The autumn leaves are falling like rain. Although my neighbors are all barbarians and you, you are a thousand miles away, there are always two cups at my table.

T’ang Dynasty poem

Ten thousand flowers in spring, the moon in autumn, a cool breeze in summer, snow in winter. If your mind isn't clouded by unnecessary things, this is the best season of your life.

~ Wu-men ~


Thursday, July 21, 2005

All's well that ends well, but the road isn't always smooth


It's been a bumpy road the last few weeks. All's well that ends well, but getting to the end isn't always easy or fun.

Backing up to June 14, I was in Florida watching Katie play volleyball at the AAU Nationals. Just before the start of the 2nd match, she sprained her ankle. That was bad enough, but there were a number of things coming up - immediately on returning from Florida, she was supposed to go to Pom Pon camp for the highschool team (now she would go, but couldn't participate), immediately after that was the Junior Olympics, and soon after that, there was the High Performance Camp, where 12 of the 24 girls selected for the camp were to go to a national tournament the following week.

On the 15th, I get a call from my mother's assisted living home. She had taken a fall and was being taken to the hospital. Ashley, my oldest daughter, who was home working and going to school, stepped up and handled everything while I tried to get a flight home. In the end, I made it home that day, at about 11 pm. I'm very proud of the way Ash took care of everything while I wasn't there.

My mother had had some physical problems that seemed to be a progression of some existing issues. It turned out that since the last time she was in the hospital, two years ago, she had developed diabetes. That fed a vicious circle of conditions that she already had to contend with, and added new ones.

The bright side was that we now knew she was a diabetic, and with the right treatment, many of her issues cleared up. She looks better now that she has in months. The other side was that it became clear that she could no longer live in the assisted living home. She required more assistance than they could give.

That meant that her next stop was a nursing home.

The way it works is while your loved one is in the hospital, you have to do a whirlwind tour of nursing homes in the area for both rehab and long term care. Then you give a list of the ones you've selected to the hospital social worker. On the day of release (which is always sooner rather than later), the social worker tries to find a bed in one of the nursing homes on your list.

Due to my mother's finances, she would be in long term care under Medicaid. Not all nursing homes have Medicaid beds (they therefore require "private pay" which can come to anywhere from $5K to $7.5K per *MONTH*), and most have only a limited number.

The nicest one I found had SOME Medicaid beds (which were all full), but had been working with the state to get all of their beds certified before my mother would be finished her rehab, and could simply stay there.

In the meantime, I had to move her out of her apartment at the assisted living home, dispose of her furniture, decide what to keep and what to throw away, figure out where to store things, etc.

So time passes, and after a couple of weeks, it's time that I have my meeting with the staff of the nursing home to discuss their evaluation of my mom's health, what their goals for rehab are, what input I could give them, etc., the usual. It's at this time (this is on a Thursday) that I find out that my mom has plateaued in rehab (basically getting her back on her feet with a walker, getting herself into and out of bed, the bathroom, or a wheelchair), and that she was going to be done with her rehab (which is covered under Medicare), and will have to then switch over to Medicaid.

Fine. That was the plan. However, they had another piece of news. They didn't get the building wide cerification. My mother would have to leave. Yes, they were continuing to try and get all the beds certified, and if I wanted, she'd be on the waiting list to occupy a vacant Medicaid bed as soon as one became available, but she'd have to leave next week. The doctor could fudge her records a little to give her an extra day or two, but it would be just that; days, not weeks or months. The soonest they thought they could get the building wide certification was October.

To stay there as a "private pay" patient was just under $200 a day.

The costs of long term care are mindboggling. Basically, if someone has to enter long term care, you have to use up all of their assets, then finally, when there isn't any money left, go on Medicaid. The next time long term care insurance is offered during the enrollement period for my company benefits, I'm going to have to take a close look at that.

Medicaid beds are hard to come by. Two days before she was supposed to leave, they found a bed for her at a place actually just around the corner from the assisted living home that is owned by the same company as the nursing home she's due to leave.

It's a much older buidling, and on account of that, simply isn't as "nice" as where she was leaving, but it was still pretty impressive as far as nursing homes go. They were pretty creative with what they had to work with, and if they didn't have some architectural constraints, this place could be right up there with where she was.

Ok. She's always been one to make the best of her situation. I moved her in there without any complaint, and I'm sure she'll do well. She has a lot less space at the new place, and it's not quite clear what I can bring in there for her, and what I can't. She's well enough that I can take her out of there for lunch sometimes, for example. They also have group outings, which she always enjoyed when at the assisted living home.

It's gutwrenching to think that so many lives are summed up in what can fit into a closet and dresser. Even when families live close by, so many people have no one to visit them. It's a shame.

This whole episode has been grinding on me, but it's done. I just have to wait until the old place has an opening, then decide to move her back or not.

As for Katie, she attended, but didn't participate in the Pom camp.

The rest allowed her to play at the Junior Olympics. She wasn't 100%, and by the end of each play day, her ankle was sore. Due to delayed flights, they played the first day with only 2 hours sleep. They finished pretty poorly on the first day, putting them in the lower half. They did the best they could have in the lower half though, finishing 25th out of 48 teams (top of the lower half).

She wasn't 100% for the High Performance Camp either. Her speed wasn't quite there, and neither was her jumping. She wasn't selected for the team that would go to Austin, Tx. She wasn't disappointed at all though. The camp had been so gruelling, that she was ready for volleyball to be over with.

From April through mid July, her team had played 181 games of volleyball spread over 76 matches, on 23 days of play. This didn't count the day she was called up to the 16's team on a day she was idle. Their record was 50-26 (in terms of matches), and 113-68 (in terms of games).

As for me, I'm leaving for long planned weekend at a neighbor's lakehouse. I've got a couple of days of doing nothing ahead of me. My mother in law will stop in to see my mom. I'm just going to sit and watch the waves and the birds.

See you in a couple of days.

Rick