Legal Arrangements

In the following weeks I had several legalities to deal with. 

The first was the house sale. It was delayed until I had the death certificates, but the following week, I showed up at the attorney's office and we closed the house. 

I dealt with their bank, and I still, at the point of this writing need to go in person with the death certificate. But because all their accounts were in joint, there was not much to be done there, and initially I had hoped Corona would pass quickly and then I'd go into the bank. 

I also notified his annuity and various health insurance companies. 

Oddly, in the fall I had feared having to deal with the Social Security administration, but in one phone call and some paperwork mailed to me, we dealt fairly quickly with the issues that needed to be handled. My mom was his listed survivor and she had direct deposit so they simply started putting her widow's share into her account. I was signed up as her "payee" since social security doesn't take power of attorneys. I had to get the doctor where she was to sign that she couldn't handle her financial affairs. 

My Dad was a champion and had a written obituary ready to roll. My brother lightly edited it including the newly named virus that honored Dad. The crematory put that up on their website and I sent it to the three universities he had been associated with. 

Funeral Delayed

My brother and I had already discussed Dad's final arrangements. I had made some preliminary inquires, but my brother told me our mom had asked to be cremated and her ashes thrown off the top of nearby state park. It was the park I remember most from childhood. It was not far. 

He and I agreed I would arrange for cremation and then we would try to arrange a time to take Dad's ashes once Corona wasn't a looming threat. 

Good Byes

After the facility called me about visit limitations, the hospice folks also touched base. In the week before the house was to close, the last week of March, I got another call. They thought Dad was close to the end, they would call me when I was allowed to come this would be in the last day or so of his life. 

By this point, they had reduced visitation to me. I would be called and given a time; I could come for around three hours.

In talking with the care givers, I heard that mom had told them she didn't want to visit and see him like that. I asked them if I could talk with her. I had a conversation and talked to her about the situation. I couldn't make her go, but I wanted to make sure I had asked her to visit. 

On Friday, I got the call mid afternoon. I was to come at five. 

The good news when I got there was that mom had listened and had visited him three times in the last 36 hours. She hadn't stayed long. We found a cookie piece on the floor of his room, we were all pretty sure it was hers. 

By this point Dad was not fully conscious. He would occasionally open his eyes and at least once I felt he answered a question I asked. 

The three hours in my memory were brief. I relayed the message my brother had sent as well as from my own family. I played his YouTube videos one more time. I brought some short things to read that said what I felt. I hoped they might comfort him if he was still listening. I held his hand during most of this time. 

There was a shift change and the folks I mostly saw were replaced with folks I didn't know. They told me they would check in on him as often as possible that night. 

I had in my mind a time to leave, as that time approached his breathing became further apart. And finally it came to an end. When I was sure he was gone, I went to find the care staff. I had a surreal moment when the staff person had never had a patient pass away before my dad. Fortunately there was a more experienced person there as well. They stopped the oxygen machine. We discussed what would happen next. They had the information on who to call. 

You Tube

Thanks to corona, I was already thinking about how to communicate via the internet. Both my children were at home as well. I shot some short videos for Dad and Mom and put them into a YouTube playlist. My brother did the same and I added his. I also dug up some videos my children had made years ago. Altogether I had about 15 minutes of video. 

I called Dad's nurses in particular and had them play the list for him. I asked that they play it once a day. I knew he would not remember viewing it. I also knew that Dad wouldn't be able to use the smart TV in his room to get to the correct place. 

House

The house was by now not only on the market but had been sold in the first 36 hours on the market. Thankfully we could continue to move the house through the process. 

There were a few bittersweet moments. I was excited by how beautiful the house looked, how I had gotten rid of so much, and how quickly it sold. I wanted to tell my parents, but I knew neither of them would understand or be happy about this news. 

At some point mid month, I did have a discussion with our realtor to express my concern about Dad possibly dying before the sale was finalized at the end of the month. 

Corona

As we approached March, I was aware of the corona concern beginning in China. I kept an eye on it, but at first it was just another news story. 

Then the first cases appeared in my state. First near where my brother lived and then in the county adjacent to my own. I still wasn't over concerned because in both instances the people involved had been on trips. 

After the one in the county next to us, the facility called and told me they would be restricting visitors. This first call told me because of Dad's condition they would allow up to four people from our family to visit him. I relayed this to my brother. This was on a Friday. On Monday morning I got a second call, lowering that to one visit. 

Decline

As I continued to visit, my father declined more at each visit. 

He was put on an oxygen feed. 

He was shifted from the walker to a wheelchair. 

There was dramatic visit where he was very shaky and seemed discombobulated by his situation. He would remove his oxygen nose tubes, look at them and then put them back every minute or so. He seemed to be looking around trying to determine where he was. Thankfully there were other less concerning visits. 

My mom seemed mostly oblivious of his decline. I did tell her at some point that we had learned he had cancer. She seemed briefly paused by the information, but not dramatically upset. 

Visits

After I received the hospice news, I called family members that I thought might wish to visit him. This included my brother and my cousins. My brother could come over on his own, but I worked with my cousins who were out of state to help them visit. 

I prepared my dad for the visit by printing out a photo of him with them and one of their spouses. By this point I was aware of the possibility he wouldn't recognize them. 

The visit went well, although I admit I suspect that it took my dad five minutes or so to figure out who these people were. But they had a great conversation with him. 

We then walked down to see mom. She was, as ever, out and about. As soon as she saw who was with me, she lit up. The interesting thing to me was it was the spouse's name she said first. I suspect that since my cousins are male, she spent more time talking with the spouse. We had a nice visit there. 

Hospice

The week that the carpets were removed and the painters came, I got a call from my parents' facility. The nurse practitioner who did check ups each week wanted to talk with me. We had a brief conversation; she wanted to call hospice in for my Dad, he had been going down steadily and she thought we would need hospice to help manage his healthcare in a better manner. 

Later in the week, I met the hospice intake nurse, we completed paperwork, and Dad was admitted. 

I wasn't sure exactly what to think about this. I could see his decline too, but just months ago I had been told that the prostate cancer was very slow moving. 

I told others at the time it was if he was a rubber band wound up as tightly as it could be wound and he just let go. I don't know for sure, but I've always thought it arose from he and I's "come to Jesus" talk. Up until then he had been holding on tight because he felt the need to care for mom was still present. After that meeting he seemed to let go of that last thing he for which he had been staying alert. 

Looking back, I suspect there was unnoticed decline over the early part of the fall as well. I thought he walked slower and slower in that time period.  

Break

Throughout February I was keeping updates at my parents' house on track, making visits, and finalizing the car sale. 

I had a tiny bit of break. In the fall I had started to sleep a bit more than I had in the first two months after my mom's fall, not as much as I wanted, but the average went up from four to five hours to six or seven. 

But much of what I was doing in the fall was physically exhausting. By the end of the day, I knew what it was to be bone tired. Throughout this period I was transporting my Dad to see mom and spending time at their house sorting belongings and transporting those things to final destinations. 

It certainly helped me a lot to have both my parents in the same place. The biggest gain for me was more time with my mom. While I was transporting Dad to see her, I felt I couldn't sit with her for any lengthy period of time. Between the time spent driving him to her and back and the work that had to be done at their house and in dealing with various financial aspects, I wasn't able to spend a lot of one on one time with her. 

While I enjoyed spending time with my Dad, it was my mom throughout this period that made me laugh. I missed that. 

Once I got to the point of calling the realtor, my own physical work at their house was done; I was less tired. I had time to spend with my mother. 

AT&T

Shortly after my Dad moved to the new place, he left his cellphone in his pocket and it was washed. I was sent home with it in a bag of rice. 

At the Garden he had used it to try to call for taxis. At some point I had found odd messages he had left for my mom at their house. It must have been when she was in rehab for the second time. There were two; both were on the same day. He wanted to know how she was doing could she call him. In the second he had sounded impatient. 

I had not taken the phone because while he and mom were at different facilities it had been useful for him to have a phone. I could call him when I was on my way and he could walk out to me. I could call him and see how he was doing. 

I had asked both Alexa and the facility staff about the cell phone. They, like me, understood both the problematic side to the phone and the positive value of his having it. 

Until the washing incident, I had left it with him. But I decided this was a sign to close out the account. I hoped that since I no longer had to transport him to see mom there would be no need for the phone. 

Early in the fall when I worked on the cable bill, I had called AT&T and had a fairly straightforward call and had mom's phone which she had not used in years removed from the bill. However, the person had not responded to my request to switch their account to the Senior Rate AT&T advertises. And she had a hard time finding the account at all. Near as I can tell they had had cell phones since around the year 2000 and the phones they were using were the original flip phones they were given. 

So I expected that I'd have another nice chat and wrap up Dad's phone service. 

Nope. 

The gentleman I got this time was very uncooperative. I didn't have the magic code and I told him I doubted my Dad would know it either, after all the account was two decades old. But he wanted me to email the POA to a special email for that. After two days I  should hear back. 

This step mostly worked okay. I got the return email, but it told me I had to go into an office. 

I did so on a Friday morning only to find that the office still had to call someone, somewhere and verify my email. Oh joy! The someone somewhere had a computer that was down. I could come back in a few hours. 

A few days later I walked into another office, I was in the door at opening, but several people were ahead of me. 

When my turn came, I got to deal first with one lady and then with a woman who I assumed based on the interaction, her boss. Neither of them had any idea what to make of my POA and the account was still hard to find. Then after more than an hour of investigating, I was told that the account could be canceled, but only by the branch manager who wasn't there. 

On the plus I was told that I could call him that afternoon, and I was given his card. So I waited again and called. To be honest, I wasn't sure he had any idea who I was or why I was calling. I had decided that we had paid our last bill and I had by now a long chain of fairly well documented evidence of how many hoops they put me through, more than people who gave me access to thousands of dollars of my parent's money. So after I hung up, I texted him back and thanked him for closing my Dad's account. I saved a screenshot to my folder. I was prepared for failure. 

Thankfully the branch manager apparently did have more clues than I heard on the phone and we received no more bills. 

But I will say this: I will never deal with AT&T again!

Ongoing

Through December, January and early February, we all slowly fell into a "new normal." My mom received some speech therapy to help her speak more clearly. I visited on a regular basis. My brother and his family also visited.

Dad never had a bad word to say about the new facility after that first day. But also over this time period he seemed to decline both physically and mentally. My youngest noticed, and I verified that my Dad had been calling him by his uncle's name. I noticed that he would ask me how everyone at my house was doing instead of asking with names. 

Mom often could tell me about things she had done or if someone had visited. Dad thought he never went anywhere. I think he knew mom ate with him. 

Part of physical decline meant a switch to using a walker, and he had some physical and occupational therapy both to build strength and some safety skills. 

Friendship

While I still believe the move to the new place was the correct one, I do want to consider for a moment this friendship piece. I think it is important. Further I think many older folks end up isolated. The bigger question for me is how does that isolation happen and what can be done to prevent it? How can you help your older relatives not to be isolated and what can you do in your own life to prevent isolation?

To think about this I need to go back in time and look at what both my parents had done over the years in terms of friendship.

My mom and Dad has spent the bulk of their adult years in the town I grew up in about 30 miles from my town. After retirement. they moved to the town in which I live.

For mom her early retirement life was one of activities and get togethers. She joined a weight loss group called TOPS and went to it for a decade or more. She was in multiple card and game groups. Early on she was in a senior water aerobics class. As they aged and moved from their first house in my town to a smaller townhouse, and the final house they lived in at the time of her accident, her activities changed a bit, but there were still many.  

Dad was always the quieter of the two of them, but he went along to lunch and dinner meetings. He even joined a weekly bowling group at their last location. He made some friends early on at that location because the developer went bankrupt and forced home owners to take some matters into their own hands. 

But in the last six years all of these activities had slowly vanished. All that was left that I knew about was bowling. My mom had been by my father's telling kicked out of groups over those last years. One group moved their meeting time and didn't tell her. At another a man accused her of cheating, patently ludicrous. At her last one, the week she had her stroke, someone called my dad and told him they didn't want her to come any more; she was discouraging new members, because of her mental condition.

I knew from my conversation with the Ref that these weren't as clear cut as I heard from Dad. If they had been younger they might have ignored the snubs and insults and continued on participating. In at least one instance the Ref told me it was just one person that rarely came that ended my parents' participation. 

Thinking back, all my dad's friends from the past were slowly aging and dying. So although it was less obvious to me prior, he had very few friends left. I think that was part of his desire to stay at the Garden.

I wish my parents had been more proactive, if they had moved during their mid to late seventies to an independent facility they would have been able to build ongoing friendships. Sure as they lived longer, some friends would have disappeared, but at a facility they would have been replaced by new older people. Further I'd be willing to bet that my mom wouldn't have been kicked out of activities, that staff would have kept that from happening or there would have been alternate groups for her to join. 

Even more striking was the thought that when the time came they might both have been able to stay in the same location. For my Dad he might have been able to stay in an independent room while mom moved to assisted. And those friends would have had a short walk to visit both of them. 

Realtor

The house was now ready for a realtor to take a look. I decided to call the one who had sold the front unit in my parent's garage court. That neighbor told me she had sold it in six hours. Further this was the third time she used this realtor, and the neighbor was very positive.  

I had her come on a Tuesday. She was very well organized and we discussed both timing and what needed to be done to the house to have a quick successful sale. I was happy to hear that paint and new flooring was all that needed to be done. She had a notebook with suggested companies and highlighted one for each. 

She gave me the color she wanted to paint the walls and we went ahead and made an appointment for the flooring company the following Tuesday. By Friday I had the painter in for an estimate. 

Tuesday we picked out laminate flooring for the public rooms and basic carpeting for the two bedrooms. The flooring company would come a couple days before the painters and rip everything out. 

We were making progress!

The Car

Once Christmas breaks were over I decide to finish up the house and figure out Dad's car. 

At some point over this time period I had come into Dad's room and found him not in the room and both his key wallet and his regular wallet left on his bedside table. After a pondering for a moment, I left his regular wallet and took the key wallet. During my emptying of his desk I had found the second key to the car. 

The car's registration expired at the end of February. I had paid insurance on it for the next quarter at the beginning of January. I decided it was time to tackle the car. Early on I had a friend of friend test drive it. She had driven a much nicer car earlier in the week so she passed on the car. I tried to start it at least once every two weeks, but it had had several slow starts in the weeks over Christmas. Given the age of the car, I assumed the battery needed replacement. 

I made an appointment with my car mechanic who specialized in this brand of car. On the day of the appointment, it wouldn't turn over. I called for a tow and then drove over after the tow truck. 

We had the car inspected and the battery replaced. I also spent a bit of money because the driver's side door no longer unlocked with the key. But the car was ready to list. 

I began by posting in on my private Facebook feed, I had plenty of interested parties and one came through. They liked the price (and I had priced it to sell) and they were fine with the scratches on one back panel. 

We met at the car registration office and the transfer paperwork went without a hitch. We drove to my parents house and off they went with Dad's car. 

About those tests

When all the blood tests came back, the medical folks were sure Dad had prostate cancer. Many of his random and seemingly unconnected symptoms fit with this diagnosis. His number was stratospheric. His primary doctor said based on another part of the blood work he was sure it had already metastasized to his bones (this may well explain his day of great leg pain). 

But everyone I spoke with was fairly unconcerned given his age and the slow growing nature of prostate cancer, he would probably not die of it but with it. 

Doctors and Facilities

Dad's family doctor had convinced me at the visit after Dad's ER visit to sign him up for a check up.  The first week in December, I took him to the doctor. It was a standard check up and the doctor drew blood to run in part for the problems he had seen over the summer in Dad's urine. 

What I didn't know at the time was that the facility's in house service had also scheduled a check up the same day and drew and ran the same blood tests. Because of results that they got back I had an interesting conversation with one of the staff members. I really like her a lot, but she is a straight shooter. She told me I might end up paying the full cost of one of the visits and tests. 

Both the doctor and the nurse wanted additional tests run so we did that as well. But it was fairly frustrating because the doctor's nurse did not want to cooperate with the staff at the facility. I had to call and leave her a message asking her to have them draw and run the tests. I told her on the phone that it took me 45 minutes from leaving my home to get Dad to their office. 

The doctor asked me to make a quarterly appointment for Dad in March which I did. At that point I knew I'd have to make some kind of decision about who the main doctor for Dad was. It was frustrating. 

I wished both facility focused medical practices and standard in office practices would be more open to cooperating. In office doctors should be prepared to work with facility medical staff in terms of tests, vaccines, etc. For these simple needs it is much easier on patient and family to leave the patient in place. But facilities need to be open to using office doctors as the primary and being aware of appointments made with those doctors. Often the patient has a long track record with a doctor and that can help in navigating health issues. 

Mental Gymnastics

 An odd thing would occur as I worked at my parents' house. 

On some days, I would wrap up and look at how much progress I had made and although I knew I wasn't doing what I hear from others, emptying the whole house in a week, I was making progress. I was proud and happy at what was getting done. 

Other days, I would take a moment at the end of the day to walk around and make a to do list and be overwhelmed by what was yet to be done. My rational side told myself that if I continued to plug away it would happen, but I worried if it would be quick enough. 

Looking back I had great respect for my mom. The place they were living prior to this house had sold accidently and on a quick time format. They had listed the house, but it hadn't sold. So they took it off the market. A few months later a realtor approached them with an offer. One of their neighbors in a duplicate townhouse had his place listed. When her client had made an offer, his realtor couldn't reach him. Her client needed to be out of her place in a month. My parents leapt at this, and found their current house, packed and moved. 

My mom undoubtedly did the bulk of the packing. I'm sure Dad packed his books and office, but the rest of the house was all mom. She did it in way less time than I did. 

Emptying the house

By this point the house was slowly emptying of items. When their furniture moved back, I began to find folks who would want it. A friend's daughter had bought her first house so I offered her first look. She took the large four poster bed from the guest room and all the bedroom furniture my parents had used that went with the bed, the couch; she called her fiancé about Dad's huge executive desk. They would take that as well. They moved everything but the desk on the first move. They need more muscle power for the desk and more space on the trailer, but it eventually left as well. 

I advertised the other pieces through a local email group and had a taker. He was working with a homeless family and took both the twin beds, a small dresser, a couple of small bookcases and end tables. 

When I got no more takers, I waited until Christmas break and the youngest and I rented a van and hauled the dining room table and some other items to goodwill. We took a second load to our house. My oldest wanted his grandmother's recliner. 

After that I called several charities with pick up services. One could come the next week. The truck driver would decide what could be taken. Thankfully, they took everything that was left. The house was nearly empty. 

Things I Learned During Applications

As I was preparing to move Dad from the Garden to the new place, I needed to gather various medical notes and documents from the Garden. Because of their assisted living status they did not have as detailed notes as the new place so they gave me their nursing notes as well. 

I sent them onto the new place, but also read them as well. 

I learned that they had diagnosed him with mild depression and had been treating him with Zoloft for that. He was unhappy that mom was not with him, but he was also unhappy because she blamed him for her current status (absolutely true, I had tried to get her to understand that if she wanted to blame a family member, she should blame me, but she was sure Dad could break her out). 

It shocked me because at no point had anyone contacted me to let me know any of this was going on with Dad. I was his medical power of attorney as well and they had all the paperwork on that. 

I am pretty sure I would have gone along with treatment especially if it had been started in the first month or so, but it appeared in the paperwork that it had started more recently than that. The only thing I can  think of that might have triggered an evaluation was the one event when I was moving my oldest out of town. 

Further, after we got the cognitive evaluation I had been told they would start him on a medication for that. There was no indication this had been done. 

I also cynically observed that if lack of sleeping and a racing mind were symptoms of depression, I was depressed too. 

Wrapping Up

I had scheduled a Monday morning move for the furniture that remained at the Garden. Unlike the last move, I didn't have any muscle to help so I scheduled a moving company.

Over the weekend, I went to my parent's room and gathered up all the small loose items and took them to their house. I also spent a moment figuring out where I would have the furniture placed.  

The move went like clockwork. The movers were on time, they were careful with my parent's things. We made a brief stop at the new place to drop off Dad's recliner. 

As an aside: in skilled nursing you are not generally able to bring your own furniture. They provide the bed and in the new place the dresser was built into the wall. On the assisted side, I could have brought all of the furniture that he would need or use theirs. I mostly used the facility's large items. I brought a few lamps, a small bookcase and a small TV for Dad. I had hoped their recliner would work for him, but it was one you had to push back against the floor to use and he no longer had the leg strength for that. 

I considered bringing their things, but their twin beds did not have head or foot boards so they were generic and the dresser was my son's. Those facts and the fact that I had moved them only three months prior discourage me from having anything I couldn't move by myself. 

Later

Late on the afternoon Dad moved, I got a call from him. I cringed but picked up. 

He wanted to know when I was going to come get him to take him back. He wanted to be there for dinner. I reminded him he was now staying where he was. 

He then sounded very lost. He told me he didn't have a reservation. I could picture him standing in the very long hallway between mom's room and his and being very confused about where he was (even in the final week at the Garden he would often turn the wrong way in the lobby when he came in from visiting mom). I asked him if there were any staff around. 

I was happy to learn someone was with him. I told him they would help him find his room and we ended the call. 

Antics

In the first week at the new place, my parents got themselves in a bit of trouble. 

First, my Dad managed to lock my mom in her bathroom. The staff had to scramble for a key. I suspect that maybe he'd tried to "help" my mom do other things he should not have as well. 

Then he'd brought her back to his own room and closed the door. The staff person up there was concerned since they didn't check with patients as frequently as on the skilled nursing side. 

They told me they'd like to bring my parents together for meals and events. I agreed. I admit I had considered the possibility that together they might be a bit dangerous to each other. 

Where's the Lasik?

The morning following Dad's check in I got a call from his staff medical person. She wanted to know why the Garden had stopped giving him Lasik. I had no idea and told her that his doctor had never said to stop.

She told me she had noted that his ankles were swollen the evening before and looked through his records. She could see the order for Lasik but could not see anything about stopping it. Based on this she had called their pharmacy and she already had the medicine. 

In the next few days when I visited the Garden to pack up my parent's things, I stopped and asked the nurse who gave out medications why Dad had stopped getting Lasik. She told me she had noticed it had stopped but did not know why. 

You're Out

At the end of the week it was time to move Dad. I came at his regular pickup time in the morning. 

I was happy to see he was napping. This gave me time to quietly pack up all his clothes in the rolling suitcases I had brought. 

As I was leaving to take the suitcases to my car, I found the tour guide and two prospects in the hall hoping to look at the room. I asked them to give us ten minutes because Dad was still asleep. 

I returned to the room after stashing the suitcases in my trunk and brought him out as if we were going to visit mom. 

Once again I took him back to mom's room and left him. I returned to the offices and did his paperwork and then got his clothes and unpacked for him. Once done, I took a deep breath and returned to mom's room. 

I can't remember the full sequence of events, but I think she had been taken down to lunch and Dad was to eat with her. Instead I found them both back in her room and my Dad telling me she had not wanted to eat. I accepted this without arguing, but I knew mom well enough to know this was not the full story. She liked to eat. 

I asked if he would like to come see where he was to stay. On the way down, he was angry and not happy about mom's room and him staying. He didn't have anything other than the darkness on that front. 

Once in his room we sat on his bed. He looked around and told me this room was much better. But he had made a friend at the Garden and he didn't know he was moving. He was upset. 

I told him I was sorry to hear the part about the friend. That was indeed sad. I hoped he'd find someone to talk to at this new place. 

Now let me admit, I did not strictly follow my previously learned rules of engagement. I had in fact a bit of a "come to Jesus" moment with my dad. I didn't get angry with him, but I did go over my thinking fairly assertively. 

First there was the cost, and for the first time since he wrote those checks to the Garden, I told him dollar amounts. I knew the idea of saving $2000 would appeal to his sensible money saving core. 

But I also told him how angry I was at the Garden for not taking mom back. I didn't want him to continue there and keep paying them.

Further while he had lost a friend, he had the opportunity once again to be with his wife. I hoped that was an offset. 

I am so thankful to be able to say this is the last time I heard any disputing over living conditions. 

In the Batter's Box

Early the following week, I brought Dad for his regular visit. He would move in himself at the end of the week. 

I had scheduled mom's caregiver meeting for the same time. My plan was to go to the meeting and then go back and visit with both parents before taking Dad back to the Garden for lunch. 

I told him about the new facility on our drive. I told him that he could come out and be in the same facility, but not the same room or hall. 

I had planned to spend twenty minutes settling both of them. I knew from the last few months that they both generally sat in mom's room, chatting, looking at magazines or napping. Unfortunately Dad took an instant dislike to mom's room. It was too dark. The other room had been much better. I tried to implement my strategies of assurance and tell him what mom had said, but it didn't seem to take. 

I went to the meeting and was impressed. The place Mom had come from had not had anything like this meeting. Even the gentleman who ran the cafeteria came and found out what mom liked to eat (dessert). 

At the end of the meeting, an aid brought mom and dad into the room. They had been looking for me. 

Things continued in the same vein as previous. I had planned to stay longer, but given the tone, I decided it was time to take Dad back to the Garden. 

Moving Mom

Mom's move to the new place went easily. Paperwork was handled well. I planned to pick up mom on the morning of the first. When I got to her facility she wasn't in her room, but since I needed to pack, I began to work on that process. Just as I was wrapping up the facility wide alarm went off. Once I was finished I left the room and asked if I could continue to load up my car and then find mom. I assumed it was a test run something that we had experienced in the past. 

As it turned out the sprinkler system in one section had decided to malfunction. The staff was a bit frazzled. Within a few moments I had been given permission to take things out and then return. They were still looking for mom when I got back. I knew from those past experiences that staff immediately confined patients to the nearest room when the alarm went off. Mom liked to roll around the facility so they had to figure out where she was. 

But she was found and we were on our way. I settled her in her room and unpacked her things. I did paperwork and left her. The following day I paid her visit. She liked the food and told me the staff were sweet. Her room was about the same level of dark; no curtain this time, but a smaller window. On the other hand the TV was never on in her room.  

Changes

Late in October, Alexa had suggested another nursing home mainly because it was on the same side of town as the Garden. At this point I wasn't sure. When I mapped out the distances it didn't help much in terms of my circular pattern. But over that weekend I visited their website and noticed they mentioned assisted living as well. I called Alexa on Monday and sure enough my Dad could go as well. 

I visited later that week. What I found was something between where mom was and the Garden. Mom's area had similar smallish double rooms, but each hall had its own smaller dining room and I didn't see as many patients who seemed to be warehoused in the area around the nurse's desk compared to where she was currently. I'm not sure I would have made the change just for her. 

On the assisted side, Dad's room was much smaller. It was probably the size of his bedroom at the Garden, but he had his own bathroom. It was quiet. 

In talking with the tour guide, she told me that they would be happy to work with this unique situation and that mom could be brought for meals with Dad or he could join her group. 

Further unlike the Garden my tour guide seemed like a sweet concerned young lady who didn't try to razzle dazzle me with amenities or introduce me to long serving staff as the Garden tour had. She even told me that if we needed to seek Medicaid assistance they could help with that. I remembered that at the Garden, the only time that came up, I could sense that the tour guide didn't want to talk about their policy.

Finally there was cost. Once my mom was removed from the Garden officially our cost did go down by her care cost and the additional person fee. But this left Dad's cost at $6150. As a contrast I was paying $6900 for my mom's much higher level of care. My dad's first month at the new place was $4200, even my mom's cost went down by about $200. 

I decided to move forward with this and wrote deposits for both my parents. 

It was close to the end of the month, I would move mom on the first. The garden had a two week notification period. This new place was willing to wait with an empty room for that period. So I planned to move Dad a week after mom. I would bring him for a visit in the middle of that week. 

The House and Books

By now it had become clear to me that while I had hoped not to list their house until they had been at the Garden a year that I could no longer stick to that plan. My mom was too high up the care levels to be at home and my father's deteriorating mental health would have meant staying at home would have been nearly impossible. Once he told me he couldn't remember their home I knew that bringing him back to sort objects would not be successful. It had the likelihood of upsetting him. 

I had also noticed that he was reading books he found at my mom's facility. One day in the car, I asked about the book he was reading. I did so because the cover made me thing it was a Harlequin romance.  He told me it was an interesting plot line about a man trying to save his family ranch. A woman had come to help him. They weren't getting along, but she seemed like a nice woman. I asked him if it was a romance. He didn't think, but turned it over and sure enough, Harlequin. 

This made me relatively sure that I could begin to sort books. I myself have a lot of books and know just how difficult they can be in a moving process. I was relatively familiar with the used book market in my town. My first thought was to donate them to a local library that Dad had suggest early in the summer. But the work of boxing them up and then the huge number and the stairs up to the building and then down to the basement where their donations went seemed daunting. 

Because I know books and the local book market I knew the rules at our local used book store. They had limits on how many books you could bring in to sell. So I couldn't bring all the books to them at once either. I considered seeing if someone would come to look at his books. That seemed a bit difficult given no one local offered a service to come and take all of the books. 

What I landed on was a process where I bagged instead of boxed the books. I could generally carry four plastic grocery bags of books. I would bag them up and put them in my back seat. Later in the week when I had an errand near the used bookstore, I'd spend an hour looking at books or even reading quietly while Dad's books were processed. I found a nice cycle where I could show up at the store when they opened on a weekday and be out quickly. 

I made this an easier task by taking the books that I knew the store was mostly likely to take first. Sure enough the first few trips I only had one or two rejected books. This was astounding to me. In the past I was happy if they took  half of my books, two thirds was a coup.

At some point I had to clear one of Dad's AV shelves filled with CDs and DVDs. I knew the VHS tapes were absolutely not taken so I tossed those. What I found on that trip was that my "store credit" quadrupled for the DVDs. So I prioritized those. It helped that they were lighter. 

Late in this process my youngest was home on break and helped me carry in the maximum amount of books. This was the last load  of books and I did have more rejects. The kid got paid in being able to shop their used video games. 

Half an Hour of Great Pain

One day around lunch on a day I had left my Dad with my mom in her nursing home, I got a call from the nursing director at the home. My Dad had hobbled to the nursing desk and told them his legs were in severe pain, so bad he needed them to take him to the emergency room. I had a back and forth with them about this. They had checked him for shortness of breath and chest pain, listened to his heart. In their view he was not an emergency, but they couldn't administer treatment because he was a visitor not a patient. 

I told the facility I was on my way, although I did take a few moments to grab some food to eat for lunch on the way down. About ten minutes later I got a second call. Now he wanted an ambulance called. I told them I'd be there soon. 

When I arrived he was in the lobby, madder than a wet hen. I should have let them call an ambulance. I repeated the questions about shortness of breath and chest pain, neither were present. His legs hurt. I suspected based on my internet searches on plantar fasciitis that it might be due to this condition.  

I pulled my car around and he slowly came out and got into the car. I decided to take him to a small outpost of our local hospital that was fairly nearby. I suspected from previous experience it might be quicker than the urgent care facility about the same distance from us. 

Sure enough we were the only people in the lobby and the emergency room appeared to have at most one or two other patients. Within a half an hour we saw a doctor. 

When asked why he was there, my dad told the doctor, "I had a little leg pain and my daughter made me come." I explained this was a bit different than merely 45 minutes prior. 

The doctor did find a spur on one of his heels and his legs had edema. He suggest keeping his legs elevated and compression socks. He also suggest a visit to Dad's doctor. I picked up the socks from a pharmacy near the Garden, reported things to the medical folks at the Garden, and asked them to help Dad with his socks which weren't exactly easy to put on his legs. 

We went to see his doctor who did see the leg swelling and prescribed Lasix and diuretic. He also encourage a full check up and I made that appointment. 

(As an aside, when I brought him back to see mom a few days later multiple staff asked about him. I told them what he had told the doctor at the emergency room. All of them laughed at his description given the scene he had caused with them. I was glad this episode didn't get him banned from coming on his own and just smiles instead.)

Long Term Care

I began the process of long term care insurance for my mom. Their policies were from a Large National Insurance Company. The intake interview was a series of questions that took less than ten minutes to complete. The week prior I had had both their POAs faxed to Large National Insurance Company and had been approved to manage their accounts. Back in September I had paid the yearly premium for my mother; my dad's was due in the spring. 

About a month after filing paperwork and bills with Large National Insurance Company I received approval and payment for our initial claim. I was given an internet form that each month I could submit an invoice and receive compensation. 

Over time I learned that Large National Insurance Company paid for the month of service after that service was provided while we paid in advance. However, I could submit my invoices when I received them and they would be processed and marked for payment. Presumably since they told me it could take ten days to process a claim, this speeded up my receipt of funds. 

Large National Insurance Company has been fairly easy to work with on my mom's claim. Everything went about as I thought it should. 

Life in Skilled Nursing

At this point, I knew I could not continue transporting my father daily. I had already had to cut out Wednesday, the day I had a long standing commitment of my own. I decided I would take Dad over to see mom on Mondays and Thursdays. I would pay a brief visit to her after my Wednesday commitment since its location was near hers. 

After Dad's fuss at the hospital, I expected to have another fuss over mom's new room. She was on the hallway side of the room, the curtain between her and the other lady was always pulled so there was no natural light on her side of the room. Further the other lady always had her television on at full volume. I found she wasn't always there due to dialysis, and I would turn it off if that was the case. Now instead of an easy chair, Dad had a small waiting room style chair.  For some reason none of this phased Dad. 

Hero at the Bank

Just before my mom's full discharge I took her to her second orthopedic surgeon's return visit. It went well, but like the first surgeon he wanted a second follow up visit. He suggested he could do both the first break and the second break. I nodded. But while I made the appointment, I knew I'd rather return to the first surgeon if possible. He had a one man office which was calm, and they had waited for Dad and me to show up. The second surgeon was in a large practice, and we waited at every turn. 

After this visit, mom and I drove to their bank. Besides her own accounts, she also had custodial accounts for all her grandchildren. I had learned she needed to sign off on these. The grandchildren, all in their majority, could not access the funds themselves. (I later had a friend tell me that despite being a sedate English teacher and wife of a pastor her father did not giver her her own custodial funds until she was in her fifties.)

As I learned that day at the bank, mom had each child's money in multiple certificates of deposit, each of which must be closed and required a signature. We worked slowly through them and I am happy to say that mom did not take as long to sign as the account closing for each grandchild took. Once or twice I had to remind her to sign her own name not the child's, but she did well. It took an hour and half; I still bless the man who did that for us. 

Closing Down Accounts

Up until now I have tried not to identify various people or businesses. None that I worked with during this process are even regional. But now I began to deal with some large companies. 

I made my first call to our regional phone company. They took my word for the POA status and disconnected the service right away. Same thing for the long distance company I'd never heard of before that billed them for long distance calls. 

For cable and internet my Dad had Comcast. I made an appointment to close the account and return the various devices they had been issued. A brief wait, a cursory glance at the POA and the account was closed. The person doing so did note I was short one device. I suspected it had been taken to the Garden. I got a serial number and a drop off location if I did find it. 

Sure enough there were two small cable boxes at the Garden, one on the working TV and one in the TV cabinet. I took the one in the cabinet to the drop off location. 

I also returned to my parent's bank and took over their accounts and had the mailing address changed to mine.   

Alexa Saves the Day

Over these first weeks of yet another transition, I called Alexa and asked her to begin to look for another place that had both assisted and skilled nursing where my parents could stay. I understood they might not be in the same room, but the same roof would be helpful. 

Alexa told me she would reach out to various facilities, but she warned me this was a more difficult find. Most facilities that had both assisted and skilled nursing were part of continuum of care facilities that only admitted people with large up front deposits and mostly in the independent phase of their life. 

While we had one hopeful interview, when the other facility learned my dad's mental health score they got nervous about his ability to go to my mom's room without wandering outside.

The fabulous thing that happened during this time period was that I shared with Alexa that I had not yet applied for the long term health care for my mom because my Power of Attorney was so useless. Alexa told me that she did not advertise this, but she was a notary and she'd be happy to notarize new POAs for me. 

The week following my son's move, we met at each of my parent's facilities and did this. 

Trip

The following week, my son would move to his new apartment. His dad and I would drive a separate vehicle up and carry furniture from our house to his new home. 

I would miss three days of driving my Dad. I explained this to him on Tuesday. The following day we would leave. By this point I wasn't sure he'd remember. 

On the way up the next day I got a couple of calls from the facility, but I missed them. He had once again wandered, looking for a taxi. By the time I returned these calls, a few hours later, he was back in his room and fine. I heard nothing further. 

Lull

As it turned out Mom's insurance continued to pay. They paid over five weeks. But eventually I was notified and I notified the Garden. 

During this time period, my oldest interviewed for a job out of state. By the time mom got her walking papers, he knew he'd be moving late in September. 

I thought mom was still within the Garden's care ability, if anything her slightly reduced ability had made her less able to get up and fall again. But I had gotten clear warning signals over these weeks from Garden staff that Mom was not going to be an automatic return. 

I got a call from the Garden after they had assessed mom. They were not going to take her back. 

I immediately asked them to consider if they could help me by transporting Dad to see her once or twice a week and that we be given a refund for the rest of her monthly money. 

Neither of these were exactly received with open arms. On my Dad's transport I heard both that they had to check with their out of state bosses and that timing could be difficult. On the money, I could tell I had surprised them. 

Later I heard back on transport. What I heard then was couched in such a way that I knew the staff person who I would have to ask to transport Dad would never have time to do it. Further they wanted the other facility to sign off and be responsible for my dad. I also knew that wasn't happening. After all at the other facility my dad was a visitor. I saw this second request as a way to make the other facility look bad and get them off the hook of helping us. 

I called mom's rehab facility and asked they move her back to skilled nursing. This was the place I hoped she'd never end up; now she was trapped. 

The House Early

As I began to seriously work on their house, I decided that I would be wise to begin with things my Dad was not likely to notice. This way if I did bring him back to sort clothes or books, he wouldn't have another thing to upset him.

So I started in the kitchen, nonperishable food first, donations, and then a few boxes to be used at my house or by my sons as they set up their own homes. 

Next I began to get rid of nick knacks. Since the kitchen panty was now cleared out, I put things I had remembered from childhood in there for later evaluation. But my mother loved little objects and seasonal decorations, most of those were donated. 

Then I moved onto linens and bathroom materials. I found a mass of supplies under their sinks. My dad still had the bandages used on his ulcer wound probably five years in the past. 

I also found a lot of cleaning supplies for a house where a paid cleaner came to clean 

Car Talk

Until the end of September, my oldest, a May college graduate, was around to help transport his grandfather. Dad was quieter with me than my oldest. The oldest came home one day somewhat traumatized by Dad's recollection of his childhood dogs: two hit by cars, one by a train. 

But over that time period I began to hear things that turned a light bulb on for me. 

Dad told me more than once on this drive that he had never been on the road on which we traveled to see mom each day. Once when we made a detour, we drove by a building and he told me he'd never seen it before (since this was the route to his favorite used bookstore and the building was fifteen or more years old that seemed unlikely). 

One day he told me, he didn't remember how to get to their house or what it looked like. 

He also told me that one morning he woke up and could not remember who he was or where he was. It had frightened him. 

The final strange thing he told me was that he had strange dreams. In one sequence of dreams, he dreamt an old movie and he had the script exactly correct. Why he saw it the next night and sure enough his dream was correct. A few weeks later after telling me about a trip he and mom had made for an anniversary, he told me the following morning he had a dream about a trip to the place. I asked him if it was about this anniversary trip, he thought for a moment and said yes it had been. 

The light bulb that went on was that I had not been wrong the year before, my Dad had significant memory issues. Near as I could tell he lived in an ever present. His long ago past existed, but nothing probably for the last year or more. 

A Two Hour Drive

At the end of my parents' first week in the Garden, I had hoped that I could turn my eyes to beginning to work through all the things inside their house. As I've outlined, we would eventually need the equity in their house to pay for their room, board, and care. Instead my mom fell. 

Because of the ongoing drama with Dad and my memory of that terrible Saturday when he got very angry and frustrated at not going to see mom, I felt it best to transport him to see her most weekdays. 

While each of them lived between fifteen and twenty minutes from my house, they lived exactly opposite. Mom was due South, Dad due North. This meant from the moment I left my house, I could expect to not return to my house for an hour. This was for a one way trip for Dad. 

The only bright spot was that their house was between where mom was and my house. It made picking up mail and possibly spending an hour or two in their house working on sorting somewhat convenient. 

Appointment

As it turned out all the urologists in our area were with one practice group. When I called it would be a month before they could see Dad. I passed. 

I called Dad and Mom's doctor, and he could see him the following day. 

I took the results from the Garden with me. I also relayed the mental health score to the doctor. He didn't seem surprised by the score. What he was surprised by was the referral to a urologist. He thought the number they were concerned about to be very low for such a referral. He ran another test.

Dad had also been having some foot pain which the doctor thought was plantar fasciitis. Cold packs were suggested. 

While there I talked with his nurse about upcoming appointments. She was concerned that if decided not to have mom's scheduled checkup, I cancel at least a week in advance. I told her since the appointment was in October, I hadn't decided. I asked if Dad had an appointment too. She closed out mom's information and opened his. Nope, he had had an appointment for his yearly check up and had missed it without canceling. I kept my mouth shut and didn't tell her maybe the doctor should have told me Dad's mental health was deteriorating. 

Neurology, Urology, It's All the Same to Me

The week following mom's 72 hour meeting, I had a question for the Garden's medical director about my Dad's UTI results. I had never heard about the second test. 

She pulled her records, got a puzzled look, and told me they had had results and someone had noted she called me and referred me to a urologist. 

I'm afraid I probably freaked her out by beginning to laugh. I explained that I had heard neurologist. She had those results as well. I don't remember the score, but it wasn't good. 

I asked if she, the medical director, had any doctor's to suggest, but no, she didn't either. 

Mental Health

Because of mom's fall, Dad had missed his mental health visit, but I was told she would come by the following week. 

Sure enough I got a call that said he should see a neurologist, nothing else. When I asked about a referral the person on the phone told me they didn't do those. 

Because everything else was in the air, I put this off. I did call Alexa and she had a doctor to suggest.

As I drove Dad, I certainly had more to tell a neurologist about Dad. 

The Garden and Costs

As I move forward, I think it would be helpful to begin to discuss where we stood financially.

First my parents had three income streams: social security, my mom's pension, and my dad's pension. All of these were stable and did not rely on personal investments. My rough estimate was that they grossed around $6000 a month. Of course they did not receive all this, their charges for health plans added to Medicare plus some tax withholding meant they took in about $5700 each month.

For the time being there were costs for their house. There were some once a year costs like taxes which I will not include in my calculations. I lowered the air and heat usage so I was able to lower those costs. Their house had a monthly HOA fee. There were also phone and cable bills. I felt stuck with those because of the power of attorney issues. All told except monthly costs  were around $500 a month. 

I knew when we signed up for the Garden we didn't have enough money on our own. But I also hoped we'd be close to covering the cost. Further I also hoped that mom's long term care policy would cover the lion's share of the Garden. 

So let's turn to those Garden costs. I was able to get my parents in a corner unit with that completely separate bedroom. The cost was $5900 a month for one person; adding my dad cost another $1800. But wait! There were also care costs. The Garden assigned people to different levels. My mom was assigned to level 4, $750. I had hoped Dad could be level 1, with no cost, but I got a long talk about how the next level, 2, would include helping him with drugs. Remembering the problems the summer before, I allowed them to put him there, $250. This brings us to $8700. So this meant we were $3000, at least, in the hole. 

My hope was that for the first two years mom's costs would be completely paid for while we paid Dad's. If so, we would save money. In my view Dad's cost were $1800 + $250. 

But insurance is smarter and cheaper than me. The Garden would not split their bills so that mom's bill  held the overall room cost on hers. Instead they split the room and second person cost between my parents. (Around $3800 each). While this wasn't as good for us, we would still be able to save a modest amount of money. 

And because I like to fret out into the future, I hoped that I could invoke Dad's long term care policy at the end of this first two years. 

There was additional financial bad news when mom fell, we had to continue to pay her full cost, even the care level cost while she was in rehab. Since she had used up her first free 21 days, we would be paying $50 a day for rehab as well. 

The Ref

Shortly after I had talked with my parents' neighbor, I got a call from the Ref. I had met him many times over the time my parents had lived in their development. He bowled with Dad and refereed high school football games, once my youngest had him as the head ref. He was a very likable guy. 

He asked me about my parents, and I explained the circumstances. He was also the HOA president so he was curious about what we were doing with the house. I told him, that we weren't willing to sell yet, and he helped me with figuring out where my parents stood on HOA payments and gave me the contact information for their treasurer. 

He also told me another part of my mom's stroke story. I knew that she had fallen and not been able to get up at bowling on a Thursday, that my brother had seen her over the weekend and she had shown signs of stroke  then. 

He told me both he and his wife had told my dad mom was having a stroke. Dad denied this. Told them mom was always like this. When they pressed him to get help, he got up to leave, telling them he would take her home to rest. That is when she fell. 

72 Hour Meeting

Mom was officially checked into Rehab on a Friday after hours. In theory you have a 72 hour meeting, I assume that would be three working days. Did anyone work with her over the weekend? I'm not sure, maybe they started evaluations. At any rate almost a week later on Thursday we had the 72 hour meeting. 

For the first time, I had the head of all their therapies in front of me. His assessment was grim on two fronts. Mom had not been at a high level when she had left two weeks before and now she was lower. Further insurance in his experience often kicked patients like mom before the 21 days. I needed to be prepared. The following Monday they would send in their first week's papers, he thought she could be released later that week.  Further he wasn't sure if the Garden could take her. 

One of the things I've learned over the multiple admissions by both my parents is sometimes the therapy people have very bleak assessments. This maybe because their goal is perfect safety. But I had noticed that often they would say my mom needed things that I did not think she did nor when I observed did the rest of the staff at Rehab. 

So after Mr. Therapy gave me the bad news and left, I walked out and asked a CNA in the hall how they were transferring her (moving her between chair and bed or other situation). Sure enough despite what I had heard from therapy, the CNA reported she could transfer my mom by herself. 

It also didn't surprise me to learn that the CNA attributed that to my mom trusting her. I, too, had seen that my mom did better when she trusted whoever she was working with in transfers. 

I guess I could have gone to therapy and pointed all this out in hopes of better evaluations, but I doubted that would help. Instead I'd hear that CNA types shouldn't be doing that, and likely the CNA would get in trouble. 

What I also did was to call the Garden's nursing director and ask her to be ready to receive my mom back quicker than the standard 21 days. I also touched base with the Rehab social worker to make sure she was sending reports to the Garden. 

Rehab and Martinis

By the following day, I knew mom would have to go to her regular rehab. The Garden was concerned her care level would be too high, and they couldn't do wound care.

Dad and I left for the hospital and while there we were told she was ready to check out. But we had to wait for transport. By lunch we had been told that transport was way behind, we should go on and they'd call us when she was on her way. 

I think I got the call around 430 or 500 PM. I headed to rehab. I sheepishly went through the intake papers for the second time in less than a month. They then took me to her room. There must have been other delays because she didn't arrive until around 700 PM. 

After they settled her into her bed, she told me, "Call your father and tell him to bring me a martini." I laughed, she liked her martinis. 

Darkness Drama

The following day I picked up Dad. On the way to the hospital I must have gotten a call because I told him I was trying to see if mom could come right back to him from the hospital. Once we got to the floor she was on I got another call, I directed Dad to her room and took the call. It was from the social worker at the hospital following up. I needed to call the Garden which I did.

These calls were brief and I walk faster than Dad so I arrived at the room shortly after him. Unfortunately I arrived to find him berating two hospital staff members. He was complaining about how terrible the room was, the curtains had not been opened so it was dark. He was also harassing them about mom being able to leave directly to the Garden. 

I quietly walked by him and opened the windows. I waited for him to finish and turned to the two staff members. They turned out to be physical therapists. I told them I was working on the discharge part and had just talked with the hospital's social worker. 

After they left, I got to hear a continuation of the room tirade. I'm not sure exactly what my dad didn't like about the room. Mom was in the newest wing. Unlike other sections of the hospital, the room was spacious with plenty of family seating. The walls had a mixed panel effect that reminded me of contemporary hotels I had stayed in. I think the darkness of the paneling was what he didn't like. 

The Car Threat

During the first week my parents were at the Garden, Dad's search for his car and taxis home worried me. His own car was in the garage at the house. By this point, I was pretty sure I didn't want him gaining access. 

I gave some thought to the problem, considered simply removing the supply cables to the battery, but was concerned Dad would check and try to fix that. So instead I went to the auto supply store and bought a car steering wheel lock and put it on Dad's car. At this point I did not have a key to the car, so putting it on wasn't perfect. 

I don't know if Dad tried to get his car or not when he was at the house the following week after his taxi ride. My son's report had him pretty confused. 

Lost

The following day I picked up Dad around 9 AM to take him to the hospital.

The miracle from the day before had not held. He immediately told me he wanted to go home. When I asked about mom, he told me she could stay at the facility but he was not going to stay. 

I told him I was disappointed that he had not stuck by what he had said the day before and that he wasn't willing to stay with mom. 

We spent the rest of a twenty minute ride in silence. And honestly I was done with this back and forth and what felt like to me selfishness on his part.

So when we arrived at the hospital, instead of parking in the garage, I pulled up to the drop off, I reminded him of the room number in which mom was staying, and told him to call me when he was ready to leave. He didn't seem surprised, maybe he was tired too. 

On previous visits at the hospital and rehab my dad would often visit Mom twice a day, morning and afternoon, but rarely did a visit go longer than two hours, often less. Usually when her lunch arrived, he'd leave. I even thought he might call in time to return for lunch at the Garden. 

Around 1 PM, I was sitting at home with my oldest and I wondered why I hadn't gotten a call. He volunteered to call his grandfather for me. Cell phone did not pick up. So he called their house number, sure enough Grandpa answered. My oldest had a brief conversation with his grandfather and asked if he could come get him?

When he got back he told me, his grandfather wasn't sure where their furniture was, but he did tell my son to take him back to the Garden.

Mostly as I relate events here, I am trying to not get too far ahead in my story because hindsight makes the story clearer, but hindsight is not something you have in the midst. However, I did eventually figure out how my Dad got to his house from the hospital. 

My husband speculated that evening that my dad had a stash of cash that he was trying to get. At some point in the next few days I did discover another credit card left on the top of my mom's dresser. It had not been there before Dad's visit.  The following month I got a bill from that card and my dad had paid $28 to a taxi with it. I have often wondered what would have happened if he had not had enough cash to pay or found this card.

When I finally began to go through their things I also found an envelope with over $1000 in cash in his bedside table. So my husband had been right there was a stash, but Dad did not take it. 

Surgery

I know I went alone the following morning. I'm pretty sure I had arranged for my son to pick up his grandfather later that morning and that my brother would drive over from where he lived.

At this point my oldest had gotten home from his summer internship so I suspect he was my driver for Dad. I also think I took my Dad back to the Garden at the end of the day. 

Mom was taken down to surgery earlier than expected, and I walked down with her. 

I had a surreal discussion with the anesthesiologist at this point. Mom had a long standing Do Not Resuscitate order in place. He told me that they had to put those aside during surgery, but wanted to know if her heart stopped what should they do. Did my dad get asked this last time she had surgery? He suggested if she was his mom that he would not want her restarted. She is chirping at me that she doesn't want to die that day. I, sigh, and diplomatically, with her in the room, tell him that maybe try once but not hard. 

Let me point out, that this came at me unexpectedly. I had always made sure the hospital and other facilities had the DNR order. For the future and for others, I suggest asking the doctor to step out of the room for these discussions. 

My dad and brother arrive in time to talk with her prior to surgery. 

Then what seemed to be a miracle occurs in the waiting room. My dad started telling my brother and me that we should try to convince mom to return to the Garden. It was a good place, we might have to overcome her, but she would like it there. 

I thought at the time the fall and him seeing it might have finally gotten through to him. 

Merry-go-Round Ride Two

Early Monday morning, I got a call from the facility, my mom had fallen while in the bathroom by herself. Looked like her other hip was broken, she was on her way to the hospital.

Off I went and sure enough the hip was broken. This break must have been a bit more painful because she asked for pain killers this time. 

Because she was admitted in the morning her surgery would happen the following day probably in the afternoon. 

I don't remember a lot of events on this day. Did I bring Dad to see her? I don't know. The only thing that I do remember him saying in this week that related to her fall was the phrase, "When I saw her fall." He only said this once and when asked about the fall later he claimed not to have seen it. 

I did put in a call to Alexa, my helper. I wanted to know if there was any chance that the Garden would take mom in and do rehab there. She encouraged me to ask. She told me that she had problems getting people back to their facilities after falls and that skipping rehab and going straight from the hospital back to the Garden might avoid that. I figured I could use out patient rehab folks and pay for a senior exercise specialist to come work with mom on the off days. 

Onward to Saturday

I decided going to the Garden didn't seem productive and was hopeful they would begin to participate in group activities. I knew my mom was a huge extrovert who had been isolated for at least the last year but probably even longer. 

I did hear at least once that Dad had wandered outside and that my mom had "slid down" (her code for falling when trying to get out of her chair.) These were bothersome, but I figured we needed to ride out some of this behavior as natural given their circumstances. 

I thought lunch with my brother went well. When my dad talked about leaving, I handed him the tablet from Tuesday and encouraged him to do that. He argued about doing it once they were home, but he was a bit sheepish. 

My brother also solved his TV problem. Dad had been able to get only one channel. Now he could get many. 

I could tell that Dad had unpacked his books. 

I breathed a sigh of relief. My brother and I grabbed a coffee and had a good chat. My brother understood that things had been difficult, but hoped, as I did, that things would improve if only slowly. 

Conversations and Arguments

Throughout this period the staff at the Garden were trying to help me not get so tied up in these arguments. They had a simple strategy.

1. Don't argue 
2. Redirect. 
3. Encourage 
4. and keep the details he is stressing about open ended and positive.

Overtime I did that as much as I could. Throughout the check in process, I had been careful to never say, "Let's give this a try until a  {specific date}." Instead I said, "Let's give this a try for a while."

Tuesday Afternoon, Hell Redux

When I got to the Garden, I began with staff about the morning's call. Apparently my dad had wandered out of the building looking for his car and then tried to get staff to call him a taxi.

In speaking with them I determined that they were in an odd dual position. They could not stop him from leaving, but if he did leave they might have to call social services, especially if he did not return. If he took mom, they would have to call social services right away. 

On the other hand, their experience also said that even if he managed to call a taxi, the driver might be unwilling to take him from an assisted living facility as taxis have regulations governing such situations. 

Later that evening, my husband listened to all that and recommended I ask the facility to do one particular thing in terms of taxi calling. Since they could not actively prevent him, I asked them to not help him in anyway. He had to find the number, call it, relay his current address, etc. They thought this was a good plan. 

Because I was fairly stressed about all this, staff accompanied me down the hall to their room and while that person could not stay to talk with my parents, they arranged for a staff member who was on their way back from lunch to check in with us. 

When we arrived at their door, just as I began to let myself in, the door was opened. There was my dad pushing my mom in her wheelchair. "We are leaving." 

I entered and returned them to their chairs and asked if we could wait for the staff folks to appear. I also texted my brother, and he was available if needed. 

In the meantime I put away clothing and put the box of books I had brought on the bottom shelf of the bookcase. 

My dad was not tolerating waiting well and continue to fume about leaving. After fifteen to twenty minutes of waiting, I called my brother and we began on our own. 

"We want to go home. We don't like here. It is a prison. No one likes it here. No one wants to be here."

When I asked about all the happy people I saw, my Dad told me they were paid staff of course they were happy. When I asked about the clients including the ones they ate with now for four meals, he blinked at me and had nothing to say. 

As we advanced into the conversation, he told my brother that I had wanted them to be moved into a place and out of their house for a long time. When my brother asked him why I wanted that, he didn't know; I just did. 

When we asked about mom's care he told us that they could arrange that from home. When I pointed out their beds were here at the Garden, and the guest bed was too high for my mom to get into, he told me they'd stay in a hotel. 

He also argued that he needed things from their home that he could not make a list for me to get. He must go there to see what he needed. My brother started to go along with him on this, but I gently told them both that there were legal issues that I could get into trouble about with social services if we did that. 

We managed to convince them to stay put until Saturday when we would both be there to have lunch with them. 

I also left Dad telling him that if they really wanted to go home, I would go along with it and not fight if he did two things: 

• arrange for a mover to take their things back to the house on the check out day
• call several in home services and set up interviews at the Garden with them. I would be happy to attend. 

I wrote these on a tablet of paper which I left for him. 

Tuesday Morning

The following morning I went to my parents' house, both to gather clothing items and to pack the books Dad had earmarked for the Garden into boxes. 

I also needed to empty their fridge. Over the last year or so, their house had developed a bad odor. Neither of them claimed to smell it, but it was the smell of rotting things. I had convinced my Dad to put their trashcan outside and not in the garage, but the smell remained. Cleaning the fridge out had worked once early in the odor's appearance. 

So that morning I cleaned everything out of the fridge and began to sort nonperishables. The trashcan filled up quickly. 

I also had my first conversation with their garage neighbor. He was a man about my age. They shared a garage courtyard with three other houses. He was directly across from their house. I told him the situation so he would know what was happening and why all of a sudden my parents had disappeared and I was there. 

He offered to take their trashcan down when it needed it. He also told me he had been a bit concerned about them for a while. 

At some point that morning I got a call from my dad. He was clearly with someone and he was angry; he wanted to call a taxi and they wouldn't let him. I calmed him and down and told him I would be over to see them after lunch. He agreed to wait for me. 

Sleep Deprivation

Throughout the first weeks, I was having a very hard time getting a full nights sleep. I either couldn't drop off until the early morning hours or would awake hours early and be able unable to return to sleep. 

While I could function like this for a day or two, the long term lack of sleep did catch up with me. I never lost it totally and yelled or screamed at anyone, but I did have less patience as the process worked onward. This lack was especially when I was I was dealing with my dad in these early weeks. I just ran out of the ability to answer the same arguments over and over. My quiet snark level went up. I had a few moments of private crying. 

UTI?

On Friday when I brought the check to the Garden I mentioned the issues I was having with Dad. The tour guide suggested that once we had Dad at the facility we run a check for a Urinary Tract Infection. She told me that sometimes those produced odd behavior and thinking in older people. 

I went home verified this issue on the internet. On Monday we made a note to run a test that afternoon. 

However on Tuesday, it had not been run because Dad's primary care doctor had not called back.

The Garden had its own "in house" doctor and I had signed mom up for this service because transferring her in and out of the car was pretty difficult. I had hoped to keep Dad ongoing with their doctor, but on hearing this, I signed to have him transferred as well. 

Within 24 hours I learned that the first test had not produced anything but a sample was sent for further analysis. 

I hoped something would turn up. It certainly would be easier if we could simply give Dad an antibiotic and get rid of all this dramatic behavior. 

But because he was now with their service their medical director suggested she also schedule the mental health nurse to drop by and talk with him. This was set for the following Tuesday. 

Return

 I brought back clothes for both of them and put them away. 

But getting out wasn't as easy as I hoped. Dad told me he had not expected to move in that day. I was honestly, flabbergasted by that statement. Further, he demanded to go home and get things ready.

Now over this last week, he and I had talked several times about getting his books ready to bring with him. I told him he had one bookcase. I encouraged him to work on the project, but by Saturday, no forward progress had been made. 

In order to bring a tall bookcase with him, I emptied one of the two he owned onto the dining room table. Knowing his orderly way with books, I was careful to keep the books on the table just as they were on the shelves. Between Saturday and Monday, he had gone through about two shelves worth of books and marked some for donation and others to come with him. 

I told him at the Garden on Monday, I would bring his books the next day, but that he must stay with mom. 

Arrival

The Garden made my parent's check in amazing. They gathered a large group of staff to greet us at the door and helped get my mom out of the car. 

We made a slow progress to their room, stopping to show my mom places, introducing them to people, and making their arrival a big positive event. 

At their door we found welcome posters and we brought them into the room. There were a few details to attend to but not many. One of those details was to remove my dad's credit cards and driver's license as well as cash. I think we left him $18. He cooperated with this. 

I told the staff that my original plan had been to leave them on their own for several days, but that I realized I still needed to bring a few more things to them that afternoon. 

As I was leaving another resident showed up, bringing them a door wreath made by residents for new comers. 

Moving Day and the Things that Can Go Wrong

I had set up with the Garden that I would call them in the morning to tell them we were on our way. I wasn't entirely sure how long check out from rehab would take. 

I showed up around 830 AM to pick up my dad. I found him a bit discombobulated. Although he had another bed to sleep in, he hadn't been able to use it. The fire alarm in that room was chirping. It needed a new battery. He had gotten his six foot ladder out to deal with it but he told me it couldn't be reached. He tried to sleep on their couch, but that didn't go particularly well. 

I looked at the ladder and knew I'd be able to reach it later. But I also knew that despite my own misgivings, it was a good thing my dad was going with Mom to the Garden. He was no longer steady enough even to go up a rung or two. I was glad he decided he couldn't reach the detector. 

On the brief drive to rehab, I got a garbled call about a doctor's appointment for my mom. When I walked into rehab I immediately went to the nursing desk only to learn my mom had been taken to her orthopedic surgeon's office for a post operative check. On the way there, I vented about why I hadn't been told about this at the discharge meeting. They had the  appointment, they knew I was checking mom out on Monday. 

This provoked another of my Dad's angry moments, "Why wasn't I told about the discharge meeting?" I told him that both I and the staff had told him about the meeting. The staff had told him within the half hour just before the meeting. He insisted they hadn't told him and they were lying. At this point I had about enough of him pretending he didn't hear about things. I told him that if I had to choose between the rehab staff and him, he would not be my choice in this situation. 

I'm happy to say that after this nothing else happened. 

The doctor's office was very accommodating. They had taken my mom's x-rays, but waited for us to show before going over the results.

We returned to rehab gathered mom's few things and her discharge papers for the Garden and were off. 

In the midst of this, I realized that neither of them had many clothes. I had some for mom that I had gotten on Sunday, but Dad had left his house without anything. 

Pre Move In

I confess I cannot remember many details about the move in walk through with my mom. Did Dad come with us? Did I bring anyone from my family? I don't remember. I think I had her tell me where to hang some things I had  brought. The good news was that I didn't hear any more dramatic resistance. No one was happy, but no drama occurred. 

After this, I went home and had a small melt down. I had been hoping someone would be with me for the move in. By now I felt overwhelmed by the ongoing dramatic moments with my father. I was worried that it would show up at the move and I'd have both my parents to deal with. 

But the light bulb finally went off for me that neither of my family members, husband or son, could come. I'd known for at least several days they both were tied up the next morning, but somehow that had not connected with the move in. 

I had a minor crying fit, but came to terms with the situation. 

Moving and Whatever Can Go Wrong

At some point in the waiting with Dad I had heard from my son that something had gone wrong with the van I had rented. They were getting a pick up truck instead and it was way more expensive. 

I picked up fast food for my guys and drove back to my parent's house. Based on the conversation with my Dad, I assumed he'd be long gone. Nope, he was still there. 

And by now he was fired up. I heard he didn't think we should move the furniture until mom saw the place. I repeated our agreement, mom would see it with her things in it. He left, I snarfed food. 

I apologized to my guys for the delay on the TB tests. I and my son were supposed to get the truck. Told them I needed to make sure to pick up the test results so Dad could move in with mom on Monday. We decided that since my husband was there, they should do the furniture part. So I left to pick up the test and get to the Garden before the first load. 

With a pickup truck instead of a van, the process took longer. Further with me out of the moving, my son didn't think he and his dad could move my parent's dressers (huge and heavy). So I had them go by our house on the last load and pick up a small four drawer dresser my older son had in his room. 

They also reported to me that Dad had reappeared and had carped at them about the move. 

But the furniture looked good. Because I was left between runs, I could set up their bed linens and other small details. 

The down side? Everyone in my family was pretty well wound up. 

More TB testing

On Friday, I had brought the Garden the checks for the first month and picked up a key to their room. the plan was to move their furniture into the room on Saturday and then show mom the room as agreed on Sunday. 

Saturday morning I picked up my Dad around 9 AM to take him for his TB test verification.

We went back to the first drug store we went to. They could read the test. Unfortunately the technician decide she needed to do a full intake on my Dad. I got called in because she asked him about his heart by-pass surgery, he didn't remember having it or didn't understand the term she used. In the midst of this her computer locked up and she wouldn't let us go until she fixed it. This took at least an hour. As expected his test was positive and now I had to find a place that could give him an x-ray. 

We drove there and I could tell that Dad was not happy. I didn't probe because I didn't want to know. We were checked in and were second in line. Unfortunately it was at least a half an hour wait. We were then asked to wait another half an hour for the x-ray to be read. My dad asked to sit in the car. When more than that time passed he came back in. By then he was exasperated. He wanted to go see mom. Why were we here? I approached the desk. It probably took another ten to fifteen minutes to find out that our x-ray had just been put in line to be read. We'd be next but more waiting. Given Dad's state I asked if I could come back later to pick up the report. Yes. 

I apologized to Dad, by now it was almost noon. I told him I had had no idea this piece would take so long, and be so unproductive. 

I asked if he wanted to stop and pick up lunch. No, thundered back, he wanted to go see mom. When we got to their house, I told him we'd be back later to pick up furniture. My husband and youngest son were getting the truck. 

Let me admit I made a mistake here. I should have probably dealt with this the night before. At the least we could have been the first in at the urgent care place that read TB tests. And looking back I should have taken him to urgent care first, they could have read the test and done the x-ray. Even worse way back on Wednesday, I  should have had him tested in the afternoon. 

What About In Home Care?

I know if I was reading along I might wonder if maybe my brother and I should have listened to my Dad and arranged in home care. I think that is a good question so I'd like to hit the reasons why we decide to try the Garden.

First it was clear that mom had to have someone other than my Dad with her 24/7. Neither my brother nor I were able to do that. We had jobs and families. 

So that meant a service. 

You often hear in home care is cheaper. In my area that didn't prove to be the case. In home care ran about $18 hour. That's $432 a day. This is almost double what even a nursing home charged. The assisted living cost would be even lower. The long term care policy would have only paid part of this cost. The rest would have to be paid from my parents. In the case of assisted living, if we sold their house we would be able to save all their income while the policy paid. 

Further I knew that in home care could be difficult to manage: finding the right person, keeping that person, scheduling supplemental people. I couldn't imagine my dad being able to do that. Even worse I could now begin to imagine that he might make things more difficult. 

In addition in home care, in my opinion, carries a greater risk of a care giver abuse. In a facility there are many staff persons and less ability to isolate a patient. At home an abusive caregiver would have plenty of privacy and ability to abuse my parents. 

Discharge Meeting and Screen

I arrive to find my mom alone at the discharge meeting. She tells me Dad has left for lunch. When the staff person who will run the meeting arrives, she tells me she saw Dad fifteen minutes or so before I arrived and reminded him of the meeting. 

I think that he's avoiding having to hear about my mom's condition. He has claimed several times she doesn't need the level of assistance we've been told and no one has told him about this. I figure he's dodging a meeting where we hear this together. 

Thankfully he is at home when I call about his own meeting that afternoon at the Garden. We ride to the Garden and he and I have a pleasant conversation. I did not raise any of his issues in this ride. I just didn't want to go over any of it again. 

He is taken away for the screen and I turn my notebooks of forms back into the tour guide. 

She presents me with the bill for each of my parents. 

I made a small mistake in not having Dad bring his checkbook. But we can deal with that on the end of this journey. 

We go back to his house and we go in to do two things. First he's told me he is having an issue connecting to the internet and there's the check I need for the Garden. 

I am able to quickly fix his internet. It appears to me that at some point his router has been turned off. 

Next we turn to the checks he needs to write. They are big,  he looks at the amounts, and asks me in a tremulous voice, "Did I really agree to this?" I say yes. He then asks me, "Was I drinking?" I say no with a laugh and we make our way through writing the checks. His handwriting also betrays a tremor.