Life in Rehab

"Tried to make me go to rehab but I said, 'No, no, no . . .” My father has been recovering in the skilled nursing unit at his retirement village for 2 weeks, with 1 more week to go before being released back to his apartment. He is dealing with everything gracefully, and I’m spoiling him to soften the blow. I spend many hours distracting him. I smuggle in food every day to bribe the nursing staff and to keep Dad’s spirits up: donuts, bagels, a meatball sub. I’m holding back on the sugary treats because his doctor lectured us to focus on protein. Dad uses my laptop to watch Mel Brooks and Monty Python movies. I took it back to write this post and noticed the keyboard was full of greasy crumbs.

I’m getting lots of feedback, mostly that I’m an amazing daughter when so many other kids never show up, which makes me sad. Sometimes the comments catch me off guard. Norm, my father’s neighbor, who is dying from COPD and dementia, told me “you look sexy, can I grab a feel?” I declined his kind offer. I saw him later that day and he said: “You look tired.” I explained that I excelled at being both sexy and tired. He said he could relate. I held his hand.

Yesterday was Staff Safari Day – the dress theme was jungle shirts and helmets. One hard-of-hearing lady misunderstood and thought it was Sephardic Day. That actually makes a lot more sense for a Jewish facility.

I’m consulting with the management team to upgrade the safety pendant system. I showed some of the residents Dad’s new watch to prevent falls, and asked them “would you wear it?” They argued about its merits. The director of the independent unit told me afterwards: “When I fall, I won’t press any button. I don’t want to be old and broken. I would just let myself go.” I understand.

Sid is progressing; he gets constant physical and occupational therapy. Using a walker, he travels to his apartment each day to visit his comfortable recliner. We’ve rearranged the bathroom to be safer, incorporating his suggestions. Adjusting the height of the shower bench was no easy task; Mom used it for a decade and the legs were rusted into place. I realized that Dad’s toolbox, brought over from his old house and stashed away in the ancient file cabinet, would finally come in handy. I found the WD-40 oil and a ball peen hammer, and whacked away at the bench. Dad was impressed that I was so handy. The supervising therapist was slightly scared, asking me “what exactly do you do?” I smiled and responded “whatever is necessary.”

A Horrible Week

This post is one of my intense ones. You can skip ahead for the cute anecdotes if you like.

Dad slipped in the bathroom 5 days ago and lay bleeding and injured on the floor for 14 hours. He couldn’t reach the call button and he had removed his safety pendant to take a shower. He wasn’t able to answer his phone or door; eventually the housekeeper heard him yelling and he was rescued. He is physically damaged but mentally alert, and will hopefully respond to intense therapy. The rehab unit is located next door to his regular building - there was one bed available which was held for him.

Moments that will stick with me for a long time:

• The treating physician at Scripps Hospital ER calling to ask if he could text me photos of Dad’s battered face to consult to make sure the swelling was related to skin cancer treatment and not the fall – versus Dad’s regular specialist laughing when I tried to send him a picture, saying “I don’t do tele-dermatology, honey.”

• Dad’s friend Shirley taking me into a hallway to press ziplock baggies and rubber bands into my hands, her caring effort to keep my father safe in the shower.

• Rushing into Dad’s room with a box full of Costco hot dogs and sauerkraut to find 3 nutritionists discussing his dietary preferences and their recommendations for a healthier lifestyle – oops.

• Dad somehow broke the audio on 2 TVs – one in his hospital room, one in rehab. I believe it was Mom showing up to get a word in.

• The occupational therapist asking Dad to take off his shirt and he responded “what for? I barely know you!”

• Dad introducing himself at the dining room table to 4 semi-functional ladies with “Hi I’m Sidney and I’ve been a damn fool” (they ignored him).

• 99-year old Ida’s withering look when I asked if she was able to hike over to the rehab unit with me to visit Sid (she walks faster than me).

• Ida telling me how she was mad at Sid for being a sloppy eater, he embarrasses her at special events because he doesn’t tuck in his shirt. I informed her that since one of my best friends just died from an exploding heart, and my brilliant, kind and somewhat messy father almost died a week later, I really didn’t give a crap about etiquette. She then shut up and apologized.

• The physical therapist on his medical team who recognized me and said “hey aren’t you the one who taught us how to dance Thriller?” (karma paying forward).

• The nurse who stopped me in the parking lot to tell me that the list of medications I provided was incredibly helpful because it not only listed Dad’s drugs, but WHEN he took them throughout the day. It allows the staff to better calibrate his meds. Dad prepared the list on his computer 2 years ago; I found and updated it. We both get bonus points for good planning.

Please prepare the following, if not for yourself, then for the people who will be taking care of you:

• Living Will and Advance Directive. Google the free templates and just do it, look at http://www.agingwithdignity.org/
• Healthcare Proxy. Who will make medical decisions if you can’t talk?
• Have your current insurance card on file. Bills going to the wrong place are a nightmare to fix.

Emergency responders had to access all of these documents within 5 minutes for my father’s treatment. Some of the documents kept by his facility were out of date. I had everything ready in a binder that I carefully prepared – and the binder was in Seattle, with me. Luckily I showed up on the scene pretty fast. Fortunately the EMTs and doctors made smart assumptions and everything went smoothly.

Dad is getting excellent health care, I am impressed and grateful. I’m now in Seattle and will be driving back to San Diego in a few days; I’ll be there for a month. This trip was already planned; however it now takes on enhanced importance. Sid has a new state-of-the-art waterproof watch that will function as an emergency alert system linked to activity sensors, tell the time, track medication and even track his steps (no, it’s not a groovy Apple watch, it’s a Lively Smartwatch: http://www.mylively.com/). And he has promised to actually wear it.

Finance Lesson

We all know that pets are family members. However when their health histories are identical to our own, it gives pause – or paws – for thought. Randy, my geriatric orange tabby, has the following issues: allergies, heart murmur, gulping of food, decaying teeth, urinary blockages, weak ankles, arthritis, and resistance to change. These happen to be the same maladies that my father have, with the addition of diabetes and the subtraction of vomiting grass and peeing on the bed when anxious (I hope, I don’t really know). Now let’s do the comparative math for their medical care* over the last month:

* Randy: routine exam, lab work, drugs = $255 total, paid with my AmEx card.
* Dad: routine exam ($250), lab work ($720), drugs ($350) = $1320, mostly paid by Medicare.

Who do you think gets better overall quality of care? Do you think my father would mind if I took him to the local vet at our next visit?

In the meantime, I’m starting to show my own signs of mid-life deterioration and I mostly ignore it. My health insurance has a whopping deductible, and I prefer to be in active denial. Just like a cat.

Community Spirit

I’ve been busy modernizing my basement so that I can have a tenant to fund my trips to San Diego. Peeling back layers and frayed electrical wiring was quite an experience, but even more entertaining was interviewing the applicants. I chatted with a botanist, pastry chef, woman fleeing from abusive husband, pool cleaner, shuttle driver, web designer, nurse, punk karaoke singer, LGBT support group organizer, ladies who insisted their elderly dogs would bond with my cats, and really tall men who hit their heads on the short bathroom ceiling. Friends expected that I would go with the pastry chef (her specialty is lemon bars), however I selected the hospitality supervisor at the Westin Hotel. She’s delightful, quiet, and most important, under 5’ 6”. Decades ago I shared a place in Washington DC where the middle-aged owner had post-it signs everywhere saying “Abdul is coming.” I never knew if it was religious conviction or she was reminding herself to pick up a guy at the airport. Let’s hope I’m not quite as bizarre, now that the roles are reversed.

Helping with the early stage memory loss support group is fascinating and occasionally tough. I observed how the social worker handled a group discussion about terminal illness; I learned about grace and coping strategies. Afterwards the facilitator told me that some of the volunteers wanted to work with young children to get lifecycle balance, was I interested? Hell, no, hyperactive kids would send me over the edge. Instead, I’m interviewing seniors who have joined the local aging-in-place community organization to assess their needs. Currently there are lots of wonderful services, including transportation, home repair, and gardening (all of which I need, but I don’t qualify - yet). Interestingly, survey respondents are mentioning healthcare advocacy, particularly assistance with insurance decisions and medical care, as something they want. Little did I realize that this mini-focus group would validate my future career path; finding a job may be right under my nose.

Yesterday my neighbor and I checked out an estate sale around the corner, where an elderly lady had recently died. It was an old house with whirligig animals that were hand carved and painted by her deceased husband. Flying high on decaying fence posts, they reminded me of the carpentry my father did a while back. Woodworking was one of his better skills, along with making animal balloons. I love folk art, and I took home two pieces for repair and rescue (Road Runner and Wylie Coyote). Feeling nostalgic, I mentioned it to Dad today, thinking he might relate. He was so excited and thanked me for giving these pieces new life. Then he had to rush off to watch the competitive basketball tournament put on by his facility (independent living and assisted living staff duke it out in the parking lot).

Lots of seemingly random events are coming together to make me confident that I’m choosing my own right path. I’m enjoying the transition.

Taxes, Death and Other Certainties

With a nod to Ben Franklin’s famous quote, tax season is the universal equalizing experience. In my father’s case, this was the first time he didn’t prepare his own paperwork. After my badgering him for oh, about 5 years, he finally agreed to have a trained expert do the returns. Since AARP sponsors a free consulting service for seniors at the local library, we went there for what I thought would be a quick chat. I gathered every possible piece of paper in his apartment that said 1099 or DIV or “important for your taxes.” To his credit, he had attempted to calculate everything on an Excel spreadsheet. However, as we found out today, it’s essential to enter commas, not periods – for instance, the amount of $34,000 is different from $34.00.

We got a lucky break with the tax specialist. She is a nice Jewish girl originally from New York, and her own mother lived at Dad’s retirement village for 21 years. She calmly organized the multiple copies of the same statements, the mutilated records, and the documents with food stains. She asked Sid what his former profession was, he said “electrical engineer”, she smiled and said “oh I could tell.” Apparently all retired engineers make many copies – just in case, you know. She plugged all the data into the amazing government software, muttering a bit, and told us there was a glitch. The computer kept trying to add my mother, even though she’s out of the picture. I explained that Mom periodically shows up to mess with us; she probably wanted a piece of the action. Did the tax lady think this was nuts? Not at all. She shared that her dead mother turns the lights on and off in her home (note to Cindy – sound familiar?)

Two and a half hours later, we had final results that were quite shocking to me, but Dad took it all in stride. He still has money in the bank to pay his bills for at least a year. Also, if the residents go broke, rent is reduced to whatever income is available – some of the centenarians live there for free. After a recovery nap, off we went to a Purim celebration to have kosher cocktails and rattle noisemakers.

I already did my own taxes with TurboTax; now I can spend more time with my father. That’s a life refund, better than anything from the IRS.

Vintage is Subjective

When I talk every day with Dad, we don’t dwell too much on memories. Recently, however, he was missing his favorite tools, specifically the heavy duty ratcheting jar opener. He was struggling to open the jar of jumbo garlic pickles (technically it’s my emergency supply I keep in his refrigerator, but never mind.) I got the “why didn’t you consult with me about what to bring to the apartment and what to throw out” speech. I pointed out that we were all a bit busy at that time dealing with renal failure and saving his life, however I did transport other great kitchen utensils. I suggested using hot water, whacking the jar to loosen the vacuum seal, rubber grabbers, getting a NEW opener (god forbid), even asking the maintenance crew to assist. Then I remembered this particular device from my childhood and it was kind of cool, so I searched the Internet for a replacement. I found one – made in 1935, available from a lady who specializes in estate sale goodies. (This is a revenue path my brother and I had not considered when we offloaded pounds of junk to Goodwill – a lost opportunity). I had the “vintage” jar opener mailed to Dad. His opener was from the 1950s; really, how different could it be?

Although my father appreciated the effort, the antique opener didn’t meet his expectations. Then my brother told me that Dad actually gave him the utensil, decades ago. It’s buried deep in a drawer somewhere in his Long Island home. Now Dan has to find it and bring it to San Diego on his next trip, along with a dozen fresh bagels. He also reminded me about the time we had Dad itemize which top 10 things he would rescue if the house was on fire. Tools were number 1. My mother was number 8. I asked Dad today if he remembered those priorities - he laughed and said yes, and he wouldn’t change the list. What were numbers 2 through 7? He’s not telling.

Seniors in Seattle

I’m getting all sorts of stories by volunteering at the senior center. Today a couple in their mid-80s came in to check out the place and they were pleased with all the free offerings. The husband told me that they had been married for 56 years – “2 decent ones and 54 years of abuse.” The wife said that he was fine company except for his obsession with football, and that she planned to murder him this Sunday during the Seahawks playoff game. Not missing a beat, I offered the phone number of a social worker for counseling and suggested she look into our legal advocacy services. We all had a good laugh. It felt so familiar, and I realized I had gone back in time and was chatting with replicas of my parents, when they were both still healthy and funny. It was delightful to have a glimpse of that love again.

The center is pursuing a liquor license to expand its appeal (and revenue). Apparently there’s a new law allowing distinct licensure for senior centers, with few restrictions other than keeping minor children away from the booze. Washington State isn’t just about giving bartenders more work. There are now guidelines for “bud-tending.” Along with medical marijuana dispensaries, wedding and private party planners are hiring folks who “must have a ridiculous sense of humor, squeaky-clean criminal record and an appreciation for platinum-level customer service” - I found this description on simplyhired.com. Not to minimize the benefit to patients who want high quality pot for legitimate reasons, but can you imagine what kinds of recreational programs could be available at retirement facilities as the boomers age?

Meanwhile, Dad is doing well and enjoying himself. He doubled his cocktail intake at happy hour yesterday, adjusted his insulin accordingly, and then excelled at the “You Play the Judge” trivia competition today. I never cease to be amazed at his resilience.