General Update #267 - Tuesday, January 5, 2021

7:49 a.m. - Craig called Dusty's cell to provide update on Joyce's condition from last night. Informed Dusty that Joyce had difficulty in getting off of toilet at end of day and had to be picked up and helped out to kitchen and made ready for bed.

7:52 a.m. - Dusty called his director and obtained permission to work remote at the farm today to assist with care for Joyce following Craig's phone call.

8:25 a.m. - Jess and Dusty arrived to the farmhouse, finding Joyce asleep in her recliner with oxygen line in place. Joyce leaning so far forward in recliner that she was almost falling out of recliner.

8:35 a.m. - BP 173/67, pulse 100. BGL @ 158.

Joyce reports that she does not know how her bottom feels for soreness or constipation. Joyce lethargic and non-responsive to verbal interrogatives. Joyce was unable to figure out which finger had been poked to collect BGL, had to be directed which one to apply pressure to to stop bleeding. Joyce not comprehending words being spoken to her - Jess asked Joyce to give hand signs (thumbs up) if Joyce could understand questions or sentences being stated...no response from Joyce. Joyce just smiled and blinked slowly, not comprehending. 

Joyce did not drink the small glass of Pepsi Dusty gave her yesterday for her lunch, or the Miralax mixed with water. Jess dumped the Pepsi, gave Joyce the Miralax water to finish. 

Dusty discovered that he had a voicemail left by Andrew (Kindred) stating that he would be out to see Joyce yesterday around noon (Dusty had missed him due to work schedule and arrival time to farm and Andrew attempting to schedule visit on day of instead of day prior). Andrew collected a urine sample from Joyce at that time and submitted it to Gritman for processing along with concerns over her high blood pressure readings being submitted to Moscow Medical. Dusty was unaware Andrew had been to farmhouse - no note left. Dusty called Andrew and confirmed visitation information from yesterday.

8:50 a.m. - Dusty called the Kindred main office after getting in touch with Andrew to confirm where Joyce's urine sample had been taken for processing, main office did not have that information - suggested Dusty contact Dr. Collins' office to clear up confusion on communications. Dusty confirmed that Andrew had arrived yesterday to the farmhouse and had the UA order put in after seeing Joyce. Dusty called Moscow Medical and left message for Wendy (who was with a patient at time Dusty called), noting that Kindred had already collected the urine sample from Joyce and had sent it to Gritman or Moscow Medical labs for testing (most likely Gritman according to Kindred's office clerk). 

8:50 a.m. - Medication administered, completed taking all pills by 8:57 a.m. Lorsartan added to morning medication. Pills were difficult for Joyce to swallow.

8:57 a.m. - Dusty returned voicemail left by Jamie at NW Respiratory. Wheel chair is ready to be picked up. Paperwork and a form of payment will need to be provided. Dusty confirmed he would work with his sisters-in-law who are handling Joyce's finances and coordinate payment information/billing information with them to have account setup on file for Joyce. Pickup and paperwork signing date and time to be determined. NW Repiratory will own the wheel chair for the first 13 months of the rental, as NW respiratory owns the chair - let NWR know if Joyce goes into hospital or long-term care facility and they will pause the rental agreement, then will resume it once family lets them know Joyce is out of the hospital or long-term care facility. - seat cushion and cushion provided as well as part of order. Jamie working on calculating deductible and other information. 

Joyce had difficult time expressing what she desired for breakfast to Jess while Dusty was on telephone. 

8:59 a.m. - Breakfast (toast with butter and apricot jam, whole banana). Breakfast finished by 9:20 a.m. 

9:20 a.m. - Bathroom trip declined. Jess negotiated a trip to bathroom to occur at 10 a.m., Joyce able to respond verbally on intermittent basis.

9:53 a.m. - Scam phone call to farmhouse landline intercepted by Dusty. Woman claiming to be part of "Police Officer Defense Alliance" group and wanting donation money from Joyce again who apparently previously donated? Dusty informed them to remove Joyce from the call list. Dusty submitted fraud report to https://reportfraud.ftc.gov/ on Joyce's behalf.

10:05 a.m. - Robocall to Joyce's landline intercepted by Dusty.

10:08 a.m. - Bathroom trip. Joyce struggling to stand up from recliner. Urinary incontinence, soaked through diaper and diaper pad insert. Legs swollen. Dusty and Jess worked to lift Joyce out of recliner together, used powered recliner to help stand Joyce up. Old wheel chair used to move Joyce to bathroom. Dusty and Jess worked together to lift Joyce from wheel chair and remove soiled clothing and diaper, then seat Joyce onto toilet seat riser. Early bladder release. Strong odor from urine. Joyce passed remaining urine and small type 1/5 bowel movement. Shoes sanitized. Bathroom floor sanitized. Sink sanitized. 

Jess called into her director to notify them she would be late in arriving. 

11:28 a.m. - Moscow Medical receptionist called farm's landline, notified Dusty that the urine sample taken by Andrew (Kindred) yesterday had been sent to Gritman. Results from the culture should be received and reviewed by Dr. Collins within 4 days.

Joyce showered with difficulty. Fresh clothes. Jess and Dusty had to assist Joyce in exiting shower, used wheel chair to move back to recliner by 11:41 a.m. Weight unable to be taken due to Joyce's instability. Compressions stockings put onto Joyce.

11:54 a.m. - Dusty taking Jess to SRC for her work shift, then returning to farm to continue care for Joyce. Dusty contacted his director and informed her he would remain on-site at farm for remainder of his work day. Dusty will remain at farmhouse until Connie arrives to provide evening care for Joyce.

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Losartan (25 mg) added to Joyce's morning medications per Dr. Collins to reduce high blood pressure, protect kidney function in diabetic patients, and to lower the chance of stroke for people with high blood pressure and certain heart problems.

Additional supplemental information for today will be added via next blog post.

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