The Official Joyce Update Blog

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...

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...

8:25 a.m. - Craig logged in Joyce's health log book that Joyce had just returned to her recliner from a solo successful bathroom trip. 9 a.m. - Dusty arrived to farmhouse, finding Joyce napping in her recliner without her oxygen line in place. Evidence found that Joyce had taken herself to the bathroom, had issue with early bladder release. Dusty cleaned floor and toilet riser. Found Craig's 8:25 a.m. note in log book. BP 168/77, pulse 71. BGL @ 140. 9:11 a.m. - Breakfast (donut from Rosauers, 1/2 can peaches, nutritional shake, Baby Bell cheese wheel). Morning medication administered. Breakfast finished by 10:12 a.m. 10:17 a.m. - Joyce stated to Dusty that she wanted to stretch out to nap when he asked her what she would like to do next for herself. Dusty setup Joyce to nap. Joyce remained stretched out in her recliner for only 1-2 minutes before she used her remote to raise herself up into sitting position and declared that she did not want to sleep but that she wanted a proj...

8:20 a.m. - Jess arrived, finding Joyce asleep with oxygen line in place. 8:24 a.m. - BP 143/75, pulse 72. BGL @ 114. 8:28 a.m. - Medication with nutritional shake. Jess applied Tiger Balm patch to Joyce's left knee. 8:30 a.m. - Bathroom trip. Urinary incontinence. Early bladder release. Remainder of urine passed. Barrier cream applied. Returned to recliner by 8:45 a.m. 8:20 a.m. - Breakfast (Sausage, egg, cheese biscuit, orange juice, and hash brown from McDonald's). Breakfast finished by 9:13 a.m. 9:25 a.m. - Enrichment activity (coloring).  9:50 a.m. - Bathroom trip without incident. Bowel movement (type 6) and urine passed. Joyce returned to her recliner by 10:20 a.m. 10:23 a.m. - Tiger Balm patch kept falling off. Jess replaced it with a lidocaine patch. 10:25 a.m. - Joyce returned to coloring for enrichment activity. 1:49 p.m. - Dusty arrived to farmhouse following meetings on campus, finding Joyce struggling to stand up from her recliner to travel to bathroom. Bathroom t...

8:13 a.m. - Jess arrived on-site to farmhouse and found Joyce awake in her recliner with oxygen line in place. She was confused over which remote worked the television and which worked the powered recliner. Television set was not working and Jess reset it. 8:17 a.m. - BP 141/78, pulse 75. BGL @ 150.  8:30 a.m. - Morning medication with nutritional shake. Jess noticed two Jell-O pudding cups in Joyce's trash - did she get them herself from the fridge in the middle of the night? 8:35 a.m. - Breakfast (Egg cup omelet with sausage, 1 slice of toast, 1/2 banana). Joyce had difficulty eating the omelet but ate everything else. 9 a.m. - Jess took omelet away from Joyce and gave her 1/2 can of peaches and additional 1/2 banana. Joyce kept zoning out while eating, requiring Jess to keep prompting her to eat so they could get in a trip to the bathroom before Jess had to leave the farmhouse. Breakfast finished by 9:29 a.m. 9:40 a.m. - Bathroom. Urinary incontinence. New disposable pad put ont...

8:05 a.m. - Jess arrived to farmhouse. Joyce asleep in recliner with oxygen line in place. 8:06 a.m. - BP 150/83, pulse 75. BGL @ 142. 8:30 a.m. - Morning medication with nutritional shake. 8:35 a.m. - Breakfast (Egg in toast with banana).  8:53 a.m. - Breakfast stopped for bathroom trip, Joyce expressing urgency. Joyce had difficulty standing - left knee not wanting to function. Jess used wheel chair to move Joyce to bathroom. Urinary incontinence (Joyce did not have a diaper pad insert in her diaper). New skirt. Joyce returned to recliner by 9:13 a.m. 9:33 a.m. - Breakfast finished. 9:55 a.m. - Bathroom trip. Joyce wheeled into bathroom on wheel chair. Jess noticed a discoloration on the lower front panel of the diaper leg - Joyce appears to have scratch marks over her right leg on her tummy in the crease where the skin folds over. Urine and type 6 bowel movement passed. Joyce reported that her buttocks was hurting and asked Jess to check for pressure sores. Hemorrhoidal cream an...

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...

Jess and Dusty arrived to farmhouse ~8:50 a.m., found Joyce asleep in her recliner with oxygen line in place. Evidence that Joyce had taken herself to the bathroom at least once since Dusty departed last night after 11 p.m.  Joyce attempted to tell Jess and Dusty that she had visitors last night but could not articulate who they were - suspecting that she was dreaming/hallucinating as Dusty left so late in the night and nothing in the farmhouse showed evidence of being moved from how Dusty had left it.  Joyce had removed her t-shirt layer of clothing, evidence she had a nosebleed. Joyce could not remember removing the shirt or having a nosebleed. T-shirt replaced. 9:01 a.m. - BP 170/81, pulse 72. BGL @ 131. 9:11 a.m. - Bathroom trip. Urinary incontinence, early bladder release. Remainder of urine passed. Toilet seat riser and floor sanitized. Diaper and diaper pad insert replaced. Hemorrhoidal cream applied. Returned to recliner under her own power by 9:28 a.m. 9:20 a.m. - Mor...

9:10 a.m. - Dusty arrived to farmhouse finding Joyce awake in her recliner without her oxygen line in place. Joyce stated that she had just returned from the bathroom, passing only urine, could not recall if she had been incontinent - toilet tank fills slowly and was filled, so at least was 30 minutes prior to Dusty's arrival.  9:20 a.m. - BP 147/87, pulse 80. BGL @ 134. Morning medication administered with nutritional shake. 9:40 a.m. - Breakfast (6 mini pancakes with peanut butter and syrup, 1/2 can peaches). Breakfast finished by 10:40 a.m., Joyce began napping. 10:40 a.m. - Joyce soiled herself in recliner without warning (type 6). Joyce cleaned up and showered. Shoes sanitized. Bathroom sanitized. Returned to recliner by 12:05 p.m. under her own power. Weight 156 lbs. 12:05 p.m. - Enrichment activity (sorting clothing from her old office clothes for donation from her closet).  Joyce napped, citing fatigue.  1 p.m. - Bathroom trip declined. Napping resumed. 1:30 p.m. ...

9 a.m. - Dusty arrived to farmhouse, finding Craig already on-site in the kitchen and Joyce in the bathroom. Urinary incontinence, diaper and diaper pad insert replaced. Remainder of urine passed. Hemorrhoidal cream and barrier cream applied. Joyce had to be wheeled out on the walker by Dusty. Craig informed Dusty that Joyce had walked into the bathroom on her own. Joyce returned to recliner by 9:14 a.m. 9:17 a.m. - BP 161/96, pulse 76. BGL @ 119. 9:20 a.m. - Nutritional shake with morning medication. 9:30 a.m. - Breakfast (2 strawberry Eggo waffles with butter and syrup, banana). Breakfast finished by 10:15 a.m. 10:23 a.m. - Enrichment activity (laundry folding).  10:45 a.m. - Joyce soiled herself in her recliner without warning (type 6 bowel movement). Joyce showered. Joyce had difficulty following verbal directions. Large mess created in bathroom. Joyce's shoes sanitized. Bathroom sanitized. Returned to recliner by 12:10 p.m. Weight 156.8lbs. Joyce completed laundry folding, too...

8:15 a.m. - Jess arrived to provide morning care for Joyce. Craig on-site, having just arrived to farmhouse before Jess. Joyce found to be stretched out in her recliner with oxygen line in place. 8:19 a.m. - Bathroom trip. Urinary incontinence. Joyce able to walk very slowly into bathroom under her own power. Joyce reporting being in "a lot of pain" throughout trip. Joyce's shoes were sanitized. New disposable pad for recliner put into place. Skirt changed, diaper and diaper pad insert replaced. Jess had to assist Joyce in standing upright at the sink to wash her hands. Jess had to wheel Joyce out to kitchen on her walker as Joyce could not walk under her own power.  9:13 a.m. - Lidocaine patch applied to Joyce's left knee in attempt to relieve pain reported. 9:20 a.m. - Jess was able to get Joyce back onto her recliner.  9:25 a.m. - Morning medication administered with nutritional shake. Cup of Red Rose tea. 9:30 a.m. - Breakfast (1 slice of toast with butter and apr...

8 a.m. - Jess arrived to the farmhouse to find Craig visiting with Joyce. 8:10 a.m. - Joyce reporting pain in her left leg. Joyce could not give a number on the pain scale when asked. Jess attempted to use the visual pain guide chart on her phone instead of numbers to get a reading on Joyce's pain levels - Joyce said the pain was at ~8 out of 10. 8:12 a.m. - Tiger Balm patch applied to Joyce's left knee. 8:19 a.m. - BP 155/86, pulse 68. BGL @ 139. 8:30 a.m. - Morning medication administered with nutritional shake.  8:35 a.m. - Breakfast (1 slice toast with peanut butter and apricot jam, banana). Joyce stated she did not have much of an appetite due to pain levels being so high.  9:26 a.m. - Bathroom trip. Urinary incontinence. New diaper and diaper pad insert. Remainder of urine passed. Joyce gassy - expecting bowel movement soon. 9:50 a.m. - Urgent bathroom trip - Joyce suddenly panicky in chair stating "it's coming out!" as she soiled herself. Jess spoke calmly ...

7:31 a.m. - Bathroom trip with Craig, returned to recliner by 7:53 a.m. 8:10 a.m. - Jess arrived to farmhouse. Craig still on-site. Joyce awake without oxygen line in place. 8:12 a.m. - BP 173/70, pulse 69. BGL @ 155. 8:36 a.m. - Morning medication administered with nutritional shake. Joyce informed Jess she prefers the chocolate nutritional shakes versus the vanilla shakes but the vanilla ones were not bad. (Vanilla shakes were all that was in stock at time supplies for farmhouse were purchased by Dusty.) 8:40 a.m. - Breakfast (1 slice whole wheat toast with egg, banana). Breakfast finished by 9:10 .am. 9:33 a.m. - Bathroom. Urinary incontinence. Joyce only wearing a diaper and no pad. Disposable mat on recliner had evidence of previous accident occurring - Jess replaced it. Skirt changed. Remainder of urine and bowel movement (type 6) passed. Hemorrhoidal cream applied. Toilet seat riser and bathroom floor sanitized. Joyce returned to recliner by 10:10 a.m. 10:15 a.m. - Joyce stretch...

Dusty and Jess arrived to farmhouse ~9:40 p.m., found Joyce awake in her recliner without oxygen line in place, reading weekend newspaper. Evidence that Joyce had taken herself to the bathroom at least once (bowel movement) since Dusty left last night. Dusty cleaned up mess Joyce created with fecal matter in the bathroom. 9:50 a.m. - BP 151/80, pulse 71. BGL @ 136. 9:54 a.m. - Morning medication with nutritional shake. 9:57 a.m. - Breakfast (McDonald's sausage biscuit, hash brown, small orange juice). Breakfast finished by 10:45 a.m. 11 a.m. - Enrichment activity (laundry folding) started. Joyce talkative and responsive to interrogatives.  11:09 a.m.- Craig and Carol arrived to visit. Carol updated Dusty that Kindred contacted her on Friday and would have a nurse arrive to do a blood draw on Joyce "early on Monday." Concern over reported "black" stool Joyce passed is what prompted blood draw to be done.  11:26 a.m. - Joyce yelped suddenly, reported "ouchie ...

Dusty arrived to farmhouse ~9:10 a.m. after treating Jess' migraine and picking up supplies for farmhouse. Craig already on-site and assisted with carrying in items. Craig reported that Joyce had already taken herself to the bathroom when he arrive to farmhouse and as she was awake he took her blood pressure levels and provided her morning medication for today. 8:52 a.m. - BP 138/70, pulse 84. 9:30 a.m. - Breakfast (1 slice whole wheat toast with butter, 1 cup Earl Grey tea, 1/2 banana, omelet with ham, onion, cheese, peppers). Joyce ate very slowly. Joyce began falling asleep while eating breakfast. Joyce began complaining that there was too much food in front of her. Joyce abandoned eating breakfast ~10:10 a.m., ate only 1/2 slice of toast and 1/4 of omelet. Joyce began going through her purse as Dusty put away her breakfast leftovers, finishing emptying and repacking it by 10:55 a.m. Began napping. Noon - Bathroom trip and lunch refused. Napping resumed. 1 p.m. - Bathroom trip a...

8:15 a.m. - Bathroom trip. Joyce still confused but was able to get out of her chair and off the toilet with minimal help. 9 a.m. - Breakfast (1 banana, 1 baby bell cheese round, 1 slice of toast with jam). Morning medication. Breakfast finished by 10:05 a.m. 10:30 a.m. - Bathroom. Urine passed. Diaper pad insert replaced. Joyce able to travel to and from bathroom under her own power. Joyce was not as confused as she was this morning. 12:30 p.m. - Lunch (bologna sandwich with cranberry juice). 2 Tylenol. Lunch finished by 1 p.m. 1:30 p.m. - Bathroom trip without incident. Minor early bladder release. Joyce able to walk to/from bathroom under her own power with minimal help. Joyce's mind was still a little fuzzy but improved over all compared to earlier in the day. 6 p.m. - Bathroom trip. 6:30 p.m. - Dinner (hamburger, Dorito chips). Evening medication. 8:30 p.m. - Bathroom trip without incident. Hemorrhoid cream applied. 9 p.m. - Ready for bed.

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...

7:49 a.m. - Craig called Dusty's cell to provide update on Joyce's condition from last night. Informed Dusty that Joyce had difficulty in getting off of toilet at end of day and had to be picked up and helped out to kitchen and made ready for bed. 7:52 a.m. - Dusty called his director and obtained permission to work remote at the farm today to assist with care for Joyce following Craig's phone call. 8:25 a.m. - Jess and Dusty arrived to the farmhouse, finding Joyce asleep in her recliner with oxygen line in place. Joyce leaning so far forward in recliner that she was almost falling out of recliner. 8:35 a.m. - BP 173/67, pulse 100. BGL @ 158. Joyce reports that she does not know how her bottom feels for soreness or constipation. Joyce lethargic and non-responsive to verbal interrogatives. Joyce was unable to figure out which finger had been poked to collect BGL, had to be directed which one to apply pressure to to stop bleeding. Joyce not comprehending words being spoken to...

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...