The Official Joyce Update Blog

Dusty arrived to farmhouse ~9:38 a.m. after picking up supplies for farmhouse. 9:40 a.m. - Joyce found in bathroom, lights off, using toilet. Urinary incontinence. Remainder of urine passed. Diaper and pad replaced. Evidence Joyce had taken herself to bathroom at least twice since Dusty departed last night - evidence of bowel movement, Dusty assisted in cleaning Joyce up.  Joyce has no recollections of being out of her chair so far today. Joyce cannot recall having nightmares. Joyce declined PT walk, citing fatigue. Joyce unsure where she was, had to be reminded she was in her farmhouse. Joyce did not know which way to go to return to her recliner. 9:54 a.m. - BP 160/82, pulse 76. BGL @ 122. 10:20 a.m. - Morning medication with nutritional shake. 10:28 a.m. - Breakfast (chocolate chip muffin, avocado toast, 1/2 can peaches). Joyce ate very slowly, finishing by 11:40 a.m. Joyce began napping after breakfast.  12:33 p.m. - Joyce woke herself up from napping. Joyce did not rememb...

8:40 a.m. - Craig reported that Joyce went to bathroom, returning to recliner by 9:02 a.m. This was at least Joyce's second bathroom trip this morning. 9:10 a.m. - Dusty arrived to farmhouse, Craig on-site. Joyce awake in recliner with oxygen line in place. 9:12 a.m. - BP 152/79, pulse 73. BGL @ 139. 9:16 a.m. - Morning medication with nutritional shake. 9:22 a.m. - Breakfast (watermelon cubes, avocado toast, Baby Bell cheese wheel, whole banana). Finished by 10:34 a.m. 10:35 a.m. - Bathroom trip. Urinary incontinence. Early bladder release. Remainder of urine passed. Joyce showered under protest, very angry with Dusty as she felt she had been tricked. Joyce upset that Dusty was "throwing off her morning routine" and preventing her from "working on projects that she had planned to do." Shoes sanitized. Bathroom sanitized. Weight 160.6 lbs. PT walk to living room, returned to recliner by 11:14 a.m. 11:45 a.m. - Carol arrived to provide lunch for Joyce. Dusty and ...

7:55 a.m. - Craig on-site, Joyce started first bathroom trip of the day. Returned from the bathroom ~8:14 a.m. 8:20 a.m. - Jess arrived to farmhouse, finding Joyce in her recliner with oxygen line in place. Joyce reported that she had bad dreams last night but not nightmares (her words).  8:26 a.m. - BP 136/83, pulse 79. BGL @ 147. 8:40 a.m. - Morning medication with nutritional shake. Breakfast declined. Jess pressed the issue and informed Joyce that she needed to eat. 8:50 a.m. - Breakfast (egg sandwich and whole banana). Jess had to coach Joyce to stay awake and eat her breakfast. Joyce constantly fell asleep and zoned out during breakfast. Finished breakfast ~9:50 a.m. after many starts and stops due to sleepiness. 9:51 a.m. - Joyce went right to sleep after refusing bathroom trip. Jess departed soon afterward. 2:18 p.m. - Dusty arrived to farmhouse, finding Joyce on her way to bathroom. Craig on-site.  Urinary incontinence. Early bladder release. Remainder of urine passed...

7:55 a.m. - Dusty arrived to farmhouse. Craig already on-site, reported that Joyce told him that she woke ~5 a.m. and took herself to the bathroom at that time. Joyce awake in her recliner without oxygen line in place, visiting with Craig. 8 a.m. - BP 160/99, pulse 84. BGL @ 135. 8:06 a.m. - Bathroom trip. Urinary incontinence. Early bladder release. Remainder of urine passed. Bathroom sanitized. Joyce's shoes sanitized. Joyce showered. High amount of flatus passed by Joyce in shower while bathing and drying. Joyce declined needing to use toilet.  Weight 159.4 lbs. PT walk to living room, Joyce returned to recliner by 8:48 a.m. 8:52 a.m. - Morning medication administered with nutritional shake. 8:59 a.m. - Breakfast (donut, whole banana, Baby Bell cheese wheel, glass of apple peach mango juice). Finished by 9:49 a.m. 9:49 a.m. - Rush to bathroom. Urinary incontinence - remainder of urine and Type 5/Type 6 bowel movement passed. Diaper pad replaced. PT walk to living room, returning...

8:03 a.m. - Jess arrived to farmhouse and found Joyce in the bathroom. Urinary incontinence. Jess stopped Joyce from putting on a new diaper pad insert into a wet diaper. Joyce did not notice the diaper was wet until Jess made Joyce stop and inspect the diaper. Joyce returned to recliner by 8:10 a.m. Bathroom sanitized. 8:13 a.m. - BP 167/87, pulse 75. BGL @ 132. 8:25 a.m. - Morning medication with nutritional shake. 8:30 a.m. - Breakfast (microwave egg sandwich, banana). Joyce very unfocused on eating. Joyce reported that she had a nightmare last night and woke up around 5 a.m. and was awake ever since. Joyce remembers Connie having issues printing something last night. 9:30 a.m. - Joyce reporting she has a small headache. 9:40 a.m. - Joyce wants to nap. Bathroom trip refused. Jess heading out. 12:19 p.m. - Dusty arrived, finding Joyce asleep in her recliner with her oxygen line in place. Joyce claimed that she had not been fed or even gotten out of her chair all day. Joyce declined b...

8:03 a.m. - Jess arrived, found Joyce awake with her oxygen line in place. Joyce was reading the stencils for decorating the flower pots that Connie had gotten for her as an enrichment activity. Joyce reported that she hadn't had any nightmares and had slept well. 8:30 a.m. - Morning medication with nutritional shake. 8:32 a.m. - BP 149/80, pulse 71. BGL @ 126. 8:37 a.m. - Breakfast (egg in toast, banana). Finished by 9:05 a.m. 9:35 a.m. - Bathroom. Bowel incontinence (type 7). New diaper and diaper pad insert. Jess had to coach Joyce to not wipe herself every two seconds as it was most likely irritating her skin. Bathroom sanitized. Barrier cream applied. Joyce returned to recliner by 10:10 a.m. 10:35 a.m. - Joyce setup to nap in recliner. 12:38 p.m. - Dusty arrived to farmhouse, finding Joyce asleep in her recliner. 12:40 p.m. - BP 114/62, pulse 66. BGL @ 176. 12:45 p.m. - V8 Juice. 2 Tylenol and cranberry supplement. 12:47 p.m. - Lunch (chicken tenders, peach pie slice, watermel...

5:52 a.m. - Dusty arrived to farmhouse, finding Joyce asleep in her recliner without oxygen line in place. Joyce woke easily but struggled to gain coherence about her environment and what was going on. Joyce did remember that she had appointments in Moscow today unprompted. 6:11 a.m. - BP 123/69, pulse 69. BGL @ 132. 6:30 a.m. - 1st barium sulfate contrast drink started. 6:40 a.m. - Morning medication administered. 7 a.m. - 1st barium sulfate contrast drink finished. 7:20 a.m. - Bathroom trip. Joyce was confused when coaxed to rise up from recliner - didn't know how to get to the bathroom "in this place." Joyce knew who Dusty was but did not know until reaching bathroom where she was overall. Urinary incontinence, early bladder release. Bathroom floor and toilet seat riser sanitized. Remainder of urine passed along with type 5 bowel movement. Joyce cleaned up and given new diaper and diaper pad. Barrier cream applied. Craig arrived to farmhouse while Joyce using bathroom....

8:12 a.m. - Dusty arrived to farmhouse. All lights off in the kitchen and recliner empty. Dusty could not initially locate Joyce. Joyce found in bathroom, in the dark, and had pulled her walker all the way into bathroom behind her and out of line of sight when Dusty walked down hallway looking for her in her bedroom and living room. Joyce semi-conscious, appearing to have half fallen asleep on toilet in processing passing a bowel movement and/or self-clean up. Joyce had soiled herself in her recliner and taken herself into the bathroom, but could not recall how long she had been in there. Recliner cover replaced. Disposable pad replaced. Remainder of type 5 bowel movement and urine passed. Shoes and bathroom sanitized. Joyce showered. Joyce whimpering and yelping as she sat/moved/stood/walked, citing pain in her left knee. Weight 160.4 lbs.  PT walk attempted then aborted due to pain in Joyce's left knee, returned to recliner by 9 a.m. 9:02 a.m. - BP 181/87, pulse 74. BGL @ 134. Br...

8:51 a.m. - Craig arrived to farmhouse, finding Joyce in the bathroom. Joyce returned to her recliner by 9:01 a.m. 9:10 a.m. - Morning medication with nutritional shake. 9:26 a.m. - Craig departed farmhouse. 9:45 a.m. - Dusty arrived to farmhouse after running errands for Jess in Moscow and picking up supplies for farmhouse. Joyce found slumped forward over her knees, asleep in chair with oxygen line in place. 9:51 p.m. - BP 144/77, pulse 74. BGL @ 158. 9:54 a.m. - Breakfast (toast with avocado spread, orange cranberry muffin, small glass of apple peach mango juice). Breakfast finished by ~11 a.m. Joyce began napping off and on. 12:30 p.m. - Lunch declined. Bathroom trip declined. Enrichment activity - folding laundry. 1:30 p.m. Bathroom trip declined. Lunch declined. Napping resumed. 3:16 p.m. - BP 134/78, pulse 69. BGL @ 156. Lunch declined. Bathroom trip declined. 3:30 p.m. - Lunch (hamburger with cheddar cheese, potato salad, V8 juice). 2 Tylenol, cranberry supplement. Lunch finish...

8 a.m. - Jess arrived and found Joyce awake in her recliner without oxygen line in place. Joyce reported no nightmares. 8:06 a.m. - BP 156/82, pulse 77. BGL @ 148. 8:12 a.m. - Morning medication with nutritional shake. 8:16 a.m. - Breakfast (McDonald's sausage & egg biscuit, hash brown, small orange juice). Finished by 8:44 a.m. 8:55 a.m. - Bathroom trip. Urinary incontinence. Diaper and diaper pad heavily saturated - Joyce may not have take herself to bathroom at all during the overnight hours. Early bladder release. Remainder of urine passed. Bathroom sanitized. Barrier cream applied. Returned to recliner by 9:10 a.m. 9:50 a.m. - Joyce had been napping since returning to recliner from bathroom trip.  12:57 p.m. - Dusty arrived to farmhouse after picking up her CT Contrast from Gritman Medical Center for Monday's CT Scan appointment. Contrast bottles placed into farmhouse refrigerator. Joyce found awake in her recliner without her oxygen line in place. BP 137/61, pulse 74....

7:48 a.m. - Dusty arrived to farmhouse (covering for Jess who is down with migraine). Craig already on-site. Joyce awake in recliner without oxygen line in place. BP 138/81, pulse 77. BGL @ 150. Bathroom trip declined, Joyce wants to eat breakfast first. 7:52 a.m. - Morning medication and nutritional shake. 8:02 a.m. - Breakfast (donut, whole banana, Baby Bell cheese wheel, apple peach mango juice with Miralax added). Breakfast finished by ~9:10 a.m. Bathroom trip declined. Dusty preparing to return to campus for work. 9:19 a.m. - Joyce soiled herself in her recliner. Assisted to bathroom by Dusty and cleaned up. Remainder of type 5 bowel movement and urine passed. Joyce in agitated state, did not follow verbal directions from Dusty and made bigger mess. Joyce showered under protest. Laundry started. 159.2 lbs.  PT walk to living room before returning to recliner by 10:35 a.m. 11 a.m. - Joyce stretched out to nap, Dusty heading to campus for work. Will return early afternoon to fix...

8:05 a.m. - Jess arrived to farmhouse. Craig already on-site. Joyce awake with oxygen line in place. Joyce had reported to Craig that she had been to the bathroom "at some point" during the night. No nightmares reported. 8:10 a.m. - BP 145/66, pulse 74. BGL @ 127. Joyce "very out of it." Joyce is zoning out and not talkative. 8:30 a.m. - Morning medication and nutritional shake. 8:35 a.m. - Breakfast (4 small pancakes and whole banana). Finished by 9:15 a.m. 9:25 a.m. - Bathroom trip. Urinary incontinence. Early bladder release. Remainder of urine passed. New diaper and diaper pad insert. Barrier cream applied at Joyce's request. Toilet seat and floor sanitized. PT walk to living room. Returned to recliner by 9:38 a.m. 9:55 a.m. - Joyce setup to nap. 11:48 a.m. - Dusty arrived to farm, finding Joyce awake in recliner without oxygen line in place (nasal ports of canula blowing into her left ear).  BP 117/55, pulse 78. BGL @ 249. 12:02 p.m. - Lunch (V8, orange Jel...

7:55 a.m. - Dusty arrived to farmhouse. Craig on-site. Joyce using bathroom, sitting in the dark unaccompanied (urine passed, Type 1 bowel movement).  Joyce showered. Weight 160.4 lbs. PT walk to living room. 8:56 a.m. - BP 164/86, pulse 79. BGL @ 119. 9 a.m. - Morning medication with nutritional shake. Breakfast (donut and whole banana). 9:30 a.m. - Bathroom trip without incident. Urine passed. 9:40 a.m. - Departed farmhouse for footcare appointment at Palouse Foot & Ankle with Dr. Capawana.  10 a.m. - Joyce's toenails trimmed, feet appear to be in good health. No diabetic extremity concerns. Next appointment set for May 4, 2021 at 11 a.m. Dusty will update appointment calendars and request time off to cover taking Joyce. 10:15 a.m. - Bathroom trip declined while preparing to depart doctor's office. 10:23 a.m. - Joyce soiled herself in the car. 10:40 a.m. - Craig assisted with getting Joyce into farmhouse. Bathroom (urine and remainder of Type 6 bowel movement passed)....

8:58 a.m. - Dusty and Jess arrived to farmhouse. Craig already onsite. Joyce was just returning from using the bathroom. BP 165/83, pulse 78. BGL @ 139. 9:05 a.m. - Morning medication with nutritional shake. 9:15 a.m. - Breakfast (donut, whole banana, apple peach mango juice). 1:15 p.m. - Bathroom. Urinary incontinence. Early bladder release. Remainder of urine passed along with large amount of flatus. Shower declined. Diaper and diaper pad insert replaced. Barrier cream applied - open pressure sore on buttock (right cheek) - Joyce appears to have torn/picked it open. Bathroom sanitized. PT walk declined. 2:20 p.m. - Lunch (fish filets, mashed potatoes, V8 juice). 2 Tylenol. 3:30 p.m. - Lunch finished, Joyce began napping off and on. 6:15 p.m. - Bathroom trip. Bowel movement passed. 7 p.m. - Dinner (meatloaf, scalloped potatoes, French cut green beans). Evening medication. All of meal eaten. 7:58 p.m. - Bathroom trip. 8:25 p.m. - Craig departed for home, Joyce left sleeping. --- Joyce...

8:35 a.m. - Joyce just finished using the bathroom. 9:10 a.m. - Breakfast (3 blueberry pancakes, 1 small coffee). Breakfast finished by 10:15 a.m. 10:45 a.m. - Bathroom trip, cleaned up from morning bowel movement. 11:05 a.m. - Joyce napped, only dozed off and on until ~noon then finally went to sleep. 12:48 p.m. - Joyce woke up. 1:06 p.m. - Bathroom trip. Urinary incontinence. Diaper and diaper pad insert replaced. 1:35 p.m. - Lunch (macaroni & cheese, 1/2 cookie, V8 juice, banana). 3:40 p.m. - Bathroom trip. Urinary incontinence. Diaper and diaper pad insert replaced. 4 p.m. - Joyce left watching television and looking at stencils. 6 p.m. - Bathroom trip. Urinary incontinence. Diaper pad insert replaced. 6:30 p.m. - Dinner (salmon patty, sweet potatoes, green beans, cottage cheese, bread, cupcake). Evening medication. 8:20 p.m. - Bathroom trip. Urinary incontinence. Diaper pad insert replaced. 8:30 p.m. - Ready for bed.

7:59 a.m. - Joyce found awake, stated that she has not taken herself to the bathroom yet. 8:49 a.m. - BP 138/67, pulse 79.  Breakfast (2 pieces toast with jam, Baby Bell cheese wheel, banana). Nutritional shake with morning medication. Breakfast finished by 9:10 am. Socks put onto Joyce. Noon - Bathroom trip. Diaper pad insert changed. PT walk to living room. 12:30 p.m. - Lunch (tuna fish sandwich, Baby Bell cheese wheel, banana). Mid-day medication. 2 p.m. - Bathroom trip without incident.  PT walk to living room. 4 p.m. - Connie arrived to provide evening care for Joyce. Joyce found awake with oxygen line in place. 4:11 p.m. - Bathroom trip without incident. 6:30 p.m. - Dinner (spaghetti and garlic toast). Phil arrived to join Connie and Joyce for dinner. Dinner finished by 7:23 p.m. 7:30 p.m. - Bathroom trip. Urinary incontinence. Diaper pad insert replaced. 9:10 p.m. - Bathroom trip without incident.

8:30 a.m. - Jess arrived to farmhouse. Joyce found to be asleep, slumped forward and almost falling out of her recliner. No oxygen line in place. Took a bit to wake her up. 8:33 a.m. - BP 140/77, pulse 72. BGL @ 138. Talked about the bad dreams from the night before last. Joyce was much calmer today. No nightmares reported last night. 8:45 a.m. - Bathroom. Urinary incontinence, early bladder release. Remainder of urine passed. New diaper and diaper pad insert. Toilet seat riser sanitized. Returned to recliner by 9:05 a.m. 9:25 a.m. - Morning medication with nutritional shake. 9:30 a.m. - Breakfast (eg in toast and banana). Breakfast finished by 10:10 a.m. 12:58 p.m. - Dusty arrived to farmhouse and found Joyce asleep in her recliner with oxygen line in place. Joyce was very drowsy and difficult to wake. BP 117/63, pulse 69.  1:05 p.m. - Lunch (soft taco with ranch dressing). Joyce continuously fell asleep while trying to eat her lunch, even with Dusty sitting beside her and shaking...

7:58 a.m. - Craig arrived on-site at farmhouse and found Joyce had just returned from bathroom, appearing very weak. Craig suspecting that Joyce had been in the bathroom for an extended period of time. Unable to determine when Joyce had gone into the bathroom. 8:15 a.m. - Dusty arrived to provide morning care coverage in Jess' stead due to injury sustained. Joyce and Craig in kitchen, visiting. Joyce had changed out of the clothes Dusty had put her into yesterday following showering, having folded them up and put them onto her walker. Joyce had gotten into her closet for a dress sweater and shirt (or possibly took them from the Goodwill donation sort pile) and changed herself at some point. Joyce denied having any bodily fluid accidents and reason for changing clothes and could not articulate when questioned why or when she had changed clothes. Potential cause for exhausted state Craig found Joyce to be in upon his arrival. 8:19 a.m. - BP 153/84, pulse 74. BGL @ 147. 8:25 a.m. - Br...

8:12 a.m. - Jess arrived to farmhouse, finding Joyce awake without her oxygen line in place. Joyce did not know who Jess was and did not know that Jess arrives every week day morning to make her breakfast and take care of her. 8:15 a.m. - Bathroom. Urinary incontinence, early bladder release - remainder of urine passed. New diaper and diaper pad. Returned to recliner by 8:23 a.m. 8:30 a.m. - BP 150/89, pulse 77. BGL @ 135. 8:35 a.m. - Morning medication (minus Tramadol, Dusty acquiring today if pharmacy refills) with nutritional shake.  8:40 a.m. - Breakfast (egg sandwich and banana). Jess had to keep encouraging Joyce to eat her meal. Breakfast finished by 9:35 a.m. 9:40 a.m. - Jess noticed that Joyce is showing signs of being in pain but Joyce would not self-report pain when asked. Jess had to keep asking Joyce if she was in pain. Joyce reporting that her right knee (artificial replacement) is hurting today and her head is also hurting a bit. Jess applied a Tiger Balm patch to Jo...

8:13 a.m. - Jess arrived to farmhouse, finding Joyce awake and happy to chat. Craig already on-site and using telephone. Craig informed Jess that he had only been on-site 10 minutes prior to her arrival - Joyce had been awake in her recliner with her oxygen line in place when he arrived. 8:15 a.m. - BP 153/76, pulse 73. BGL @ 146. 8:25 a.m. - Bathroom trip. Urinary incontinence, early bladder release. Remainder of urine passed. New diaper and pad. Toilet seat riser and bathroom floor sanitized. Returned to recliner by 8:38 a.m. 8:50 a.m. - Morning medication with nutritional shake. 9 a.m. - Breakfast (microwaved egg sandwich and banana). Breakfast finished by 9:55 a.m. Joyce had to force herself to finish eating all of her banana. 12:30 p.m. - Dusty attempted to pickup refilled Tramadol prescription he called in on Sunday. Refill was declined. Dusty called Moscow Medical when pharmacist informed him that they could not refill without doctor's consent due to classification of the dr...

8:15 a.m. - Jess arrived to farmhouse, Craig already on-site. Joyce claims to have taken herself to bathroom before Craig arrived. Evidence Joyce had a bowel movement at some point since Dusty left last night. 8:19 a.m. - BP 136/67, pulse 73. BGL @ 155. Jess found a bottle of Aleve  on Joyce's shelves next to her recliner. Joyce became mad at Jess when this was taken from her. Joyce informed Jess that she had gotten it for herself and took Aleve yesterday morning before Dusty arrived to farmhouse. Jess had long talk with Joyce about taking medication without informing family caregivers. Jess removing bottle of Aleve from farmhouse so Joyce does not self medicate with it off the books again. 8:45 a.m. - Morning medication with nutritional shake.  8:48 a.m. - Breakfast (egg in toast, whole banana). Breakfast finished by 9:40 a.m. 9:45 a.m. - Bathroom. Urinary incontinence. Remainder of urine passed. Joyce was distressed at remainder of bowel movement in her diaper. Joyce cleaned...

8:55 a.m. - Dusty arrived, finding Joyce awake in her recliner and struggling with television remote. No oxygen line in place. Joyce claimed she had taken herself to the bathroom "much earlier" in the day. 9 a.m. - BP 153/75, pulse 76. BGL @ 122. 9:03 a.m. - Morning medication & nutritional shake. Breakfast (McDonald's sausage biscuit and whole banana). Ate slowly, kept falling asleep. Joyce extremely fatigued, slept throughout most of morning. Noon - Lunch refused, bathroom trip refused. 1 p.m. - Lunch refused, bathroom trip refused. 1:14 p.m. - BP 115/62, pulse 72. BGL @ 226.  2 p.m. - Lunch refused, bathroom trip refused. 3 p.m. - Joyce woke herself, asked Dusty if he would bring her dinner from town and buy groceries for the farmhouse. Dusty discussed with Joyce that the family was handling her groceries and that she didn't need to provide them with a list except for anything she might request special. Joyce expressed concern that she would be without "vi...

7:30 a.m. - Craig arrived to farmhouse, lights were turned on by Joyce at some point. Joyce sleeping in recliner. Craig woke Joyce to visit, Joyce could not recall when she had gotten up. 8:50 a.m. - Joyce found asleep in recliner, slumped over to far right, without oxygen line in place. Difficult to wake. BP 164/86, pulse 74. BGL @ 131.  8:58 a.m. - Bathroom trip. Urinary incontinence. Diaper and pad replaced. Urine passed and high amount of flatus expelled. Evidence that Joyce had taken herself to the bathroom at least once since 9:30 p.m. last night. Shower refused, citing fatigue. Joyce unstable/unbalanced and having difficulty standing (nearly toppled sideways with walker while dragging it behind her into bathroom). 9:11 a.m. - Morning medication with nutritional shake. 9:22 a.m. - Breakfast (omelet, whole banana, baby bell cheese wheel). Joyce extremely sleepy, kept falling asleep while eating. Napped after breakfast concluded. Bathroom trips and lunch declined at intervals, ...

7:25 a.m. - Craig arrived to farmhouse and found Joyce in bathroom. 7:30 a.m. - Joyce returned to her recliner.  8:30 a.m. - Jess arrived to farmhouse, finding Joyce awake in her recliner without oxygen line in place. 8:40 a.m. - BP 164/77, pulse 71. BGL @ 135. 8:45 a.m. - Morning medication with nutritional shake. 8:50 a.m. - Breakfast (cinnamon twist donut and whole banana). Breakfast finished by 9:30 a.m. 9:30 a.m. - Bathroom trip. Urinary incontinence. New diaper and diaper pad insert. Small bowel movement. Returned to recliner by 9:50 a.m. 12:30 p.m. - Dusty arrived to farmhouse, found Joyce asleep in recliner without oxygen line in place. Difficult to wake. Bathroom trip declined. Lunch declined. 12:35 p.m. - BP 123/76, pulse 69. BGL @ 199.  Lunch and bathroom trips continually declined, napping resumed. 3:34 p.m. - Bathroom trip. Urinary incontinence. Early bladder release. Toilet riser and bathroom floor cleaned. New diaper and diaper pad insert. Urine passed along wit...

7:45 a.m. - Craig arrived to farmhouse. Joyce had apparently been up and turned on all of the lights in the kitchen. Joyce reported she had woken up and taken herself to the bathroom ~ 6 a.m. 7:50 a.m. - Bathroom trip. Returned from bathroom unaided ~8:03 a.m. 8:07 a.m. - Jess arrived to farmhouse. Joyce reported that she had just returned to her recliner from using the bathroom and was getting settled. Oxygen line not in place. 8:10 a.m. - BP 153/77, pulse 75. BGL @ 136. 8:20 a.m. - Talked breakfast and not being interested in food. Joyce said that her lack of appetite recently was due to "just being tired." Joyce was asked if she had sores in her mouth again. Joyce said no. Joyce said that pancakes sounded good for breakfast today. 8:40 a.m. - Morning medication with nutritional shake. 8:45 a.m. - Breakfast (4 small pancakes and banana). Finished by 9:30 a.m. 9:35 a.m. - Bathroom. Urinary incontinence. New diaper and diaper pad insert. Remainder of urine passed. Barrier cre...

8:14 a.m. - Jess arrived. Joyce found sleeping in her recliner without oxygen line in place, slumped forward and almost falling out of her chair. 8:16 a.m. - BP 158/80, pulse 69. BGL @ 133. 8:25 p.m. - Morning medication with nutritional shake. 8:30 a.m. - Breakfast (McDonald's sausage, egg and cheese biscuit, hash brown). Joyce started eating very quickly and then halfway through eating started to fall asleep. Breakfast finished by 9:25 a.m. 9:35 a.m. - Bathroom. Urinary incontinence. Urine and type 4 bowel movement passed. Hemorrhoidal cream and barrier cream applied.  Joyce reporting that her left knee is hurting really bad today. Joyce able to return to recliner under her own power very slowly by 10:03 a.m. 10:07 a.m. - Joyce's legs elevated half way to help with leg swelling. Joyce very sleepy this morning. 12:21 p.m. - BP 119/59, pulse 74. BGL @ 209. 12:26 p.m. - Lunch (turkey sandwich with cheddar cheese, mayonnaise, mustard, whole banana, V8 juice). 2 Tylenol. Lunch fin...

Craig stopped by farmhouse to check in on Joyce. Joyce reported that she had taken herself to bathroom ~6 a.m. 8:03  a.m. - Jess arrived and found Joyce asleep with her oxygen line in place. 8:05 a.m. - BP 154/77, pulse 73. BGL @ 138. 8:10 a.m. - Joyce declined bathroom trip, stating she had taken herself to the bathroom about an hour ago. 8:12 a.m. - Bathroom trip without incident. Urine passed. Barrier cream applied. Returned to recliner by 8:21 a.m. 8:40 a.m. - Morning medication with nutritional shake. 8:45 a.m. - Breakfast (egg in toast, banana). Breakfast finished by 9:23 a.m.  Joyce appears to be losing interest in food again - nothing sounds appealing to her for eating. 9:54 a.m. - Joyce refused bathroom trip, continued napping. 11:29 a.m. - Debra (Kindred nurse) called Dusty's cellphone to schedule visit for Thursday. 12:54 p.m. - Dusty arrived to farmhouse and found Joyce asleep with oxygen line in place. BP 145/69, pulse 73. BGL @ 203. Lunch declined. 12:59 p.m. - B...

7:55 a.m. - Jess arrived to farmhouse finding Joyce in bathroom with her diaper off and bowel movement in progress. Type 5 bowel movement and urine passed. Hemorrhoidal cream and barrier cream applied. Returned to recliner by 8:20 a.m. 8:25 a.m. - BP 147/83, pulse 75. BGL @ 131. 8:30 a.m. - Nutritional shake and morning medication. 8:40 a.m. - Breakfast (McDonald's sausage, egg, & cheese biscuit and hash brown). Joyce fell asleep halfway through eating, Jess had to keep rousing her to finish. Breakfast finished by 9:30 a.m. 9:45 a.m. - Joyce refused bathroom trip. Returned to sleeping in her recliner. 12:45 p.m. - Dusty arrived to farmhouse, found Joyce asleep in recliner without oxygen line in place. Very difficult to rouse her from sleep. Bathroom trip declined. Lunch declined. 12:49 p.m. - BP 117/62, pulse 74. BGL @ 179. Worked on waking Joyce up and negotiating lunch. 12:51 p.m. - 2 Tylenol with nutritional shake (drank half to get Tylenol down). Lunch (maple bar, whole ban...

8:47 a.m. - Joyce found awake without oxygen line in place, claimed that she had just returned from a bathroom trip but could not recall how long ago that was. 8:51 p.m. - BP 124/68, pulse 75. BGL @ 145. 8:55 a.m. - Morning medication administered with nutritional shake. 8:59 a.m. - Breakfast (donut, watermelon). Finished by 10 a.m. Bathroom trip declined. Napped, citing fatigue. 1 p.m. - Lunch declined. Bathroom trip declined. 1:30 p.m. - Lunch declined. Bathroom trip declined. 1:31 p.m. - BP 126/72, pulse 67. BGL @ 188. 4:07 p.m. - Bathroom trip. Urinary incontinence. Remainder of urine passed. Showered and fresh clothes. Weight 159.2 lbs. Returned to recliner by 4:44 p.m. after PT walk. 5 p.m. - Dinner declined, began napping citing fatigue. 6 p.m. - Dinner declined, bathroom trip declined. 6:11 p.m. - BP 128/67, pulse 67. BGL @ 130. 6:20 p.m. - Dinner (butternut squash ravioli, 1/2 can of peaches).  7:15 p.m. - Evening medication with nutritional shake. 7:26 p.m. - Bathroom tri...

8:31 a.m. - Joyce found awake with out oxygen line in place. Bathroom trip declined, citing she had already taken herself to the bathroom prior to Dusty's arrival. 8:32 p.m. - BP 164/80, pulse 78. BGL @ 117. 8:33 a.m. - Morning medication with orange juice. 8:41 a.m. - Breakfast (McDonald's sausage & egg biscuit, hash brown). 10:25 a.m. - Bathroom trip without incident. Urine passed. PT walk. Returned to recliner by 10:35 a.m. Enrichment activity (folding laundry, coloring). Napped. Noon - Bathroom trip declined, lunch declined citing fatigue and lack of appetite. 2:29 p.m. - BP 119/69, pulse 66. BGL @ 110. 2:38 p.m. - Lunch (leftover Panda Express - teriyaki chicken breast and noodles). 2 Tylenol. Finished by 4:21 p.m. 5:45 p.m. - Bathroom - Urinary incontinence, early bladder release. Remainder of urine passed. Bathroom floor and toilet seat riser sanitized. Diaper and diaper pad insert replaced. PT walk to living room, returning to recliner by 6:04 p.m. Napped. 9:04 p.m....