The Official Joyce Update Blog

 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

7:45 a.m. - Craig arrived to farmhouse to cover Jess' morning shift as she was getting her teeth repaired at the dentist. Joyce informed Craig that she had already been to the bathroom. 8:48 a.m. - BP 146/77, pulse 78. 9 a.m. - Morning medication administered. Bathroom trip. 9:30 a.m. - Breakfast (banana, 1 piece of toast with jam, baby bell cheese wheel). Joyce informed Craig she was not particularly hungry. 11:02 a.m. - Joyce was returning from using the bathroom as Craig re-entered the farmhouse. Joyce informed Craig that she had a bowel movement. 11:25 a.m. - Dusty arrived to farmhouse. Found Joyce in her recliner, awake, without oxygen line in place struggling with the television remote - she had loaded some sort of Spanish dubbed video onto the television and was frustrated she could not get it to stop or change back to Netflix. House smelled of bowel movement. Evidence of type 6 bowel movement in bathroom - floor, toilet seat riser, sink were sanitized. Evidence found Joyce ...

8:05 a.m. - Craig entered into logbook that Joyce had taken herself to the bathroom and "was successful."  8:13 a.m. - Jess arrived to farmhouse and found Joyce awake in her recliner with her oxygen line in place. Joyce informed Jess that she had just set herself back into the recliner before Jess arrived. 8:15 a.m. - BP 148/81, pulse 72. BGL @ 162. 8:36 a.m. - Wendy called Dusty's cellphone to follow up about Joyce's confusion and pain mitigation - curious if Tramadol has helped or hindered Joyce with daily living. Dusty confirmed that the remaining doses of Tramadol were given to Joyce with each meal and there seems to have been improvement on Joyce's ability to walk and reduction of pain overall - no increase in Joyce's confusion noted by family caregivers. Wendy confirmed that the anti-inflammatory medication must have exacerbated Joyce's dementia/confusion and noted for it not to be prescribed again. Wendy will report to Dr. Collins and have prescript...

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...

Dusty and Jess called Joyce this evening around 7:50 p.m. She was having her blood sugar levels checked, with a reading of 256 ("too high"). The nurse excused herself while the phone call continued and returned with insulin. Joyce was thankful that the needles for blood testing and insulin injections were so small. Tramadol was administered to Joyce for pain control.  Joyce reported her pain level was around a 2 out of 10 at the time of the phone call. Joyce claimed that she did not have physical therapy today, believing that the staff might've been too busy to get her on the schedule today. She said that tomorrow she will begin a new regimen with a therapist assigned to her to work on some specific and new exercises. Joyce has continued to sleep in her recliner for comfort but is considering attempting to try sleeping in the bed in the coming days. She stated she will discuss that option with the day nurses as they are more knowledgeable about what she should and should ...

Sue (Doctor of Nursing Science) and Rachel (administrator) at Aspen Park contacted Dusty via phone around 12:10 p.m. with an update on Joyce, reporting that Joyce was experiencing hallucinations.  Joyce informed a nurse today that she has been seeing a little boy and a little girl in her room while she sat in her chair. The nurse asked Joyce to elaborate on what she was seeing and Joyce reported that for the last 2-3 days she would see the children playing and moving through the room in front of her, then lay down on the floor to rest. Joyce also reported that they would occasionally move behind her chair and kick her chair or move it as they played behind it. The nurse assured Joyce there were not children in the room, and that the entire facility was not open to visitors at this time due to COVID-19 safety protocols. When presented with this information Joyce asked to confirm if the children she had been seeing in the room were real and the nurse confirmed they were not. Sue and ...

5:09 p.m. - Joyce's oxygen/pulse sensor attached to her finger failed and unit was replaced around 5:19 p.m. when a new one was brought up. Joyce's oxygen level at 95%. 5:30 p.m. - Joyce finished entire tray of food. Requesting hot water for tea. Joyce asked if that means that she is feeling better and Dusty commented that he thought it was a good indicator.  5:51 p.m. - Stocker arrived to check on Joyce and remove her food tray. Will return with hot water for Joyce. 5:52 p.m. - Joyce asked Dusty to update her on what they are planning to do with her. Dusty provided recounting of current plan for moving Joyce to Aspen Park facility tomorrow. Stocker returned with hot water for Joyce. Stocker informed Joyce that he is heading home for the day and probably won't see her again before she is transferred to Aspen Park. Stocker let Joyce know that she has been a delight to care for, that he enjoyed visiting with her, and he hopes to meet her again out around Moscow in the future ...

3:59 p.m. - Jackie arrived to check on Joyce's pain levels. Joyce indicated she probably irritated things in her back when she dropped herself down into the recliner by herself when she should have summoned nurse's aides to help her leave the bathroom. Jackie assisted Joyce with readjusting her pillows in the chair and provided a warm blanket to pad her back. Jackie departed to tell Mark from PT that Joyce will need some more time to rest before continuing with afternoon PT plan.  4:08 p.m. - Room service arrived to take Joyce's dinner order. After some deliberation, roasted red potatoes, prune juice, and a half a banana were selected. Joyce resumed napping. 4:20 p.m. - Mark from PT returned. Joyce announced that she could go for a short walk. Mark thought that would be important, even if just walking a short ways to the room door. Joyce walked to the room door and back twice with Mark's assistance and using a Gritman 2-wheeled walker. Joyce was settled back into reclin...

11:20 a.m. - Joyce woke and asked Dusty how he was doing and what had been done to her. Dusty explained that she had a kidney stone removed from her left kidney and she acknowledged that happened. Joyce commented that when they have you under anesthesia "you're just out of it." All sorts of images just go through your mind when you're affected by the anesthesia drugs. That was sort of it yesterday, too, so you just sort of get to sit and experience it. All the images and the thoughts and the stuff that just comes and goes through your mind as you are under the influence of the drugs. Joyce resumed sleeping.  11:26 a.m. - Room service arrived to take Joyce's lunch order. Joyce stated that she hadn't eaten anything today so that would probably be a good idea. Mac & cheese, green beans, and half banana was ordered with hot tea for beverage. Estimating that they will bring it by around 12:30 p.m. to give Joyce some more time for anesthesia to wear off. 11:45 a...

5:47 p.m. - Nurse's aide arrived to take Joyce's blood sugar level. Reading was 168. Joyce asked if that was good or bad and nurse's aide said "That's pretty high." Joyce's blood oxygen levels at 94%. After nurse's aide departed, Joyce asked if she had ordered prune juice. Dusty stated she had not. Joyce said she had been dreaming about it. Dusty let Joyce know he would ask room service for some prune juice when they brought her the broth and half banana, or that he would ask nurse Becky to bring some if she arrived before the room service hostess did.  5:59 p.m. - Becky returned to check in on Joyce. Dusty relayed that Joyce wanted prune juice. Becky thought that was a good idea.  6:01 p.m. - Joyce asked Dusty to inform her on what is going to happen to her tomorrow. Dusty reviewed plan that Dr. Keizur laid out for tomorrow. Joyce pressed call button to go to the bathroom soon afterward. Bed pad and diapers were changed due to incontinence issue. Nurs...

3:14 p.m. - Nurse's aide arrived to take Joyce's vitals. Oxygen levels at 95%. Body temperature at 98.1 degrees. Blood pressure reading is 122/75, pulse is 68.  3:38 p.m. - Alicia, one of the other nurses, arrived to place an IV into Joyce. It was decided to move Joyce back to bed for this process. IV setup was unsuccessful, with technician giving up at 3:53 p.m. to go request a "vein finder" device. Assuming dehydration the cause for difficulties. Joyce's oxygen levels went down, due to her tensing from being poked with the IV needle. Tech asked Joyce to continue practicing deep breathing. Dusty continued working with Joyce to practice deep breathing. Joyce continues to want to hyperventilate with quick, shallow breathing. 4:11 p.m. - Nurse Becky arrived to check on Joyce, offered to get her back into the chair. Joyce declined. Becky asked about Joyce's overall pain levels. Joyce indicated some pain and Becky said she would go get another Tramadol for Joyce t...

10:08 a.m. - Nurse Becky checked in on Joyce. Dusty confirmed with Becky that while bites were taken from the toast, none was swallowed. Only the half of a banana was eaten. Joyce reported tummy ache to Becky. Becky asked Joyce how much overall body pain she has, Joyce reported that she just "has an ache" but doesn't need any pain medicine. Becky reported that Joyce will be working with the physical therapists soon when they come around. After they are done with Joyce, Becky will apply a new lidocaine (Icy Hot) patch to Joyce's back around that time as that seems to be helping her with pain mitigation. Becky reported to Dusty that Joyce was taken off of Hydrocodone per previous concerns about it causing the nausea, so Joyce has only been taking the Tramadol and Mobix (non-steroidal anti-inflammatory) orally for pain relief. Joyce was given blood pressure and heart medicine at 10:13 a.m. by Becky. Other vitamins and supplements paused due to Joyce's stomach issues....