19 July 2025
I'm keenly aware that I owe you a report on the "quarterly" meeting that occurred after eight months of residency. But I was just exhausted yesterday and thought a night's sleep would be just the ticket. Except my chronic cough kept me up for two hours in the middle of the night and I slept in to make up for it. So I'm just now getting to it. Apologies.
"Why should today be different?" the protagonist, a sort of Kafkaesque bureaucrat, says in Brazil the movie. And, in fact, that's pretty much how I'd sum up the whole experience.
Joyce's lunches this week were different. They included a salad with hard boiled egg, ham, American cheese (no tariff on that), Ranch dressing and croutons. Plus Magic Cup ice cream. And one or two other desserts. In addition to the alway mysterious main course and the Boost she ends each lunch with.
They are out of the high protein Boost, so we make do with the lower protein versions because they have the vitamins. She only has the one I give her, I notice, when I see the ones on her table haven't been touched over night.
And she refuses to touch breakfast.
So the RNAs have been weighing her daily. We started weighing her without the wheelchair this week, getting her to stand up and walk onto the scale. Which is something of a circus act.
And to avoid the drama, the RNAs used a Hoyer lift on Friday. Which Joyce did not remember.
So when I told the RNAs she had weighed 107 again, they told me she had weighed 106 on the Hoyer. She weighs 107 lbs. and 8 oz. with her clothes and shoes on, factors I had accounted for with the wheelchair's 39 lbs. So, if you're following along, you can see she has weighed 106 for a while now.
The meeting was scheduled for 1:40 p.m. But at 1:30 Joyce had a bowel movement and I had to tell the RN we had to get the CNA to change her quickly so we could make the meeting.
And Sheik the CNA did that. He pointed out that her bowel was loose and I worried again that it was because her Lexapro dose had been increased from 15mg to 20mg (it's a side effect). But wait, there's more on that.
I go to the meeting room while Sheik changes her diaper but the door is shut with a notice that a meeting is in progress. I return to the room and get Joyce in her wheelchair. I had planned to have her walk to the meeting but not to stand outside the door. We wait a few minutes and the see the physical therapists Cassie and Leonie leaving. I stop them to ask just how to proceed. Nock (it says not to knock) or wait? They tell me to just wait. So we do. Half an hour.
At that point, I go to the front desk to ask the friendly nurse who has been giving me the high protein Boost when they have it, what to do. She calls them and then she walks over and barges in to tell them we have an appointment.
So we finally get in there to confer for Jeanne a nurse and Laura the dietician. It's the Social Services office and there are some social service people in there, too.
We start by going through the medications. I add a few footnotes, like the Lexapro increase.
It turns out they have been giving her a stool softener because she didn’t have a bowel movement for three days after her recent diarrhea. So we don't know if the Lexapro or the stool softener is the cause of her diarrhea.
The nutritionist wants to give her a probiotic and Musilex for regularity.
I don't think regularity is the problem but I don't object. Instead, I ask if she might get some soup for lunch because the eats all of that when I take her home. OK. She also eats Greek yogurt but not French yogurt. Laura nods, she knows but that's all they have.
She also points out the Magic Cup ice cream she has ordered has vitamins. Joyce should also be getting Boost twice a day but I know she only drinks one when I’m there.
When I mention Joyce's fear when standing and walking, the nutritionist thinks it's because she hasn't eaten anything for breakfast. So they discuss with her a breakfast she might like. Bananas and oatmeal wins.
I mention the scheduled toileting that the Memory Clinic nurse practitioner had suggested (and I thought ordered) and they're all for it. Apparently the memory care clinic nurse practitioner's order didn't get passed along.
Jeanne discusses a schedule with Joyce that turns out to be four times a day escorted to the bathroom toilet instead of to a commode. The CNA will do it, they tell me.
I mention the wound care problems too. When Binita and Emilla aren't there the RN does it, training or not, Jeanne says. But they don't follow the order (or, apparently, read it). Princess did it this morning, for example, and I had to rewrap the Ace bandage.
And then it's over.
I take Joyce back to the room and collect the laundry. But on my way out I suddenly remember the podiatrist. So I go back looking for Jeanne, who has escaped. Two of the social workers are still there and one escorts me around looking for her before we give up and go back to the office when we can't find Jeanne.
They show me the podiatrist roster for June and that Joyce wasn't on it. They didn't hear from Mike the Administrator at all and never got the consent form from Eric the RN that I signed. So I fill a new one out and they promise she'll be on the next one in two months for $65.
As I got in the car I couldn't help wondering, "Why should today be different?"