170/83, pulse 77. BGL @154,  Joyce stated she was thirsty and was given a large glass of water. Jess was uncertain if the upcoming blood draw to be done by the Kindred staff this morning at the farmhouse was supposed to be one that required a fast so she did not feed Joyce food at this point just in case.  Joyce did not know who Jess was today but knew Jess' voice. Jess informed Joyce who Jess was and Joyce appeared to acknowledge. 9:08 a.m. - Debra (Kindred) arrived to farmhouse to take a blood draw from Joyce and recertify Joyce for continued in-home visits from Kindred.  Losartan added to Joyce's records (again). When Joyce was asked by Debra if she h...

Dusty and Jess arrived to farmhouse ~9:40 p.m., found Joyce awake in her recliner without oxygen line in place, reading weekend newspaper. Evidence that Joyce had taken herself to the bathroom at least once (bowel movement) since Dusty left last night. Dusty cleaned up mess Joyce created with fecal matter in the bathroom. 9:50 a.m. - BP 151/80, pulse 71. BGL @ 136. 9:54 a.m. - Morning medication with nutritional shake. 9:57 a.m. - Breakfast (McDonald's sausage biscuit, hash brown, small orange juice). Breakfast finished by 10:45 a.m. 11 a.m. - Enrichment activity (laundry folding) started. Joyce talkative and responsive to interrogatives.  11:09 a.m.- Craig and Carol arrived to visit. Carol updated Dusty that Kindred contacted her on Friday and would have a nurse arrive to do a blood draw on Joyce "early on Monday." Concern over reported "black" stool Joyce passed is what prompted blood draw to be done.  11:26 a.m. - Joyce yelped suddenly, reported "ouchie ...

Dusty arrived to farmhouse ~9:10 a.m. after treating Jess' migraine and picking up supplies for farmhouse. Craig already on-site and assisted with carrying in items. Craig reported that Joyce had already taken herself to the bathroom when he arrive to farmhouse and as she was awake he took her blood pressure levels and provided her morning medication for today. 8:52 a.m. - BP 138/70, pulse 84. 9:30 a.m. - Breakfast (1 slice whole wheat toast with butter, 1 cup Earl Grey tea, 1/2 banana, omelet with ham, onion, cheese, peppers). Joyce ate very slowly. Joyce began falling asleep while eating breakfast. Joyce began complaining that there was too much food in front of her. Joyce abandoned eating breakfast ~10:10 a.m., ate only 1/2 slice of toast and 1/4 of omelet. Joyce began going through her purse as Dusty put away her breakfast leftovers, finishing emptying and repacking it by 10:55 a.m. Began napping. Noon - Bathroom trip and lunch refused. Napping resumed. 1 p.m. - Bathroom trip a...

8:15 a.m. - Bathroom trip. Joyce still confused but was able to get out of her chair and off the toilet with minimal help. 9 a.m. - Breakfast (1 banana, 1 baby bell cheese round, 1 slice of toast with jam). Morning medication. Breakfast finished by 10:05 a.m. 10:30 a.m. - Bathroom. Urine passed. Diaper pad insert replaced. Joyce able to travel to and from bathroom under her own power. Joyce was not as confused as she was this morning. 12:30 p.m. - Lunch (bologna sandwich with cranberry juice). 2 Tylenol. Lunch finished by 1 p.m. 1:30 p.m. - Bathroom trip without incident. Minor early bladder release. Joyce able to walk to/from bathroom under her own power with minimal help. Joyce's mind was still a little fuzzy but improved over all compared to earlier in the day. 6 p.m. - Bathroom trip. 6:30 p.m. - Dinner (hamburger, Dorito chips). Evening medication. 8:30 p.m. - Bathroom trip without incident. Hemorrhoid cream applied. 9 p.m. - Ready for bed.

8:30 a.m. - Dusty arrived to farmhouse to provide morning care for Joyce (Jess down with a severe migraine). Joyce found awake in her recliner laid back in a prone position, no blankets on, oxygen line not in place. Joyce semi-responsive to verbal interrogatives, delayed responses and long processing times. 8:35 a.m. - BP 159/77, pulse 71. BGL @ 131. 8:38 a.m. - Morning medication administered with nutritional shake. 8:50 a.m. - Pill cups refilled for remainder of today and tomorrow. Nabumetone prescription refill order placed with Wal-Mart pharmacy. Dusty will pick up on Saturday when it is ready. 8:58 a.m. - Bathroom trip. Urinary incontinence. Does not appear that Joyce got up at all during the night - heavy urine saturation in diaper, diaper pad insert, skirt, and disposable chair pad. Diaper and diaper pad insert replaced.  Joyce could not stand under her own power but was able to walk into bathroom very slowly (and unstable).  Garbage bags emptied. Disposable chair mat r...

Craig covered morning care for Joyce while Jess was out at dental appointment and Dusty was being COVID-19 tested. 8 a.m. - Breakfast. Joyce ate very slowly. Dusty arrived to farmhouse ~12:25 p.m., found Joyce in bathroom with Courtney in attendance. Dusty assisted with cleanup of Joyce. Urine and small type 1/5 bowel movement passed. Joyce unable to rise up from toilet or remain standing independently under her own power. Preparation H applied. Dusty moved Joyce to sitting position on her walker and wheeled her out to kitchen, transitioning her to recliner with difficulty by ~1:45 p.m. Bathroom sanitized. Lunch negotiated. Courtney relayed that Craig provided morning medication to Joyce. Courtney remained onsite at farmhouse to monitor Joyce when Craig departed earlier in the morning. Courtney departed shortly after Joyce was returned to recliner, informed Joyce that she would most likely return this evening with Carol to provide evening care. 12:58 p.m. - BP 158/75, pulse 66. BGL @ 1...

Dusty returned to farmhouse ~12:58 p.m. after taking Jess to work and picking up additional bag of diaper pad inserts from Walgreens. Joyce found to be awake in her recliner, sitting upright, without oxygen line in place or blankets on. Joyce able to communicate verbally, stated that she had had a dream. Dusty negotiated lunch with Joyce after initial refusal. 1:15 p.m. - BP 159/84, pulse 69. BGL @ 125. 1:18 p.m. - Lunch (bologna sandwich with mustard and mayonnaise, whole banana, nutritional shake). 2 Tylenol. Lunch finished by 1:58 p.m. Dishwasher emptied and dishes put away. Laundry processed.   Joyce began napping after lunch. Joyce woke from napping ~3:30 p.m. and started flipping through a binder from the bookshelf next to her recliner. 4:15 p.m. - Bathroom trip. Joyce unable to stand on her own. Dusty assisted Joyce into standing position and Joyce was able to walk into bathroom with extreme difficulty. Severe urinary incontinence, early bladder release upon standing in...