The Official Joyce Update Blog

6:45 a.m. - Craig found mom awake without her oxygen line in place. Joyce informed Craig that she "likes the sunshine on Thanksgiving." 7:16 a.m. - Joyce returned from her recliner after using bathroom. Blood oxygen level at 95%, pulse 91. 8:31 a.m. - Joyce finished breakfast (banana, baby bell cheese wheel, nutritional shake). Morning medication taken. Joyce wants to sleep. 12:48 p.m. - Dusty arrived to farmhouse after picking up supplies for farmhouse (paper towels and nutritional shakes) in Moscow. Joyce asleep in recliner with oxygen line in place, appearing to have passed out while coloring. Bathroom trip declined. Lunch declined. 12:50 p.m. - BP 128/69, pulse 79. BGL @ 185. O2 level at 92%. Temperature 97.5 degrees Fahrenheit. Lunch negotiated. 1:02 p.m. - Lunch meds (2 Tylenol and cranberry supplement) with water. 1:03 p.m. - Lunch (turkey and cheddar cheese sandwich with mustard and mayonnaise, diced peaches). Joyce proceeded to drum her fingers on the tray, play with...

7:25 a.m. - Craig arrived to farmhouse and found Joyce awake without oxygen line in place. Joyce reported that she has not been to the bathroom yet. 7:54 a.m. - Joyce returned from bathroom. Started eating breakfast (toast with jam, baby bell cheese wheel, applesauce, nutritional shake, morning medication). 10:17 a.m. - Dusty arrives to farmhouse, finding Joyce awake without oxygen line in place. Joyce had towels in her walker's basket...could not recall where they came from or what she was doing with them. 10:19 a.m. - BP 127/74, pulse 76. O2 @ 87%. BGL @ 300.  10:25 a.m. - Bathroom trip without incident. Urine passed. Evidence of bowel movement and poor attempt at self-cleaning discovered. Fecal matter in shoes and on bathroom floor from earlier trip. Shoes sanitized. Showered under protest.  Weight 157.4 lbs.  PT walk, returned to recliner by 11:20 a.m., legs elevated. 1:27 p.m. - Joyce removed her oxygen line. When instructed to put it back into place by Dusty, Joyce ...

7:13 a.m. - Craig found Joyce awake and taking herself to bathroom. Diaper and pad changed. 11 a.m. - Dusty arrived to farmhouse, finding Marshall (Kindred) on-site while Joyce was using bathroom. Urine passed. 11:07 a.m. - Vitals collected by Marhsall once Joyce returned to recliner. O2 @ 84%, BP 140/70, temperature 97.8 degrees Fahrenheit.  11:10 a.m. - O2 @ 94 % after Joyce placed back on oxygen line. Joyce reported pain in her leg when asked. Marshall worked with Joyce on leg, stand/sit, and arm exercises. Joyce exhausted by 11:20 a.m. Marshal directed Dusty to get Joyce to do more walking around the farmhouse if possible when family care providers are available to monitor Joyce. Marshall encouraged continued leg elevation to help control swelling in legs for Joyce. Marshall departed farmhouse. Joyce declined lunch, informing Dusty she had just recently finished the breakfast Craig had made for her. 11:25 a.m. - Snack (applesauce). Finished by 11:50 a.m., lunchtime medications ...

 7:04 a.m. Craig arrived. Joyce asleep with oxygen in place. Blood oxygen 97%     Pulse 74 7:30 a.m. Joyce heads to the bathroom  (No data on urine/bowel movement or incontinence issues) 7:46 a.m. Joyce returns from bathroom.  8:36 a.m. Dusty arrived. Joyce asleep hunched forward with oxygen in place. BP 121/69     Pulse 74     Oxygen @ 94%     Blood glucose @ 163. Bathroom trip declined. claimed she already went (remembered) Evidence of early bladder release. Dusty sanitized bathroom floor.  8:48 a.m. Breakfast (cream of wheat with equal, banana, dices peaches, cheese round) Dusty also set mouse traps up in pantry and upstairs.  9:47 a.m. Breakfast paused, Holly (Kindred PT) arrived to do start of care paperwork. Joyce fairly responsive. Recommendation family consider having vision and hearing checked. Reviewed dental history- Joyce claimed she doesn't have dentures. Slight pain reported to Holly- day & night - unable...

 6:20 a.m. Craig stopped by to check on Joyce. Joyce awake ( Joyce scale #1.5 *) told Craig about holding her water glass all night. Spilled a little on her blanket. She was perplexed and amused by the fact she held on to it all night.  6:30 a.m. Craig encouraged Joyce to make a bathroom trip.  (No data on urine/bowel movement or incontinence issues) 6:51 a.m. Joyce back in her chair. Took herself on a PT walk. She is in good spirits this morning. Oxygen @ 96%     Pulse 77 8:23 a.m. Dusty arrived. Joyce asleep in her chair with oxygen line in place. BP 137/72     Pulse 72     Blood glucose @ 150     Oxygen @ 96%      Spirometer @ 0 (unable to move disc at all) 8:42 a.m. Jess arrived. Breakfast (Banana, Babybell, and Cinnamon twist donut) 9:15 a.m. Joyce very very here mentally. She knows who Dusty and Jess are. Had a talk with them about how important it is to tell caregivers when she is hurting. Dusty explained how v...

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...

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...

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....

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...

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...

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 ...

8:07 a.m. - Craig arrived to farmhouse. Joyce reported that she had just sat down on her recliner after taking herself to the bathroom on her own.  8:08 a.m. - Jess arrived to farmhouse, finding Craig on-site. Craig reported that Joyce reported she had a good night. 8:15 a.m. - While Jess was talking with Joyce about what to have for breakfast Joyce said that "it depended on what everyone else wanted." When Jess asked who else Joyce was referring to, Joyce said "all the others." Jess reminded Joyce that it was just the two of them (Jess and Joyce) as Craig already had his oatmeal. Joyce said "oh" and dropped it - Joyce may possibly be hallucinating again? 8:30 a.m. - Joyce was rocking forward and backward in her recliner every minute or so while Jess was preparing breakfast (usually a sign that Joyce has to go to the bathroom). Jess took Joyce to the bathroom - Joyce had removed her diaper pad insert at some point but did not replace it. Joyce was dry. Uri...

8:09 a.m. - Jess arrived to farmhouse to provide morning care for Joyce, finding Joyce in the bathroom. Urinary incontinence, Joyce had taken off her diaper and diaper pad insert. Remainder of urine passed. Jess assisted Joyce with cleanup. Hemorrhoidal cream applied. Joyce returned to recliner by 8:19 a.m. 8:23 a.m. - BP 170/83, pulse 77. BGL @154,  Joyce stated she was thirsty and was given a large glass of water. Jess was uncertain if the upcoming blood draw to be done by the Kindred staff this morning at the farmhouse was supposed to be one that required a fast so she did not feed Joyce food at this point just in case.  Joyce did not know who Jess was today but knew Jess' voice. Jess informed Joyce who Jess was and Joyce appeared to acknowledge. 9:08 a.m. - Debra (Kindred) arrived to farmhouse to take a blood draw from Joyce and recertify Joyce for continued in-home visits from Kindred.  Losartan added to Joyce's records (again). When Joyce was asked by Debra if she h...

Craig covered morning care for Joyce while Jess was out at dental appointment and Dusty was being COVID-19 tested. 8 a.m. - Breakfast. Joyce ate very slowly. Dusty arrived to farmhouse ~12:25 p.m., found Joyce in bathroom with Courtney in attendance. Dusty assisted with cleanup of Joyce. Urine and small type 1/5 bowel movement passed. Joyce unable to rise up from toilet or remain standing independently under her own power. Preparation H applied. Dusty moved Joyce to sitting position on her walker and wheeled her out to kitchen, transitioning her to recliner with difficulty by ~1:45 p.m. Bathroom sanitized. Lunch negotiated. Courtney relayed that Craig provided morning medication to Joyce. Courtney remained onsite at farmhouse to monitor Joyce when Craig departed earlier in the morning. Courtney departed shortly after Joyce was returned to recliner, informed Joyce that she would most likely return this evening with Carol to provide evening care. 12:58 p.m. - BP 158/75, pulse 66. BGL @ 1...

8:19 a.m. - Jess arrived to farmhouse to provide morning care for Joyce. Joyce found awake with oxygen line in place. Joyce had taken herself to the bathroom recently. 8:20 a.m. - BP 156/101, pulse 81. BGL @ 152. 8:45 a.m. - Morning medication taken with nutritional shake. 8:50 a.m. - Breakfast (1 slice egg in toast with syrup). Breakfast finished by 9:05 a.m. Joyce reported to be "1000 yard staring" but enjoyed her breakfast. 10:12 a.m. - Joyce slept most of the time Jess was at farmhouse following breakfast, declined bathroom trips. ~Noon - Andrew (Kindred nurse) arrived to check Joyce, no family care provider present for visit. 1:18 p.m. - Dusty arrived to farmhouse, finding Joyce asleep in her recliner without oxygen line in place. Joyce had taken herself into bathroom and passed a Type 1 bowel movement - large mess left in bathroom (toilet seat riser, toilet handle, sink, floor) and in hallway where Joyce had tracked portions of fecal matter). Evidence that Joyce had ext...

Craig arrived to farmhouse to provide morning care for Joyce while Dusty and Jess went to medical appointments. Craig provided Joyce with morning medication and nutritional shake. 9:20 a.m. - BP 184/73, pulse 76. Cup of Earl Grey tea. Breakfast (scrambled eggs, cinnamon roll, banana). Joyce ate everything she was given. Craig reported that Joyce had a bowel movement in the morning hours. 12:45 p.m. - Jess and Dusty arrived to provide afternoon care for Joyce. Found Joyce in bathroom passing a bowel movement (constipation, clay-like and sandy texture). Preparation H applied to treat hemorrhoids. PT walk to living room before returning to recliner. Pain reported in left knee and right shin. 1 p.m. - Lunch (Dairy Queen cheeseburger and fries with ketchup). 2 Tylenol. 2:45 p.m. - Bathroom trip. Urinary incontinence. New diaper pad insert. Remainder of urine passed. Preparation H applied. PT walk to living room before returning to recliner. 3 p.m. - Carole (Kindred) arrived to check Joyce....

9 a.m. - Dusty arrived to farmhouse after purchasing supplies in Moscow. Joyce found awake in her recliner without her oxygen line in place. Joyce was fairly alert and responsive. 9:20 a.m. - BP 151/79, pulse 70. BGL @ 138. 9:24 a.m. - Breakfast (2 Eggo waffles with butter and syrup). Nutritional shake with morning medication. Breakfast finished by 9:50 a.m.  10:07 a.m. - Bathroom. Joyce released her bladder early while moving to sit onto toilet seat riser. Mess cleaned up, new diaper and diaper pad insert. Joyce passed remaining urine and small bowel movement (type 3/4) with flatus. Joyce remained in bathroom for a length of time longer than normal, citing feeling of constipation. PT walk to living room. Joyce was returned to recliner by 10:46 a.m. Joyce began napping. 1 p.m. - Lunch (turkey sandwich with Colby cheese and mustard on whole wheat bread).  1:36 p.m. - Carole (Kindred) arrived to farmhouse.  Vitals taken. 90% oxygen (Joyce reminded to use her oxygen), pulse ...

~8:30 a.m. Carole (Kindred) called Dusty's cell phone and let him know she will be out to see Joyce today around 1 p.m. 8:45 a.m. - Jess arrived to farmhouse to find Joyce awake with her oxygen line in place. Joyce had been in the laundry room at some point since Jess and Dusty left last night, pulling out fabric "to make pillow cases." Jess spoke with Joyce about going into laundry room unsupervised, the hazards of her moving around in the clutter in there with her walker and the dangers to her in lifting and moving heavy items without help. Joyce agreed with Jess. 8:54 a.m. - BP 143/86, pulse 80. BGL @ 121. 9:20 a.m. - Morning medication taken with nutritional shake. 9:25 a.m. - Breakfast (1 slice of toast with egg). Breakfast finished by 9:40 a.m. 10:15 a.m. - Bathroom trip. Urinary incontinence. Joyce passed remaining urine and bowel movement (type 6). Wound cleaned and fresh barrier cream applied. 10:30 a.m. - Jess vacuumed kitchen carpeting to help settle Joyce'...

7:45 a.m. - Dusty arrived to farmhouse to find Joyce asleep, doubled over in recliner but had her oxygen line in place. 7:55 a.m. - BP 152/83, pulse 83. BGL @ 120. 8:20 a.m. - Breakfast (6 mini pancakes with peanut butter, banana slices, and syrup; small cup of apple juice).  8:50 a.m. - morning medication with nutritional shake. 2:49 p.m. - Carole (Kindred Nurse) arrived for weekly visit to Joyce.  Temperature taken (98.4 degrees Fahrenheit), pulse 76, blood oxygen level @ 90%, BP 140/82. Sore throat reported to Carole, no body pain reported while resting (only while moving). Pressure sore checked, determined to be healing well. Leg swelling noted, elevation of legs and use of compression stockings recommended - confirmed that these were being done. Joyce did not self-report issues with urinary or bowel incontinence when asked - Dusty confirmed these were still ongoing issues with Carole. Health log for Joyce was reviewed, blood sugar levels were deemed good. Confirmed that a...

 8:30 a.m. - Jess arrived to farmhouse, finding Joyce asleep in he recliner without her oxygen line in place. Joyce was feeling "very fuzzy." 8:50 a.m. - Bathroom. Urinary incontinence, remainder of urine passed. New diaper and diaper pad insert. 8:56 a.m. - BP 168/97, pulse 79. BGL @ 98. 9:25 a.m. - Morning medication with nutritional shake. 9:30 a.m. - Breakfast (5 small pancakes, butter, and syrup). Breakfast finished by 9:45 a.m. Dusty arrived to help prep Joyce for her morning appointment in Moscow. 10 a.m. - Bathroom. Joyce was dry but released her bladder early while sitting down onto toilet riser. Bathroom cleaned.  10:15 a.m. - Jess changed Joyce's clothes. 10:30 a.m. - Jess departed farmhouse, Dusty began loading Joyce into Subaru for trip into Moscow. 11 a.m. - Joyce's appointment with Dr. Capawana at Palouse Foot & Ankle Clinic in Moscow. Toes inspected, toe nails trimmed. No ingrown toenails, Joyce's feet doing good. Praise for new shoes that Conn...