IHSS Worker Provider # 003136634

Tuesday - 15/10/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient reported a mood at 3 out of 5 on the mood scale this morning. She cooked for herself today and did her laundry. Nothing further to report.

IHSS Worker Provider # 003136634

Monday - 14/10/2024

Morning Notes

Administered medication to Patient at 8am PDT.

Patient XX woke up at 7:30am this morning. She reported having strong back pain and experiencing a 3 out of 5 on the mood scale. The other IHSS worker arrived at 8am today. She cooked, cleaned, and provided the patient with companionship. We will be resuming computer lessons for Patient XX later this week, to help stimulate her mind.

Evening Notes

Administered medication to Patient XX at 10pm PDT.

She reported experiencing a 2 out of 5 on the Paranoia scale. She spent a couple of hours reading the Bible tonight and went to bed after praying at around 10:30pm. Overall, she seems to be progressing with the increased dose of Risperidone.

IHSS Worker Provider # 003136634

Sunday - 13/10/2024

Morning Notes

Administered medication to patient at 8am PDT.

This morning, she attended Church. Patient reported feeling a 4 out of 5 on the mood scale when she woke up. She ate normally, no new increase in hunger due to the higher dose of Risperidone. She returned from church around noon and spent some of the day cleaning and doing laundry.

Evening Notes

Administered medication to Patient XX at 10pm PDT.

She reported experiencing a 3 out of 5 on the paranoia scale tonight. She read from the Bible in the early evening. I prepared dinner for us. She went to bed at her usual time, after praying.

IHSS Worker Provider # 003136634

Saturday - 12/10/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient reported her mood at a 4 out of 5 on the mood scale. She slept well the previous night. Nothing further to report.

Evening Notes

Administered medication to patient at 10pm PDT.

She returned home from Church services late in the evening feeling well. Patient reported experiencing a 2 out of 5 on the paranoia scale shortly before going to bed.

IHSS Worker Provider # 003136634

Friday - 11/10/2024

Morning Notes

Administered medication to patient at 8am PDT.

Her mood this morning was a 4 out of 5 on the mood scale. Patient woke up at 6:30am today to get ready for market shopping and her therapy appointment. Other IHSS worker arrived at 9am and took Patient XX to the supermarket. Then she cooked and cleaned and drove us both to Patient XX's appointment at Alliance For Wellness, ending her work session at 1pm. Patient and I took the bus back home, getting some exercise by walking some of the way.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient reported being at a 2 out of 5 on the paranoia scale. She went to sleep at her usual time, after praying.

IHSS Worker Provider # 003136634

Thursday - 10/10/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient slept well the previous night and began her 1st day of treatment at the new dose of Risperidone. Mood was at a 4 out of 5 on the mood scale in the morning.

Evening Notes

Administered medication to Patient at 10pm PDT.

Patient went to bed at usual time. Paranoia was at a 3 out of 5 on the paranoia scale, representing little paranoia. Nothing further to report.

IHSS Worker Provider # 003136634

Wednesday - 09/10/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient remained awake after medication to prepare for her medical appointments today, one for her eye doctor and the other for her psychiatrist. She slept well and reported her mood at a 4 of 5 on the mood scale. The other IHSS worker arrived at 10am to drive us to her appointments. 

Evening Notes

Administered medication to Patient XX at 10pm PDT.

She went to bed around 10:30pm and paranoia was minimal. Tomorrow she begins her treatment with increased dose of Risperidone.

IHSS Worker Provider # 003136634

Tuesday - 08/10/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient was feeling a 3 of 5 on the mood scale. She slept well. Her paranoia was at a very low level this morning. Tomorrow, she will see her psychiatrist.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient's mood was stable and paranoia was low. She read the Bible before going to bed at 10:30pm. Nothing further to report.

IHSS Worker Provider # 003136634

Monday - 07/10/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient reported feeling strong back pain this morning. Mood was at a 3 out of 5. She felt better as the day went on. The other IHSS worker took her to have her hair done at a nearby salon. Patient XX spent much of the afternoon singing along to church songs on youtube, using her iPhone. 

Evening Notes

Administered medication to Patient XX at 10pm PDT.

She was feeling much better tonight after spending so much time singing earlier. Fortunately, her paranoia was at a minimum until late in the evening. Her psychiatric appointment is in a couple of days. She is scheduled for a dosage increase for Risperidone, so hopefully, that will help a bit more. Patient went to bed at 10:30pm tonight.

IHSS Worker Provider # 003136634

Sunday - 06/10/2024

Morning Notes

Administered medication to patient at 8am PDT.

This morning, Patient XX reported feeling a 3 out of 5 on the mood scale. The other IHSS worker arrived at 7:30am this morning to make up for needing to leave 30 min earlier the last time. She cooked and cleaned, stayed until 11am. Patient went to Church around 9am and did not return until the evening. We planned a hike together to help Patient XX get some physical activity and enjoy the outdoors.

Evening Notes

Adminisitered medication to patient at 10pm PDT.

Unfortunately, tonight her paranoia returned at significant levels. She expressed sorrow over potentially being taken at any time by law enforcement. On a scale of 1-5 for paranoia, 1 representing none at all and 5 representing the most severe paranoia possible, I estimate her paranoia was approximately a 3 out of 5, representing serious paranoid rumination present. Her mood was also noticeably lower by bedtime. She mentioned feeling depressed. I will make sure to discuss this with her psychiatrist this coming Wednesday, so she can make an appropriate dose change(s).

IHSS Worker Provider # 003136634

Saturday - 05/10/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient reported feeling like a 3 out of 5 on the mood scale this morning. Anything above a 2 is generally positive. We ate pizza for lunch and she read a little bit in the afternoon before preparing for evening church services. A church brother came to pick her up and take her to the evening service. Nothing further to report.

Evening Notes

Administered medication to Patient at 10pm PDT.

Patient returned from church feeling well and went to bed at her usual time, after praying.

IHSS Worker Provider # 003136634

Friday - 04/10/2024

Morning Notes

Administered medication to Patient XX at 8am PDT today.

She reported her mood upon waking, initially at a 3 of 5 on the mood scale, and then later during our morning walk, at a 4 of 5. Today, the othe IHSS worker had an emergency come up so she could not arrive at 8am.

For lunch, I prepared a banana and spinach smoothie for Patient XX and myself. She slept well last night, approximately 9 hours. If the trend continues this way, I estimate her to be at near full recovery from her previous medication relapse by early November.

Evening Notes

Administered medication to Patient XX at 10pm PDT.

Patient read the Bible and prayed before going to sleep at usual bedtime. Minor paranoia still present in the evening, but minimal.

IHSS Worker Provider # 003136634

Thursday - 03/10/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

She reported feeling 3 out of 5 on the mood scale this morning. She awoke at 5am, a bit unusually, but returned to sleep and slept well. No paranoia, no depression. Good progress.

Evening Notes

Administered medication to patient at 10pm PDT.

She did not exhibit any symptoms of paranoia tonight. Nonetheless, some lingering paranoia still exists in the back of her mind, as she described it. Mood in the evening was positive. She went to bed at 10:30pm this evening.

IHSS Worker Provider # 003136634

Wednesday - 02/10/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient XX woke up today at 7am to get ready to go to the market with the other IHSS worker and me. She expressed again feeling better this morning, between a 3 and 4 out of 5 on the mood scale. We finished grocery shopping around 10am. Patient did not exhibit any paranoid symptoms at the supermarket. Discussed possibility of taking Patient XX on a hike later in the week or next week with the other IHSS worker and a guest.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX went to bed at her usual time 11pm. No trouble falling asleep. Very minimal paranoia. Nothing further to report.

IHSS Worker Provider # 003136634

Tuesday - 01/10/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Today I implemented a daily mood scale for Patient XX. Each morning, previously, I was asking her to report her mood between 3 general states, "depressed, neutral, and content." As of the 1st of October, I began asking her to rate her mood each morning on a scale of 1 - 5, 1 representing the worst sadness possible and 5 representing the happiest state possible. She expressed to me that her mood was at a 3 out of 5 this morning, which represents neutral mood. She slept very well last night, falling asleep at approximately 11pm (waking up briefly at 8am only to receive her medication from me) and waking up today around 12pm for a total of almost 13 hours of sleep. This extra somnolence is due to the addition of Risperidone (still at 0.5mg daily, soon to be increased to 1mg). The sleepiness side effect may eventually subside with time, as her brain adjusts to the medication changes (neurological adaptation still occurs within 8 -12 weeks of any change).

Evening Notes

Administered medication to patient at 10pm PDT.

Patient mentioned paranoia being very minimal in the evening. She went to bed at 11pm. Nothing further to report.

IHSS Worker Provider # 003136634

Monday - 30/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

She woke up with flu-like symptoms this morning, but felt well aside from the virus. Mood was positive and paranoia not present this morning. Nothing further to report.

Evening Notes

Administered medication to patient at 10pm PDT.

She had a peaceful Monday afternoon and evening. The other IHSS worker had cooked, cleaned, and shopped for groceries earlier, so everything was taken care of by 1pm. She read the Bible and prayed before going to bed tonight at 10:30pm. She is definitely making excellent progress on her current medications. She mentioned still having a tiny amount of paranoia in the back of her mind, but most of it has subsided. Her next appointment at Alliance For Wellness is in less than two weeks, when she is expected to increase her dose of Risperidone one last time.

IHSS Worker Provider # 003136634

Sunday - 29/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient slept well, over 9 hours. She got ready for Church and took the bus by herself to her Church in Burbank. She stated that she experienced only minimal paranoia while awaiting the bus, but that it dissipated once she was on the bus and on her way to Burbank. Her improvement is not unremarkable, considering she is still only taking 0.5 mg of Risperidone (plus Quetiapine). I'm glad to see her feeling better and actually able to go out in public without fear. She returned from Church around 1pm and reported feeling good. Progress continues.

Evening Notes

Administered medication to Patient XX at 10pm PDT.

Patient reported feeling good and with minimal paranoia tonight. She went to bed shortly after 10:30pm.

IHSS Worker Provider # 003136634

Saturday - 28/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

She slept well and even accompanied me and our pet dog to lunch in the afternoon today. Since she has been too paranoid for the past two months to be able to go out in public, this was progress today. Things are getting better.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX was feeling well today. Lately, she has begun to attend Church service on Saturday evenings as well, so tonight, she enjoyed a peaceful, relaxing night with her Sisters from Church. She went to bed at 11pm tonight, no longer anxious that she will be taken away by some unknown entity (her central paranoid delusion that comes back when she discontinues any of her medications). Her medication is working, slowly. I believe she will be fully stable and mentally healthy again by the end of Fall. Until then, she is still suffering some symptoms.

IHSS Worker Provider # 003136634

Friday - 27/09/2024

Morning Notes

Administered medication to Patient at 8am PDT.

Patient reported feeling okay this morning. She slept well last night. Today was her therapy appointment. I accompanied her to Alliance For Wellness, but let her see the therapist alone while I waited in the waiting area, just this once, as requested by her therapist. I asked Patient XX about the intensity of her paranoia this afternoon and she said that it was "getting better."

Evening Notes

Administered medication to Patient at 10pm PDT

Patient XX reported feeling good tonight. She read the Bible and prayed. Her earlier therapy appointment went okay, according to her. As mentioned earlier, I accompanied her to Alliance for Wellness, but gave her extra privacy during this session. She alone spent about an hour with her therapist. She mentioned that she spent some time remembering some traumatic events from her past, but that was all she said to me. Overall, she is doing much better as the medication addition (risperidone) begins to take full effect. In another two weeks, her psychiatrist indicated that she will increase the dose to 1mg while potentially keeping all her other medications the same. Patient went to bed at her usual time tonight.

IHSS Worker Provider # 003136634

Thursday - 26/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient went back to sleep and awoke again at 11am. The addition of Risperidone is definitely contributing to extra somnolence, but her psychiatrist said not to be alarmed about it. Patient reported feeling good in the morning with almost no paranoia. Tomorrow is her appointment with the therapist. I will accompany her to Alliance For Wellness but not participate in the session, since the therapist requested one on one time with Patient XX for just a session.

Evening Notes

Administered medication to Patient XX at 10pm PDT.

Patient was less paranoid tonight. She went to bed at 11pm. Nothing further to report.

IHSS Worker Provider # 003136634

Wednesday - 25/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient awoke at approximately 7am today to get ready for her psychiatry appointment at Alliance For Wellness. She had her regular toast and coffee. She reported feeling neutral (not depressed) and not paranoid. We headed to her psychiatrist at 11am and discussed progress since the last appt (2 weeks ago). Her psychiatrist decided not to make any changes to her medication for another two weeks. At that point, she will increase the dosage for Risperidone to 1mg for Patient XX. Patient has her therapy appointment in two days. 

Evening Notes

Patient ate dinner and watched a movie tonight. She also read her Bible and prayed before going to bed at midnight. She reported feeling ok tonight but a bit paranoid again.

IHSS Worker Provider # 003136634

Tuesday - 24/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient slept well last night. She briefly woke up at 5am to pray, and at 8am for medicine, but went back to sleep. She awoke again finally at 10:30am.

Evening Notes

Administered medication to Patient at 10pm PDT.

Tonight, she reported feeling content which is a big improvement. Paranoia was still present but at a much lower level than last week. She read the Bible for a few hours, prayed and went to bed at 11pm. Tomorrow is her psychiatry appointment. I will accompany her to Alliance For Wellness.

IHSS Worker Provider # 003136634

Monday - 23/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient reported feeling just ok this morning. She mentioned feeling a little depression. Other IHSS worker came at 8am and left at 1pm. She cooked, cleaned, and provided companionship to Patient XX, while I was out walking the dog. Uncertain whether her paranoia will return in the evening. She is still transitioning and on a very low dose of Risperidone.

Evening Notes

Administered medication to patient at 10pm PDT.

She reported feeling better tonight. She mentioned that most of her paranoia seemed to be gone and that her mood was neutral, rather than depressed. This is good, however she is still in the middle of transitioning to new medication, so changes are still to be expected. Patient went to bed at 10:30pm after praying.

IHSS Worker Provider # 003136634

Sunday - 22/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

She slept well and felt good in the morning. Patient went to Sunday Church services today.

Evening Notes

Administered medication to Patient XX at 10pm PDT.

Overall, she had a good day. Paranoia that is typical of the evenings seems to be diminishing, although still present at significant levels. Her next appointment with the Psychiatric team at Alliance For Wellness is on Wednesday. I will also be emailing them ahead of time on the progress so far, since adding Risperidone.

IHSS Worker Provider # 003136634

Saturday - 21/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient reported feeling well in the morning. Nothing further to report.

Evening Notes

Some paranoia is still present, but Patient XX seems to be improving. She went to Church tonight and went to bed at her usual bedtime - 11pm. It's hard to predict what will happen at this point as her antipsychotic medications are gradually swapped by her psychiatric team.

IHSS Worker Provider # 003136634

Friday - 20/09/2024

Morning Notes

Administered medication to Patient at 8am PDT.

Patient reported feeling better this morning. Other IHSS provider arrived at 8am and drove us to the supermarket. Patient XX was not as paranoid as the night before. Upon returning home, the other IHSS worker cooked lunch and left at 11am.

Evening Notes

Administered medication to Patient at 10pm PDT.

Her paranoia has improved marginally, but not enough for her to feel comfortable going out in public, with the exception of attending Church and going grocery shopping. She spent a few hours reading the Bible tonight and went to bed at 10:30pm.

IHSS Worker Provider # 003136634

Thursday - 19/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient went back to sleep after taking medication and slept until noon. As the Risperidone builds up in her system at this relatively low dose, it is clear that it is making her more sleepy. Today, she reported that her paranoia had decreased a bit, but it still returns in the evenings. Will continue to monitor the pattern for changes. Her next appointment with her psychiatric team is in approximately one week.

Evening Notes

Administered medication to patient at 10pm PDT.

By evening, Patient XX was clearly suffering from strong paranoia again, as she indicated to me that she might be taken away anytime by the next day. She also declined to walk together. She read the Bible for a few hours in the evening and went to bed around 10:30pm.

IHSS Worker Provider # 003136634

Wednesday - 18/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

She woke up today with strong back pain, but overall, in a better mood. The starting dose of Risperidone is helping. However, she is a bit sleepier than usual. Note: she usually goes back to sleep after taking her morning medications and wakes up within 1-2 hours again. The other IHSS worker visited at 8am today, cooked, cleaned, and left at approximately 1pm.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX has been making moderate progress since adding Risperidone to her medication regimen. Tonight however, she reported she was a little more paranoid than previous evenings. She spent a couple of hours reading the Bible tonight and eventually felt a little better, but she still resisted my offer to go on a short walk with her. She went to bed at 10:30pm.

IHSS Worker Provider # 003136634

Tuesday - 17/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient slept well last night. She awoke feeling better and even went to inquire about volunteering at the Salvation Army by herself this morning. We both ate a salad for lunch. Patient became unusually sleepy in the afternoon.

Evening Notes

Administered medication to Patient XX at 10pm PDT.

She again reported feeling less paranoid. She cleaned the apt a bit and did her laundry. Went to bed at 10:30pm.

IHSS Worker Provider # 003136634

Monday - 16/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient XX slept well last night and awoke feeling better. It’s too early to tell if the Risperidone is having a net positive effect but it is definitely causing her to slur her speech a bit. The other IHSS worker arrived at 8am this morning and cooked, cleaned, and picked up medication for Patient XX at the pharmacy. Aside from some back pain, patient had a good morning and ate lunch in the afternoon.

Evening Notes

Administered medication to Patient XX at 10pm PDT.

Patient ate a light dinner tonight and reported feeling better than last week. Paranoia still present but not as much as several days ago. It should take at least a few days for the new medication to reach steady state levels in her system, so this is good progress. She also read the Bible tonight and prayed. Patient went to bed at 11pm.

IHSS Worker Provider # 003136634

Sunday - 15/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient XX awoke feeling better this morning, although she did not sleep too well last night. I attended Church service with her at a new church in Los Angeles (we walked there). Unfortunately, Patient XX did not feel comfortable enough to want to return. She is considering volunteering there on Tuesdays with their food pantry donations, however the work may be too strenuous for her back. Overall, she had a pleasant morning.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX reported feeling a little less paranoid this evening. She spent most of the afternoon reading her Bible. We prepared a dinner salad together and watched the news on tv for a short while. Patient went to bed at 11pm. Tomorrow, the other IHSS worker will come. One note to follow up on - it seems the Risperidone has begun to cause Patient XX to slur her speech a bit. I will try to help her notice when it happens, so she can work on this small side effect.

IHSS Worker Provider # 003136634

Saturday - 14/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT. Patient began treatment with Risperidone (0.5mg) today.

Patient XX seemed better this morning. She awoke early to prepare for a breakfast get together with some family members. This is her first day on Risperidone while on the current cocktail of medications listed above. No noticeable side effects in the first hour since ingesting the medication. Her psychiatrist indicated that she would like to gradually increase Risperidone while decreasing Quetiapine in the coming months.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX attended Church on Saturday night for a change. She was doing ok at Church, but her paranoia did return after returning home. She is currently unable to watch television without the delusion that all televised media is about her. Sunday will be her 2nd day on Risperidone; it will take at least a week or more before any positive effects are noticeable. Patient went to bed at 11:30pm tonight.

IHSS Worker Provider # 003136634

Friday - 13/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient XX awoke with considerable back pain this morning. It's uncertain why, but she does suffer from regular back pain due to a pinched nerve in her spinal cord. She slept well, but her back pain was strong this morning. The other IHSS worker arrived at 8am this morning and drove me to the supermarket to help me do the grocery shopping for the week. Patient XX was in too much pain to accompany us. After cooking, the other IHSS Provider (who I will refer to by the alias, "Jean," out of respect for her privacy) dropped the patient and me off at her therapist's office for her appointment. Jean ended her IHSS work session at 1pm today.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX seemed to be doing better tonight. She read her Bible for several hours tonight, prayed, and went to bed at approximately 11pm. Saturday morning will be her first day with Risperidone added to her mix of medications. Hopefully, this new antipsychotic medication will help clear her evening paranoia. I also want to note that although her Psychiatrist is a nurse practitioner, she has specialized medical education and years of training in psychiatry. I do believe Patient XX's treatment at Alliance For Wellness is some of the best she has ever received in her long struggle with Schizophrenia. Hopefully, with time and enough quality feedback from the patient and myself (even if it takes a few more months), her new psychiatrist can help Patient XX reach a solid and balanced regimen of medications that alleviates most of her symptoms.

IHSS Worker Provider # 003136634

Thursday - 12/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient XX reported feeling much better this morning. She slept well and we attended her psychiatry appointment at 2:30pm. Has been averaging about 5-6 cups of coffee every day.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient and I spent approximately 30 minutes with her psychiatric team. First, Patient XX spoke and then I discussed my observations about her over the past month. I mentioned her pattern of instability (fluctuating paranoia) from morning to evening in a bit more detail and the psychiatric nurse-practitioner decided it was the appropriate time to add another antipsychotic medication to Patient XX's regimen of medications. The nurse practitioner, whose name will be omitted from this public record, asked me to email her a status update on Patient XX in a week. Next appointment is scheduled 2 weeks from now. Patient went to sleep at 10:30pm tonight. She will begin the additional medication on Friday.

IHSS Worker Provider # 003136634

Wednesday - 11/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

She woke up feeling well this morning. Patient XX instructed the other IHSS worker to prepare lunch today. Afterward, patient and I went for a short walk with our dog to check out a new Christian Church a very short distance away from the apartment. She liked it. We spoke about her trying new Churches and she seemed open to the idea. Overall, she had a good morning.

Evening Notes

Administered medication to patient at 10pm PDT.

She reported feeling very paranoid in the evening and did not wish to go out, even on her birthday. Appointment with psychiatric team on Thursday. Will discuss this pattern of instability and try to rectify.

IHSS Worker Provider # 003136634

Tuesday - 10/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

She returned to sleep, as usual, and woke up a couple of hours later. Patient reported feeling well. For lunch, we both had a large salad. Uneventful morning.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient and I watched the Presidential debate together. We ate my grandmother's signature chicken stew dish, prepared by the other IHSS worker yesterday. Patient went to bed at approximately 11pm.

IHSS Worker Provider # 003136634

Monday - 09/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient did not resume sleep after her medication this morning. She slept approximately 9 hours since the previous night. She drank coffee and organized and cleaned her room a bit. Reported feeling ok.

Evening Notes

Administered medication to patient at 10pm PDT.

Read from my old neuroscience textbook with Patient XX this evening. We cooked and ate dinner together. She watched some news on Youtube and spent some of her day praying. The other IHSS worker came by at 9pm to prepare a meal and clean up a bit. Patient went to bed at around 10:45pm.

IHSS Worker Provider # 003136634

Sunday - 08/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient felt ok this morning. The other IHSS worker drove us to the supermarket today. Patient XX reported feeling a bit paranoid at the market. Afterward, IHSS worker drove patient to Church and returned back to the apartment to finish her duties, including cooking Sunday Lunch. Patient XX returned from Church at approximately 1pm.

Evening Notes

Administered medication to Patient XX at 10pm PDT.

She was again more paranoid in the evening. The pattern is consistent. Emailed her psychiatric team yesterday to update them. Her next appointment is on Thursday. Patient did not read the Bible today.  She went to bed at approximately 11pm.

IHSS Worker Provider # 003136634

Saturday - 07/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient XX awoke today feeling well. Paranoia not present at high levels. She ate her usual breakfast and spent a few hours reading the Bible.

Evening Notes

Administered medication to patient at 10pm PDT.

Emailed psychiatric team with update on Patient XX's mental status. She is still very paranoid in the evenings and feeling relatively good in the mornings. I don't know what changes they will make to her medication but this mental instability is unacceptable at this point.

IHSS Worker Provider # 003136634

Friday - 06/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient awoke at 10:30am. She was feeling ok. However, later in the afternoon, her paranoia was evident again. Will email her psychiatric team on Saturday with notes on her instability.

 Evening Notes

Administered medication to patient at 10pm PDT.

Patient spent a few hours reading the Bible tonight and prayed several times today. She went to bed at approximately 11pm.

IHSS Worker Provider # 003136634

Thursday - 05/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient awoke feeling well. Spent a few hours in the afternoon reading the Bible. Uneventful day, aside from the extreme heat wave.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient did not want to go for a walk, nor did I in this triple digit weather. She seemed less paranoid this evening, and again spent a few hours reading her Bible. I will be emailing her psychiatric team this Saturday to update them on her condition. Hopefully, that will give them more time to process the info and come up with a better medication plan at the next appointment. Patient went to bed at 11pm.

IHSS Worker Provider # 003136634

Wednesday - 04/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Once again, in the morning, her mental state was far healthier than the previous night. I asked her if she remembers how different and unstable she was yesterday evening, and she confirmed that she could recall her paranoia and delusional thoughts being very strong. Unfortunately, knowing this does not change how the patient is able to respond to her paranoia when it resumes in the evenings. It is clear that one or more of her medications is failing her with regard to this instability. I will wait a couple more days to see if this behavioral pattern persists and if so, email her psychiatric team about this concern. Her next psychiatric appointment is on the 12th of September.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX spent time demonstrating duties to the new IHSS worker today. After about 5pm, IHSS worker left and patient spent a few hours reading the Bible. We prepared dinner together. She is still much more paranoid in the evenings, which she has begun to become aware of, herself, without me having to point out her behavior to her.

IHSS Worker Provider # 003136634

Tuesday - 03/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient slept well this morning. She reported feeling better. Accompanied her to her Therapy appointment at Alliance For Wellness. Discussed patient's symptom history with therapist, going back decades, whenever Patient XX could not remember some details. Patient mentioned a strong interest in volunteering. Patient and I returned home and ate a late lunch. Overall, she seemed ok, but still mentioned feelings of paranoia. Patient has another appointment with her therapist scheduled within a week.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX is unfortunately still demonstrating the pattern of symptoms mentioned previously. On her current medication regimen, which has not been changed since mid August, she is still exhibiting significant instability between the morning and evening. In the morning, she reports feeling rested and better, but by the late evening, her paranoia returns at high levels. By nightfall, she becomes convinced of her central paranoid delusion repeatedly, that she will be taken away by government law enforcement of some type. It's really a stark contrast to the healthier person she is in the mornings. I will email her psychiatric team by the end of this week to keep them updated, and to help coordinate the best treatment options for her.

IHSS Worker Provider # 003136634

Monday - 02/09/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient is doing ok. She slept over 9 hours. The other IHSS worker (IHSS Provider #001186986) visited for the 1st official day of work. She drove us to go supermarket shopping together. Patient XX was a little reluctant to go shopping initially and seemed a bit anxious but she stated that her paranoia was not too bad. Supermarket shopping went well, patient did not seem too distressed.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX spent some time reviewing duties with the other IHSS worker toward the end of her shift (ended approximately 5:30pm). The worker departed and Patient XX spent much of the rest of the day reading the Bible. She went to bed at approximately 11pm, following her nightly prayer.

IHSS Worker Provider # 003136634

Sunday - 01/09/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

She reported feeling good this morning but facial affect indicated otherwise, perhaps a little nervous. She left the apartment at approximately 9:40am, headed for Church.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX is still dealing with paranoia in the evenings. The pattern has become clear, she starts off her day, usually feeling well but by nighttime, her paranoia and depression return. I mentioned this pattern to the psychiatric team earlier in the week, but they decided to wait a bit longer before making any modifications to her medicine.

IHSS Worker Provider # 003136634

31/08/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient is feeling well. Helped prepare her breakfast. Medication seems slow to work but is progressively getting better.

Evening Notes

Administered medication to patient at 10pm PDT.

Overall, today Patient XX seemed to be doing better. We cooked meals together, she read the Bible, and we went for a walk in the evening. Her paranoia was not as bad and her depression seemed to be alleviated. She went to bed at approximately 11pm,  ready to go to Church on Sunday.

IHSS Worker Provider # 003136634

30/08/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient reported feeling better this morning. At the time of writing, she has consumed 2 cups of coffee. Today, I encouraged her to read an old neuroscience textbook of mine. She finally opened the book and read a bit. For dinner, we will prepare a strawberry smoothie. It is not necessary to eat meat every day. Together, we are trying to eat less animal products and more plant-based protein, including soy, nuts, and beans. Her paranoia seemed to be less severe today.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX read the bible in the evening and went to shortly before 11pm. She is improving.

IHSS Worker Provider # 003136634

29/08/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient was doing better upon waking, today. She drank 2 cups of coffee in the morning and showered to prep for her psychiatric appt. Accompanied her to her psychiatry appt. Psychiatric team noted all the patient's issues over the past 2 weeks and decided to wait 2 more weeks before making any changes to Patient XX's medication.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX and I prepared a large salad for dinner and enjoyed it with a side of garbanzo beans. She was ok today, not as paranoid nor depressed. Will continue to monitor her closely this week for signs of improvement. She reads the Bible almost every night before going to bed, usually around 11pm.

IHSS Worker Provider # 003136634

28/08/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient reported feeling better this morning, however, I suspect an increase in dose or change of medication will be necessary, as patient's mood has not stabilized over the past 2 weeks nor have her paranoid delusions been resolved. Psychiatric team will decided what changes to make, if any, tomorrow, during her appointment at Alliance For Wellness Inc.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient is still suffering from paranoid delusion, especially toward the evenings. She refused to put on her pajamas and stayed dressed in her regular clothes, as if to prepare for being taken away at any time in the night. Will update the psychiatric team on all of this during her appointment on the 29th. Regardless, we will get her well again.

IHSS Worker Provider # 003136634

27/08/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient appeared to be doing better, however, upon arriving at the Therapist's office for her appointment today, she was still paranoid about being taken away. Therapist and psychiatric team may get access to these notes. I will need to get permission from Patient XX.

Evening Notes

Administered medication to patient at 10pm PDT.

Accompanied patient to Therapist appointment. Patient spent approximately an hour with therapist. Therapist covered a wide variety of topics and noted that Patient XX was still very paranoid. Appointment with psychiatric team is in a couple of days. Upon arriving home, patient helped me prepare dinner. She spent the rest of the evening reading the Bible.

IHSS Worker Provider # 003136634

26/08/2024

Morning Notes

Administered medication to patient at 8am PDT.

Patient was feeling ok in the morning. An IHSS provider visited today to speak with patient and said she would return with the proper forms to work for Patient XX.

Evening Notes

Administered medication to patient at 10pm PDT.

As mentioned previously in prior posts, Patient XX has developed a pattern of feeling better in the morning and worse in the evening, especially with regard to her paranoid delusions of being taken away by authorities. Since these symptoms have not diminished after two weeks of treatment since beginning Bupropion, I will inform her therapist about this issue.

Patient is doing significantly better than at the beginning of the month, however, it seems that her medication will still require further adjustment by her psychiatric team.

IHSS Worker Provider # 003136634

25/08/2024

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient reported feeling less paranoid but still depressed. Accompanied patient on bus to Church for part of the way to make sure she was ok.

Evening Notes

Administered medication to patient at 10pm PDT.

Talked about her Church visit today. She said she felt much better after her Church Sisters prayed for her. Another positive sign is that Patient XX was willing to accompany me and our dog for a walk tonight. At the end of the evening, we shopped at Ralphs together (online). Patient went to bed at 11pm.

Will continue to monitor patient for signs of improvement throughout the week ahead. She has two mental health appointments this coming week, one with a therapist and one with the psychiatric team.

IHSS Worker Provider # 003136634

24/08/2024 Notes

Current work being performed today:

Helping to organize duties and paperwork for the other IHSS worker who will be starting on 08/26/2024. Helping Patient XX to plan the week ahead, including two medical appointments and wellness plan.

Morning Notes

Administered medications to patient at 8am PDT.

This is the final time adjustment in dosing, which will allow her to wake up early enough for Church on Sundays. Patient initially reported feeling good upon waking this morning, but subsequently reported not feeling too well later in the afternoon. She indicated some symptoms of paranoia still bothering her. Will continue to monitor mood and thoughts throughout the day and will bring notes to patient's psychiatric appointment this coming week.

Evening Notes

Administered medication at 10pm PDT

Patient went to bed at 11pm. She reported not feeling too well, but a pattern is emerging. She seems to be feeling better in the mornings and worse in the evenings. Will continue to monitor this pattern for changes.

IHSS Worker Provider # 003136634

23/08/2024 Notes

Current work being performed today:

Getting all paperwork for IHSS pay taken care of today. 

Morning Notes

Administered medication to Patient XX at 8am PDT.

Patient reported feeling better this morning. This should be the final  medication schedule change for the patient, allowing her to wake up at the appropriate time to visit her Church on Sundays. Going forward, Patient XX will regularly take her medications at 8am and 10pm, daily. Patient mentioned her paranoia has begun to subside and she is no longer experiencing extreme delusions of persecution by law enforcement. This is good news indeed. However, she still reports depression at significant levels.

Evening Notes

Administered medication to patient at 10pm PDT.

Patient XX cooked a traditional family dish for dinner and spent the evening reading her Bible. Patient went to bed at 11pm. Compared to 2 weeks ago, patient has experienced substantial recovery..

IHSS Worker Provider # 003136634

22/08/2024 Notes

Current work being performed today:

Monitoring patient for signs of progress, taking notes, and locating IHSS paperwork for submission to Patient's trustee (sibling).

Morning Notes

Administered medication to Patient XX at 9am PDT today.

Slowly moving her medication schedule earlier to allow patient to be alert when she wakes up on Sundays for Church. Today she interviewed an IHSS provider for 2 days per week of work. The IHSS provider mentioned that the patient would be responsible for compensating her for gas on any longer-distance trips. Trips to the local supermarket need not be compensated. Patient decided to employ this IHSS worker and set up an appointment for next Monday. Patient ate lunch and spent the rest of the day reading the Bible. In the afternoon, she spent about 1 hour on a call with her cousin, living within the same state. Patient's family bonds and church friend relationships are important to her. When she is well, she generally keeps in touch with various members of her family. Today is the first time in several weeks that Patient XX had a long phone conversation with a family member, so this is a very promising sign that she is recovering, albeit at a slow pace.

Note: Patient XX is still consuming high levels of caffeine daily, usually 5-6 cups of coffee. Will notify psychiatric team on next visit this coming week.

Evening Notes

Administered medication at 10pm PDT.

Patient XX was feeling ok in the evening. She went to bed at approximately 11pm. As mentioned previously, she is shifting her medication schedule a little earlier to align with her Church time on Sundays. Her 1st appointment with the psychologist is on Tuesday, followed by her psychiatric appointment on Thursday.

IHSS Worker Provider # 003136634

21/08/2024 Notes

Current work being performed today:

IHSS Worker visited today at 8:30am. Discussed job duties with Patient XX. IHSS worker said she would think about the position and let the patient know, because she is seeking only 1 day per week. Will call more IHSS providers from the list today to schedule interviews with Patient XX.

Morning Notes

Administered medications to patient at 10am PDT.

Patient reported feeling better today than yesterday. She woke up early enough to interview the IHSS Provider. She also prepped a salad for lunch. Will coordinate with patient to make more appointments with IHSS workers.

Evening Notes

Administered medications at 10pm PDT.

In order to help patient wake up earlier for Church on Sunday, medications will slowly be given earlier over several days, aiming for 8am morning medications. Patient was feeling better today. Went for a walk with her to pick up her eye medication at a local CVS and then to pick up dinner. She had a brief conversation with a family member in her country of origin. After praying, patient went to sleep at midnight. Overall, patient XX's condition is improving. 

IHSS Worker Provider # 003136634

20/08/2024 Notes

Current work being performed today:

Meeting with IHSS provider today at 4pm. Continuing to monitor messages from providers at IHSSconnect.com.

Morning Notes

Administered medication to Patient XX at 10am PDT. 

Patient reported not feeling too well this morning. At this early stage of new medication (Bupropion addition), it is normal to fluctuate in mood a bit. Patient watched youtube coverage of Presidential campaign footage for over an hour. I am generally asking her how she feels an average of 3 times per day, to gather data alongside medication changes and daily activity.

Evening Notes

Administered medication to patient at 11pm PDT.

Asked patient about her mood several times today. She reported not feeling as good as the prior day. She spent the last several hours of the day reading her Bible. Patient stayed awake late tonight reading. Went to sleep at 12:30am PDT.

IHSS Worker Provider # 003136634

19/08/2024 Notes

Current work being performed today:

Contacted IHSS worker to schedule work appt for Tuesday, Aug. 20th at 4pm.

Morning Notes

Administered medication to Patient XX at 10am PDT.

Patient is progressing and feeling better. 

Evening Notes

Administered medications to patient at 11pm PDT.

Patient XX reports that she is feeling a bit better with each day. She read the bible in the evening today and watched television.

IHSS Worker Provider # 003136634

18/08/2024 Notes

Current work being performed today:

Continued to reach out to IHSS providers this morning. A few replied but indicated that they are too far from Patient XX.

Will continue to monitor messages on IHSSconnect.com.

Morning Notes

Administered morning medications to patient at approximately 10am PDT.

Day 3 of bupropion treatment. Patient reported feeling a little better this morning. Bupropion is a norepinephrine and dopamine reuptake inhibitor. This class of medication is relatively new for Patient XX; she has primarily been treated with SSRIs in the past. Patient XX had adjusted her sleep schedule in recent weeks, so she is now waking later than usual. Patient still does not feel comfortable going to church, which is a significant indicator of mental health for her, as she is a devout Evangelical who normally relishes her Church time.

Evening Notes

Administered medications to patient at 11pm PDT.

After spending several days reading the bible for most of the day, Patient XX did not read her bible at all today. Although still exhibiting persecutory delusions, she reported feeling significantly better,  which can possibly be attributed to the Bupropion starting to alleviate her depression. Remarkably, when I asked her to go on a short walk with me and our dog, she did not resist. This was a very good sign, as she has been reluctant to go on walks even prior to her relapse. Again, this willingness to go outside in public view is a clear indicator that her new medication combo is beginning to work. Due to her Bupropion being given in the mornings, Patient XX reports feeling better in the earlier part of the day. I will continue to monitor patient closely for both positive and negative signs.

IHSS Worker Provider # 003136634

17/08/2024 Notes

Current work being performed today:

Searching www.ihssconnect.com for another part-time IHSS worker. Will update.

Morning Notes

Administered medications to Patient XX.

Patient is on Day 2 of Bupropion in the morning. Reports feeling a little better, but still wishes to avoid all social contact at the moment. Patient is still suffering from paranoia and thoughts of persecution. Reported feeling comfortable with the psychiatric care provided by Alliance For Wellness, Inc. I visited with Patient XX during her psychiatric appointment earlier this week to ensure a thorough medical and psychiatric assessment, including recounting the details of patient's recent relapse (primarily due to ceasing her Quetiapine medication for over 1 month). Psychiatric caretaker scheduled a follow-up appointment within 2 weeks, including psychotherapy. I will continue to attend psychiatric visits with patient.

Evening Notes

Administered medications to Patient XX.

Patient had coffee just before medications. I told her not consume caffeine before bed, but she did not heed my advice. She also was reluctant to go to sleep, informing me that she wanted to stay awake. After pleading with her to go to sleep several times, I guided her to bed. Patient is still paranoid that she will be taken away to prison any day. This is a central, intense and recurring persecutory delusion that she suffers from when missing her antipsychotic medication too long.  I am uncertain if her current medication combo is helping her fast enough or not. I will request that her next psychiatry appointment be rescheduled for an earlier date. Her condition has improved noticeably since last week, but progress is very slow.

Earlier today, Patient XX prepped and cooked a delicious meal. Aside from that, she spent the majority of the day reading her Bible, as she has done for the past week. It seems to be the only thing that is able to distract her from her paranoid thoughts. Patient is adamant about her wishes to avoid going to the hospital, and to continue treatment at home.

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