The Official Joyce Update Blog

 7:53 a.m. Craig arrived. Joyce seems better to him. Making her way to the bathroom.  8:17 a.m. Jess arrived. Joyce in bathroom. Joyce trying to clean herself up after bowel movement. Jess helped clean her up. Bowel movement half diarrhea half very soft in texture. applied barrier cream. Back in recliner 8:25 a.m.  Joyce in a lot of pain. Says her neck hurt on the back and sides. Jess worked with her to figure out exactly how it was hurting and trying to describe the pain. From this it sounded like muscle strain. According to Dusty Joyce was sleeping very oddly yesterday. Jess noticed she was handing her head and almost resting her chin on the right side of her chest. Jess coached her to lean back in her chair and lean her head back. rest her neck. Craig told Jess that Joyce told him that her chest pain was not as bad. When Jess asked Joyce she wanted to rest for a while before answering questions.  8:31 a.m. BP 147/78      Pulse 88 8:53 a.m. Morning M...

 7:47 a.m. Craig arrived Joyce was in the bathroom.  (No data on urine/bowel movement or incontinence issues) 7:56 a.m. Joyce returned to her recliner.  8:15 a.m. Jess arrived giving brief up date on Joyce. Joyce had chest pains on Sunday. Craig also inquired about the bottle of tramadol since it was not with the other medications. Jess updated him about Dusty ordering the refill but since it is a controlled substance it needs to be approved by Dr. Collins before it is refilled. He said that he thinks "they" gave Joyce more Tylenol yesterday. Jess sat and spoke with Joyce about the chest pains and if she was still having them. Craig said she had reported they (chest pains) were "a lot" better. When speaking with Jess she said it (chest pain) was not as bad as yesterday. With prompting she narrowed it down to the center of her upper chest with no specific side. Both arm were not hurting. Joyce reports a minor headache. She also had some pain in her stomach but couldn...

 7:55 a.m. Craig at farmhouse. Joyce made first bathroom trip.  (No data on urine/bowel movement or incontinence issues) 8:08 a.m. Morning medication and breakfast ( banana and Babybell) BP 156/79      Pulse 79 11:18 a.m. Afternoon medication with 1/4 of a nutritional shake. 12:00 p.m. Bathroom- diarrhea- cleaned up 12:30 p.m.- 1:45 p.m. Slept 2:00 p.m. Tums for chest pain  3:00 p.m. Biscuit and sausage gravy  3:38 p.m. Only ate half. Joyce kept falling asleep. Slept on and off most of the early evening. 6:41 p.m. Bathroom - bowel movement 7:16 p.m. Soft peanut butter 1 slice and night medication. 8:30 p.m. Ready for bed

 7:33 a.m. Craig at farmhouse. Joyce had a nightmare. She is quite tired this morning and not so "chipper." She is on her way to the bathroom.  7:43 a.m. Joyce returned from bathroom.  (No data on urine/bowel movement or incontinence issues)  Joyce then "raided" the fridge for a Babybell.  8:05 a.m. Joyce took her pills and began breakfast. Toast and banana. She is in better spirits but wanting to nap. BP 155/75     Pulse 83 8:30 a.m. Trip to bathroom  (No data on urine/bowel movement or incontinence issues) 11:30 a.m. Trip to bathroom - changed pad  (No data on urine/bowel movement) 12:00 p.m. Coloring 1:00 p.m. Lunch (Fried egg sandwich and of a half Danish) Afternoon medication  2:00 p.m. Bathroom trip - changed pad  (No data on urine/bowel movement)  Coloring and watching a movie. 6:00 p.m. Bathroom Trip - Changed pad 6:30 p.m. Dinner (Roast Beef, potatoes, gravy and cooked carrots)  (Evening meds not logged)  8:0...

 8:00 a.m. Craig at the farmhouse. Mom is awake & alert. Has not been to the bathroom but is thinking "real hard" about it.  Dusty arrived soon after Craig. Mom in bathroom. Urinary incontinence. Early bladder release. Remainder of urine passed and flatus. New diaper, pad, skirt, and chair mat replaced. Two PT walks and returned to recliner by 8:22 a.m. 8:23 a.m. BP 173/84     Pulse 75      Blood Glucose @144 8:25 a.m. Morning medication with nutritional shake. 8:34 a.m. Breakfast (Omelet, apple sauce, Babybell cheese) Finished by 9:17 a.m. 9:19 a.m. Enrichment activity - Laundry folding 9:51 a.m. Soiled herself. Bathroom trip. Remained type 6 bowel movement passed. Showered. Shoes sanitized. Bathroom floor and toilet seat riser sanitized. Weight 158.8lbs. PT walk and returned to chair 11am, Started napping almost at once. 12:41 p.m. BP 137/74     Pulse 65     Blood Glucose @ 135 12:57 p.m. Lunch (Chicken Garlic ravioli, whole b...

 7:56 a.m. Dusty arrived. Joyce awake with her oxygen in place. No nightmares reported.  8:10 a.m. BP 150/75     Pulse 71     Blood Glucose @ 137 8:13 a.m. Morning medication with nutritional shake. 8:22 a.m. Breakfast (2 blueberry pancakes with butter and syrup, Babybell cheese, diced peaches) 8:40 a.m. Tramadol re-ordered  9:03 a.m. Breakfast finished 10:00 a.m. Bathroom Urine and bowel movement passed. Shower refused. PT walk. Returned to recliner by 10:23 a.m. 12:02 p.m. 2 Tylenol + Cranberry supplement 12:03 p.m. Lunch (Turkey & cheddar sandwich with mayo and mustard, apple sauce cup, Jell-O pudding) Finished by 1:17 p.m. 5:00 p.m. Bathroom Changed all clothes, pad, diaper and chair pad.  (No data on urine/bowel movement) 6:00 p.m. Dinner (Sausage country gravy, biscuit, small piece chocolate cream pie) 7:10 p.m. Done with dinner  7:20 p.m. Evening medication 8:45 p.m. Mom relaxing

 7:47 a.m. Craig at farmhouse. Joyce heading to bathroom.  Dusty arrived shortly after Joyce went to the bathroom. Major Urinary incontinence. Early bladder release. Remainder of urine passed. New diaper and pad. Bathroom floor, Hallway floor, Kitchen linoleum, toilet riser and shoes sanitized. PT Walk. 8:24 a.m. BP 155/76     Pulse 74     Blood Glucose @ 145 8:26 a.m. Morning medication with nutritional shake. 8:31 a.m. Breakfast (donut, apple sauce cup, Babybell cheese) Finished by 9:30 a.m. Started napping right after.  12:40 p.m. Asleep with out oxygen in place. Easy to wake up. TV was turned off.  12:41 p.m. BP 129/66      Pulse 66     Blood Glucose @ 181 12:45 p.m. 2 Tylenol + Cranberry supplement 12:47 p.m. Lunch (Soup, Babybell cheese, Jell-O pudding cup) Finished by 1:57 p.m. 2:00 p.m. 3.6oz Vanilla ice cream. Began sleeping hard ~ 2:17 p.m. 3:14 p.m. Bathroom Urinary incontinence. Early bladder release. Remainder...

 8:18 a.m. Dusty and Jess arrived. Joyce asleep in her recliner with out oxygen in. She did not report any nightmares. She reports she has been to the bathroom already.  8:20 a.m. Orajel applied for mouth pain she is reporting. 8:21 a.m. BP 147/78     Pulse 74     Blood Glucose @ 156 8:27 a.m. Morning medication with nutritional shake.  8:35 a.m. Breakfast smoothie (Bananas, Apples, Baby Spinach and juice) Done 9:30 a.m. 9:39 a.m. Bathroom bowel insentience type 5, Remaining bowel movement passed. Showered. Doesn't know who Dusty is. Shoes sanitized. Weight @ 158.6     PT walk, Returned to recliner by 10:24 a.m. 10:25 a.m. Enrichment activity Folding clothes. Joyce napped after.  12:47 p.m. BP 128/67     Pulse 65     Blood Glucose @ 132 1:00 p.m. 2 Tylenol + Cranberry  Supplement 1:01 p.m. Lunch (Mac & Cheese, Jell-O pudding) Ate slow, Kept spacing off and getting distracted. Finished by 2:50 p.m. 2:52 p.m. B...

7:28 a.m. Dusty arrived at the farm house. Joyce awake in her recliner with out her oxygen in, TV was turned off. She didn't have any nightmares. Her mouth is "killing" her. Orajel applied.  7:30 a.m. BP 142/92     Pulse 78     Blood Glucose @ 149 7:37 a.m. Bathroom Urinary incontinence. Early bladder release. Remaining urine passed. New diaper and pad. PT walk.  7:52 a.m. Nutritional Shake with morning medication. 7:57 a.m. Breakfast (Donut, Babybell cheese, apple sauce cup) Finished 9:12 a.m. 12:48 p.m. BP 117/67     Pulse 69     Blood Glucose @ 159 12:58 p.m. 2 Tylenol + Cranberry supplement with water. Joyce could not remember anything from this morning.  12:59 p.m. Lunch (Steamer bowl Turkey & Veggies, diced peaches, Jell-O pudding cup) Finished 1:57 p.m. 2:07 p.m. Bathroom  Urinary incontinence. New diaper and pad. Remaining urine passed. High volume of flatus discharge passed. PT walk. Returned to recliner by 2:19 p....

8:23 a.m. - Dusty arrived to farmhouse. Joyce asleep in her recliner, hunched forward over her knees without oxygen line in place. Joyce could not recall if she had any nightmares. Joyce informed Dusty that she took off her oxygen line to get up and go to the bathroom but could not recall when that was - she did recall that she didn't make it to the bathroom yet.  8:24 a.m. - BP 141/73, pulse 78. 8:26 a.m. - Bathroom. Urinary incontinence - severe. Remainder of urine passed. Diaper, diaper pad, skirt replaced. High volume of flatus discharged while Joyce seated on toilet. Disposable pad on recliner replaced. Carpet cleaned. Joyce declined to be showered. PT walk into living room, returning to recliner by 8:36 a.m. 8:37 a.m. - BGL @ 159. 8:40 a.m. - Morning medication with nutritional shake. 8:45 a.m. - Breakfast (omelet, Baby Bell cheese, whole banana, applesauce). Joyce ate very slowly - kept zoning out or falling asleep. Breakfast finished by 1:54 p.m. Joyce refused bathroom trip...

8:14 a.m. - Craig arrived to farmhouse. Lights on, Joyce has been up and moving about already. Joyce says that it was quite a while ago that she got up. 8:28 a.m. - Dusty arrived to farmhouse. Joyce in recliner with oxygen line in place. Bathroom trip declined. Breakfast declined. No nightmares reported - Joyce could not recall if she had any. 8:30 a.m. - BP 149/78, pulse 72. BGL @ 130. 8:39 a.m. - Nutritional shake with morning medication. 8:42 a.m. - Breakfast (omelet, applesauce, toast with butter). Joyce finished breakfast by 9:27 a.m. Evidence found that Joyce had taken herself to the bathroom at least twice since Dusty left last night. Bathroom sanitized. 12:11 p.m. - Bathroom. Evidence discovered Joyce had previously soiled herself on one of the two trips she made prior to Dusty's return to the farm. Urinary incontinence. Remainder of urine passed. Flatus passed. Large amount of fecal matter in shoes - shoes sanitized. Joyce cleaned up and showered.  Weight 158.6 lbs. PT wal...

7:45 a.m. - Craig arrived to farmhouse. Joyce seems good. Joyce reported that she has already been to the bathroom. Joyce reports she still has a sore throat. Craig gave Joyce more elderberry juice.  8:50 a.m. - Dusty covering Jess' morning care shift for Joyce. Dusty arrived to farmhouse after opening up office on campus for staff members without key and picking up supplies for weekend care of Joyce. Joyce sleeping in recliner with oxygen line in place. Joyce appears to have changed her clothes again since yesterday - Joyce cited that she had a major bladder release incident in her recliner and had self-cleaned without help from anyone. Dusty cleaned mess in bathroom. 9:02 a.m. - BP 167/81, pulse 77. BGL @ 127. 9:06 a.m. - Nutritional shake with morning medication. 9:10 a.m. - Breakfast (maple bar, Baby Bell cheese, applesauce). Breakfast finished by 10:30 a.m. Joyce began napping hard. Joyce refused all bathroom trips throughout morning and early afternoon each time she self-woke...

8:03 a.m. - Craig on-site at farmhouse. Joyce seems well. Joyce reports that she went to the bathroom around 7 a.m. 8:14 a.m. - Dusty covering Jess' shift, arriving to farmhouse to find Joyce awake with oxygen line in place. No nightmares recalled by Joyce. 8:15 a.m. - BP 171/83, pulse 72. BGL @ 150. 8:18 a.m. - Nutritional shake with morning medication.  8:22 a.m. - Breakfast (sausage McMuffin, applesauce, small glass pineapple banana orange juice).  8:28 a.m. - Orajel applied to mouth sore after Joyce refused to eat, citing mouth pain. Joyce had to be instructed on how to use Orajel as she claimed she had not used it before and did not know how it worked. 9:18 a.m. - Joyce irritated and hostile, having difficulty communicating verbally. Dusty determined that Joyce wanted a 2nd nutritional shake. Joyce was frustrated that she "had nothing to drink." Joyce did not want either of her two full water glasses or the small glass of pineapple banana orange juice he had brought ...

Dusty covering Jess' shift today to let her rest as he appears to have caught Joyce's cold. 8:48 a.m. - Dusty arrived to farmhouse after opening up his office to the staff member without keys and picking up supplies from Moscow. Joyce asleep in recliner without oxygen line in place. Joyce woke easily when checked. Joyce in a good mood. Joyce reported no nightmares but had nasal congestion. Bathroom trip declined. 8:50 a.m. - BP 130/78, pulse 74. BGL @ 129. 8:57 a.m. - Morning medication (minus Mucinex) with nutritional shake. 9 a.m. - Breakfast (McDonald's sausage, egg, and cheese McMuffin, Baby Bell cheese, applesauce). Breakfast finished by 9:48 a.m. Joyce began napping hard. 11 a.m. - Bathroom trip refused. Joyce irritated at being woken to go to the bathroom when she "doesn't feel like going" and was "wanting to rest." Noon - Lunch refused. Bathroom trip refused. 12:26 p.m. - Bathroom. Urinary incontinence. Remainder of urine passed. Diaper and p...

7:50 a.m. - Craig on-site at farmhouse. Joyce reported to Craig that she has already been to the bathroom this morning but is thinking of going again. Joyce's nose is still quite runny. Craig administered 3-4 ounces of Elderberry juice from new jar to Joyce. 8:15 a.m. - Jess arrived to farmhouse. Craig updated Jess about Joyce's self-reported status and what he had done for Joyce prior to Jess' arrival. Joyce miserable.  8:20 a.m. - Bathroom. Urinary incontinence. Remainder of urine passed. New skirt. New diaper and pad. Shoes sanitized. Joyce's legs and feet wiped down/cleaned. New chair pad. Returned to recliner by 8:44 a.m. 8:52 a.m. - Jess contacted Dusty about Joyce's health. Dusty called Moscow Medical to see what cold medications can be used safely with Joyce's current prescription medication regimen to treat Joyce's runny nose and cough.  Dusty left message with Autumn at Moscow Medical to have Wendy and/or Dr. Collins to follow up with him. 9:15 a.m...

8:06 a.m. - Craig at farmhouse. Joyce informed him that she had already made a bathroom trip at some point prior to his arrival. Joyce indicated that she could go to bathroom again. Joyce sneezing some. 8:15 a.m. - Jess arrived to farmhouse. Joyce's nose is running "bad." Joyce did not have oxygen line in place.  8:17 a.m. - Bathroom. Urinary incontinence. New diaper and pad. Remainder of urine passed. 8:35 a.m. - BP 176/94, pulse 77. BGL @ 175. Joyce still sneezing. Reports no bad dreams. Joyce could remember that she slept all night. Joyce thinks the sneezing and runny nose started this morning. 8:45 a.m. - Joyce is really miserable - wiping her nose and the sore in her mouth. Jess had Joyce apply more Orajel on the mouth sore. Joyce also has a small cough. 9:04 a.m. - Morning medication and nutritional shake. 9:10 a.m. - Breakfast (3 pancakes with syrup, whole banana). Finished by 9:50 a.m. Joyce seemed to have a pretty good appetite. 9:51 a.m. - Bathroom. Bowel incont...

8:50 a.m. - Dusty arrived to farmhouse after running errands in Moscow. Joyce awake in recliner without oxygen line on place. Joyce claimed to have taken herself to the bathroom before Dusty arrived and passed urine. Evidence Joyce had been up and moving around the farmhouse, had moved items and various things "that were bothering her." Joyce experiencing some confusion. Joyce did not know who Dusty was, felt like she was being "bawled out" for moving things and rearranging things in her own house when Dusty asked what she had been up to - felt like she was being treated with suspicion. Dusty clarified that he was concerned what she was doing without anyone around because he didn't want her going places she could lose her balance or attempting to move heavy items without help. Dusty cited Joyce's fall down the basement stairs as reason for protective actions and concerns - Joyce did not recall falling down basement stairs. Joyce also stated that she did not ...

8:50 a.m. - Dusty arrived to farmhouse after running errands for Jess in Moscow. Joyce awake in recliner with oxygen line in place. Joyce reported no nightmares last night. Joyce had been up and "puttering around the house." Joyce had changed into a new sweatshirt and put on a necklace from her jewelry cabinet. Breakfast refused. Bathroom trip refused - Joyce claimed she took herself to bathroom earlier in morning and did not need to go now. 8:55 a.m. - BP 155/81, pulse 74. BGL @ 131. 8:58 a.m. - Nutritional shake with morning medication. 9:02 a.m. - Bathroom floor and toilet seat cleaned. Evidence Joyce wet to bathroom at least once since Dusty left farmhouse last night, passing urine. 9:05 a.m. - Breakfast (donut, whole banana).  Finished by 9:35 a.m. 9:41 a.m. - Joyce soiled herself in recliner (type 5 bowel movement). Remainder of type 5 bowel movement and urine passed. Additional type 6 bowel movement passed while Joyce on toilet. Joyce was showered without protest - Joy...

8:02 a.m. - Craig on-site at farmhouse. Joyce returning from using the bathroom. 8:25 a.m. - Jess arrived to farmhouse. Joyce awake with oxygen line in place. Joyce in good spirits. Joyce reported that her mouth still hurts. Joyce has a sore in the middle front of the gums and inner lip. Joyce has a small headache behind her left ear. Joyce reporting that she slept well with no bad dreams. Joyce informed Jess that she did wake up a lot through the night but went back to sleep and "was surprised it was morning."  8:29 a.m. - BP 143/78, pulse 73. BGL @ 142. 8:35 a.m. - Morning medication with nutritional shake. 8:40 a.m. - Orajel applied - Jess squeezed it out onto Joyce's finger and instructed Joyce how to apply it only to the sore areas of her mouth (and to keep her tongue down and away from the gel).  8:45 a.m. - Breakfast (2 toaster blueberry pancakes, whole banana, applesauce). Breakfast finished by 9:50 a.m. Joyce was able to remain awake on her own throughout meal. 9...

8:02 a.m. - Craig on-site, Joyce making trip to bathroom. 8:06 a.m. - Joyce returns from bathroom trip to kitchen. 8:16 a.m. - Jess arrives to farmhouse. Joyce awake without oxygen line in place. Joyce reporting no headaches. Joyce's mouth still hurting her. 8:21 a.m. - BP 158/88, pulse 75. BGL @ 136. Joyce reported to Jess that she had a couple of bad dreams but was able to get back to sleep. Joyce did not believe that it was "scary" or "upsetting" programming on television during the evening hours. 8:35 a.m. - Morning medication with nutritional shake. 8:40 a.m. - Breakfast (2 scrambled eggs with Mrs. Dash seasoning, 1 cup peaches, whole banana). Joyce refused to use Orajel to treat her mouth pain. 9:30 a.m. - Joyce clutching her mouth while eating. When Jess suggested that Joyce apply Orajel to alleviate her mouth pain Joyce informed Jess that she "wants to taste [her] food." Jess instructed Joyce how to apply Orajel to the gums of the mouth and to ...

8:21 a.m. - Jess arrived to farmhouse. Joyce was awake and reading her newspaper. No oxygen line in place. Joyce in good mood, reports that her head is not hurting today. Joyce says she slept good even though she had a few nightmares. Joyce reported that her mouth is hurting worse today.  8:23 a.m. - BP 164/79, pulse 70. BGL 163. 8:40 a.m. - Morning medication with nutritional shake. 8:45 a.m. - Breakfast (2 scrambled eggs, whole banana, cup of peaches). Joyce ate very slowly and paused her eating often due to pain in her mouth. Jess kept encouraging Joyce to eat. Joyce finished her breakfast by 9:40 a.m. 9:43 a.m. - Bathroom trip. Urinary incontinence. Remainder of urine passed. Joyce very constipated. Jess gave Joyce Miralax at 9:55 a.m. Joyce tried multiple times to pull stool out of her anus by hand even though Jess instructed her not to do this. Jess had to constantly coach Joyce how to push and breathe to pass her stool. Jess had Joyce stand at one point and shift Joyce's hip...

8:10 a.m. - Dusty arrived to farmhouse to cover Jess' shift (Jess down with migraine). Joyce awake in her recliner with oxygen line in place. Joyce reporting that she still has a headache but that it is diminished from yesterday. Joyce reported she was able to sleep during the night but had nightmares.  8:13 a.m. - BP 129/73, pulse 80. BGL @ 131. 8:27 a.m. - Bathroom trip. Urinary incontinence. Diaper and pad insert replaced. Remainder of urine passed. Barrier cream applied to right buttock and left hip/pelvic crease of skin fold (minor spread of sore on hip). Pressure wound on right buttock closing up nicely and scabbing over - some signs Joyce picking/wiping at it which may cause it to reopen if she is not monitored and stopped when using toilet.  PT walk, Joyce gasping for breath as she made her way out to kitchen (Joyce reportedly not in pain, she was holding her breath while walking again).  8:39 a.m. - Morning medication administered with nutritional shake. 8:41 a.m...

8:17 a.m. - Jess arrived to farmhouse, finding Joyce using bathroom. Craig on-site and informed Jess that Joyce had been in there for ~10 minutes already. Joyce had removed her own diaper. Bowel movement (type 4). Jess had to help coach Joyce on how to pass her stool again as Joyce had forgotten what to do. Joyce reported chest pain when breathing while on the toilet. Jess believes the chest pain Joyce experiencing was due to Joyce sitting hunched over her knees while sitting on the toilet for an extended period of time unattended. Joyce also reported experiencing a headache to Jess (like "pressure").  Joyce reported that she had nightmares throughout the night which kept waking her up. Barrier cream applied to Joyce's wounds. New diaper and diaper pad insert.  Joyce returned to recliner by 8:50 a.m. 8:52 a.m. - BP 160/89, pulse 76. BGL @ 149. Joyce states that her headache is really hurting her (holding her head with her hands). 9 a.m. - Morning medication with nutrition...

9:19 a.m. - Dusty arrived to farmhouse after picking up supplies for farmhouse. Joyce awake in her recliner with oxygen line in place. Evidence that Joyce had taken herself to bathroom at least once since Dusty departed last night - urine passed, bathroom sanitized. Joyce reported having "a few" nightmares. 9:23 a.m. - BP 158/80, pulse 79. BGL @ 133. 9:26 a.m. - Morning medication with nutritional shake. 9:35 a.m. - Breakfast (2 blueberry Eggo waffles with butter and syrup, whole banana). Finished by 10:13 a.m. Joyce began napping. Joyce woke herself up at 11:20 a.m. 11:30 a.m. - Bathroom trip. Urinary incontinence. Remainder of urine and high volume of flatus passed. Diaper had rolled from Joyce shifting about while in recliner. Diaper and pad insert replaced. Disposable chair pad on recliner replaced. Joyce refused to shower. PT walk before returning to recliner by 11:45 a.m. 11:55 a.m. - Dusty departing farmhouse to lift heavy items and run errands for Jess. Will bring bac...

9:15 a.m. - Dusty arrived to farmhouse. Craig already on-site, informing Dusty he had only recently arrived himself. Joyce awake with oxygen line in place (Craig had recently directed her to put it on). Joyce fairly alert and talkative. 9:20 a.m. - Bathroom. Urinary incontinence. Diaper & pad replaced. Remainder of urine passed. Hemorrhoid reduced from yesterday - hemorrhoid cream applied. Left pelvic wound inspected, healing nicely. Barrier cream applied to right butt cheek pressure sore. PT walk into living room. 9:31 a.m. - BP 178/94, pulse 77. BGL @ 126. 9:35 a.m. - Nutritional shake with morning medication. 9:44 a.m. - Breakfast (avocado spread on toast, Baby Bell cheese wheel, cubed watermelon). Joyce informed Dusty she hates avocado. Avocado toast replaced with cinnamon twist donut.  10:04 a.m. - Dusty departing farmhouse to head back to Moscow for appointment. 12:41 p.m. - Dusty returns to farmhouse. Joyce asleep in her recliner without oxygen line in place. Breakfast t...

7:56 a.m. - Jess arrived to farmhouse. Joyce sleeping in her recliner without oxygen line in place. Joyce reported no bad dreams last night. Joyce reported that she had taken herself to the bathroom at some point but could not remember when. 7:58 a.m. - BP 173/76, pulse 73. BGL @ 152. 8:10 a.m. - Breakfast (cinnamon twist donut, small bowl of watermelon cubes, whole banana). Finished breakfast at 9:08 a.m. 9:26 a.m. - Bathroom trip. Bowel incontinence, very soft stool. Diaper had to be cut off. After about 10 minutes on the toilet, Joyce became confused and asked for direction on what she was supposed to do (how to pass her remaining stool). Jess asked Joyce for clarification on what she needed. Joyce had to be reminded to "push" every so often. Joyce kept fiddling with her legs and would not remain focused. Joyce's hemorrhoid has returned and is bleeding again. Hemorrhoidal cream applied after cleaning Joyce up. Jess inspected wound on Joyce's left pelvic area - heal...

8:03 a.m. - Jess arrived, finding Joyce awake in her recliner without oxygen line in place. Joyce was "thinking about getting up." Joyce reported that she had a bad dream last night. It was not the TV as it was turned off - Dusty's theory that Joyce's reports of nightmares were potentially her meaning she was upset by disturbing images on Netflix shows she is watching not correct. 8:06 a.m. - Bathroom. Urinary incontinence. Diaper and diaper pad replaced. Joyce reported that she does not like the new diapers she is being given to use. Joyce returned to recliner by 8:17 a.m. 8:22 a.m. - BP 160/83, pulse 74. BGL @ 133. 8:26 a.m. - Joyce noticed to be scrunching up her face a lot. When asked by Jess about this, Joyce said that she had something wrong with her head. With prompting and given descriptors to use Joyce says she "has pressure in her head." 8:35 a.m. - Morning medication and nutritional shake. 8:40 a.m. - Breakfast (egg in toast, whole banana). Joyce ...

7:50 a.m. - Craig on-site at farmhouse. Joyce informed him that she slept through the night. Joyce begins her first bathroom trip. Joyce returns to her recliner by 8:03 a.m. 8:12 a.m. - Jess arrives to farmhouse. Joyce awake with oxygen line in place. Joyce informed Jess that she is "feeling great" and had no dreams last night. 8:13 a.m. - BP 161/87, pulse 74. BGL @ 160. 8:30 a.m. - Morning medication with nutritional shake. 8:40 a.m. - Breakfast (2 blueberry Eggo waffles, whole banana, 1/2 can peaches) Joyce ate very slowly but did not fall asleep while eating. Joyce zoned out a lot and needed to be encouraged to focus on eating her breakfast. 9:45 a.m. - Joyce refused bathroom trip. Joyce informed Jess she wants to do it later on and nap now. 12:36 p.m. - Dusty finds Joyce doubled over the right side of her recliner, passed out with no oxygen line in place. Joyce difficult to wake up but she reports that today she feels like her head is "clearer" and that she ...

8:19 a.m. - Jess arrived to farmhouse. Joyce sleepy. No oxygen line in place. Oxygen line was buried under her purse and see catalog beside her recliner. Joyce was very fuzzy. Television was frozen and had to be unplugged to reset it. No bad dreams reported. 8:22 a.m. - BP 139/115, pulse 75. BGL @ 152. Joyce shifting, moving forward and backward during BP reading. 8:35 a.m. - Morning medication with nutritional shake. 8:40 a.m. - Breakfast (2 Eggo waffles, whole banana, 1/2 can peaches). Jess had to wake Joyce once to keep her eating. Joyce finished breakfast by 9:30 a.m. 9:40 a.m. - Joyce declined bathroom trip, resumed sleeping. 12:36 p.m. - Craig on-site, Joyce begins a bathroom trip. Dusty arrived to farmhouse, finding Joyce in progress of using toilet. Urinary incontinence. Early bladder release. Urine passed. Diaper and diaper pad insert replaced. Joyce cleaned up. Bathroom floor and toilet seat riser cleaned. Barrier cream applied to left hip/pelvic wound. PT walk declined - ret...

February 28, 2021 - Addendum Joyce stopped Dusty as he was departing the farmhouse for the night and informed him that she wanted all the lights in the house and the television switched off. Dusty asked Joyce for confirmation to that as she usually wants the television left on and playing through the night to "keep her company" and prevent her from becoming frightened of the "house noises" and "night time noises" around her. Joyce confirmed she wanted the televisions switched off, but consented to leaving her usual night lights on for safety. Joyce expressed concern over NCIS  playing because "they're hurting people!" and became quite emotionally distraught (no violent images were currently on display on the screen or had been for some time). Dusty offered to switch her programming to something less violent but Joyce could not decide what she wanted, stating again she wanted the television off. Dusty attempted to set Netflix to play the  Hear...