General Update #305 - Thursday, February 11, 2021

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. - Breakfast (McDonald's sausage, egg, and cheese biscuit with hash brown, cranberry juice). Morning medication administered.

Joyce expressed distaste for cranberry juice and articulated that this was why she has not been drinking it completely of late. Dusty will reach out to Dr. Collins office and confirm that adding cranberry as a dietary supplement in pill form would be acceptable.

Joyce became emotional while being setup with her breakfast tray and asked Dusty if he thought the medications that she was being given with each meal were capable of "causing mystic experiences." Dusty explored Joyce's concern pre-breakfast, working on calming her with Craig's assistance as Joyce began crying as she shared she had been "having mystic experiences," vivid hallucinations, and "voices telling her to do things." Joyce struggled to express what she had experienced and appeared quite upset or frightened (not frustration) as she tried to relay information throughout the conversation.

Craig departed farmhouse after Joyce was stabilized. Dusty sat and at his breakfast with Joyce, who continued to whimper and tearfully look around the kitchen.

Joyce abandoned breakfast at 9:48 a.m., still emotionally distraught. Dusty spent time visiting with Joyce, at her request, after contacting his supervisor to inform her he would be later than anticipated in arriving to work. Dusty confirmed that the voices were not coaxing her to do anything self destructive. Post-breakfast visit with Joyce revealed that she had been having nightmares of "unfamiliar people" "telling her what to do" around her house (example, getting after her to clean up her yard, or work on "stuff" that she was not doing). Dusty reassured her that nightmares were not real. Joyce very concerned about the "frequently happening" nightmares and if Dusty can ask the doctor for her how to make them stop occurring.

Joyce refused bathroom trip, opting to "just sit in [her] recliner and think about things for a while." Dusty departed farmhouse for work ~10:10 a.m. after calming Joyce from initial panic, reassuring her he would be back in a few hours to provide her lunch and midday care.

1:09 p.m. - BP 156/88, pulse 73. BGL @ 118.

Evidence Joyce had taken herself to bathroom and had a bowel movement after Dusty left at 10:10 a.m. Mess from Joyce attempting to self-clean was cleaned up and bathroom sanitized.

1:35 p.m. - Lunch (cheese manicotti, peas, V8 juice, 1/2 can peaches). Medication (2 Tylenol, Tramadol). Lunch finished at 3:05 p.m., everything but peas eaten. 

3:10 p.m. - Bathroom trip. Urinary incontinence. Remainder of urine passed. Diaper and diaper pad replaced. Remnants of bowel movement cleaned up. PT walk to living room before returning to recliner by 3:25 p.m.

Joyce setup to nap.

4:38 p.m. - Joyce found asleep with oxygen line in place.

6:25 p.m. - Worked on waking Joyce up, took till 7:20 p.m. to rouse her.

7:20 p.m. - Bathroom trip. Urinary incontinence. Diaper pad replaced. 

7:40 p.m. - Dinner (chicken margherita with balsamic steamer). Dinner finished by 8:43 p.m.

9:37 p.m. - Bathroom trip without incident.

9:45 p.m. - Relaxing, bed time.


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Throughout breakfast and post-breakfast Joyce was able to articulate that she has been experiencing nightmares (not hallucinations). Joyce asked Dusty to ask Dr. Collins if this was caused by any of the medications she was on. Dusty called Moscow Medical and left message for Dr. Collins' nurse Wendy, updating her on what Joyce had shared this morning and asking her to follow up about any potential "nightmare-inducing" side effects of the current prescription medications.

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