General Update #289 - Tuesday, January 26, 2021

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 to Goodwill. Joyce unhappy with the clutter and thought they should all be hung up in her closet until ready to be taken to donation. Dusty assured Joyce he would get it out of the living room today and into bags and should not be rehung into her closets.

Joyce expressed interested concern over the envelope on counter again during return to recliner. Dusty reminded her that it was not for her and she should leave it be. Joyce was concerned that if it was not for her it should be delivered to whoever it should go to. Dusty informed Joyce that Craig most likely had communicated to Derik that it was in the farmhouse waiting for him to retrieve.

Dusty departed farmhouse ~10:10 a.m. to head into work at his office on campus.

Dusty returned to farmhouse ~1:26 p.m., finding Joyce awake in her recliner without oxygen line in place. Farmhouse smelled strongly of bowel movement. Mess in bathroom, evidence Joyce had attempted to clean up herself. Joyce hesitantly informed Dusty she had just returned from bathroom trip after soiling herself when questioned. 

1:29 p.m. - BP 155/84, pulse 74. BGL @ 112.

Bathroom sanitized. Dusty started preparing Joyce for showering, much to her distress. Carole (Kindred nurse) called Dusty's cellphone to inform him she was ahead of schedule and would be arriving to farmhouse earlier than anticipated. 

2:04 p.m. - Carole (Kindred) arrived to farmhouse for weekly visit with Joyce. Confirmed she had been in contact with Moscow Medical and asked to review Tramadol effects on Joyce (good and bad, if any). Dusty confirmed that Joyce appeared to be more mobile and complaining less about pain. Noted her lethargy was still fairly high most days. Vitals taken - No fever (temperature 98.5 degrees Fahrenheit, oxygen levels at 96% with O2 line in place, BP 150/80, pulse 70. Confirmed that Joyce was not currently on a blood thinner. No neck pains, headaches, or dizziness reported by Joyce when asked. Joyce reported pain in both legs, but the left one more so than the right. Dusty confirmed Tramadol had run out and was on order with the pharmacy after it was renewed by Dr. Collins' office. Prescription was ready to be picked up tomorrow. Joyce self-reported her appetite to be "good." Urinary discharge and bowel movement log reviewed by Carole. Noted increased instances of bowel incontinence again and continued urinary incontinence and early bladder release issues when toileting. Carole inspected wound on Joyce's right side under her stomach fold above hip. Confirmed it is healing well and family is doing good on keeping it cleaned. Carole departed ~2:15 p.m.

Joyce declined lunch and expressed concerns about being showered. Dusty informed her that due to timing he no longer had availability to shower her. Joyce then felt like eating but was non-responsive to what was offered.

2:18 p.m. - Lunch (turkey sandwich with mayo, mustard, and cheddar cheese slices, V8 juice, small slice of lemon meringue pie). 2 Tylenol for pain relief. Dusty left Joyce eating lunch from her tray as she was reluctant to eat and he had to return to Moscow for 3 p.m. appointment on campus.

5:15 p.m. - Bathroom trip. Diaper and diaper pad insert replaced.

Enrichment activity - coloring.

6:26 p.m. - Dinner (tomato soup mixed with hamburger and macaroni noodles, 1 slice toast). Dinner finished by 7:03 p.m.

Dishwasher emptied.

8 p.m. - Evening medication.

8:30 p.m. - Bathroom trip. Skirt, diaper, and diaper pad insert replaced.

8:45 p.m. - Relaxation then bed time.

---

Joyce able to stand/sit and move about with little mobility issues today.

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