General Update #321 - Saturday, February 27, 2021

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 Craig departed farmhouse to meet with Loyal.

Noon - Lunch (sloppy joe, tortilla chips). Mid-day medication administered.

1 p.m. - Bathroom trip. Diaper pad replaced. PT walk to living room.

1:15 p.m. - Enrichment activity - coin sorting. 

3:40 p.m. - Dusty returned to farmhouse from lunch with Craig and Loyal in Helmer. Joyce awake in her recliner without oxygen line in place, sorting coins. No blanket on. Bathroom trip declined. Joyce stated that she hasn't been fed lunch yet and that she had "been left alone all day." Dusty reminded her that Craig and he were out earlier in the morning and Carol had just spent time with her and fed her lunch. Joyce disagreed that those events occurred. 

4 p.m. - Bathroom trip declined. Coin sorting project concluded. Joyce began napping.

4:15 p.m. - Joyce woke herself up from napping. Bathroom trip declined. Napping resumed.

4:37 p.m. - Joyce woke herself up form napping. Joyce asked Dusty who had been out today to see her. Dusty reviewed the timeline of visitors with Joyce. Joyce stated that she did not recall anyone had been out at all today. Napping resumed.

5 p.m. - Dusty woke Joyce. Bathroom trip declined, Joyce asked for time to "wake up." Joyce dozed off and on. 

5:12 p.m. - Joyce woke herself up from napping. Declined bathroom trip. Asked Dusty why the bathroom door was not on the bathroom - she could remember that it was not on the bathroom anymore and she expressed confusion over where it went. Dusty reviewed elder care protocols the family put into place for her continued living at the farmhouse and need for maneuvering space for assisting her with toileting and fall prevention efforts. Joyce expressed denial that she needed assistance with bathroom use and that people needed to leave her be.

5:15 p.m. - Bathroom trip. Urinary incontinence. Early bladder release. Remainder of urine passed. Diaper and pad replaced. Bathroom floor sanitized. Joyce embarrassed that she had gotten urine all over the toilet seat riser and onto the floor. Joyce confused as to why she had early bladder release. Joyce expressed brief confusion to Dusty about why she had to wear diapers. Joyce soon recalled her ongoing issues with urinary and bowel incontinence. 

Joyce kept fishing trash out of bathroom garbage cans to play with, citing need to "do something with [her] hands." Dusty reviewed problems with Joyce rummaging through trash cans for something to play with when those trash cans were filled with soiled items. Joyce became irritated with Dusty - Joyce eventually capitulated to leaving trash in the trash for sanitary reasons after prolonged dialogue. 

PT walk to living room, returned to recliner ~5:31 p.m. Joyce complained that her legs had become cold because she had been left in the kitchen without a blanket on. Dusty reminded Joyce that she knows how to put her blankets on and she most likely had taken them off at some point.

Dinner declined. Enrichment activity self-initiated by Joyce - working on decorating her flower pots that Connie had picked up for her.

7:33 p.m. - BP 149/81, pulse 88. BGL @ 104.

7:37 p.m. - Evening medication with nutritional shake.

7:39 p.m. - Dinner (Cheesey Italian Shells Hamburger Helper, 1/2 can peaches). Joyce kept falling asleep throughout. Dinner finished by 8:47 p.m.

9 p.m. - Bathroom trip. Joyce complained of pain on her left-side pelvic area but could not describe it accurately. Urinary incontinence. Remainder of urine passed. Left front of diaper had blood staining. Joyce appears to have developed a bleeding abrasion from the diaper (Prevail brand - more textured/rough than Always brand for Joyce's sensitive skin?) rubbing against her stomach and thigh folds as she shifted about in her recliner. Dusty cleaned wound and attempted to apply liquid bandage but stock of liquid bandage on hand at farmhouse was expired and had solidified - sterile pad and Neosporin used instead. Dusty picking up new first aid supplies for treating wound. Joyce returned to recliner by 9:16 p.m. Joyce reported that the Neosporin and bandaging made it easier for her to walk and the pain was lessened overall for her.

9:24 p.m. - Joyce made ready for bed.

Dusty departing farmhouse ~9:30 p.m., returning tomorrow morning after picking up supplies for farmhouse.

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Joyce frequently removed her oxygen line throughout the day, often after being directed to put it on and a brief period of time passed or Dusty was out of line of sight. 

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