As legal and medical POA, I am emotionally on a wild ride as I begin to wait for rehab’s assessments. Dad, 97, is being admitted to rehab today after a four-day hospital admission, after a fall where he hit his head hard. He’s ok after lots of imaging. He has dementia, advancing hydrocephalus (no shunt, he refused in 1990), and severe aortic stenosis, which probably were the cause of the fall (my back was turned for about 10 seconds and he decided to stand up on his own to remove his socks). He has been falling (without injury) more regularly in the past six months. I have a hunch rehab will make a well-considered recommendation, but ultimately the decision lies on me. If that is true, I have to face either the probability of having a catastrophic fall at home (no reliable night care), or his being quickly placed in a dreadful LTC. I’ve just toured seven LTCs. Of course the ones I felt good about have 1-2 year wait lists. Dad has such an amazing daytime caregiver at home, that even Dad’s primary doc said (before the most recent fall) -- “Keep taking the risk” of home care.” My 86-year-old dear husband has been so patient with my caretaking role for the past 10 years. He’s suggested we split so he can live out his life in the warmer climate we have both dreamed of. I really don’t want to continue making Dad’s home life work, but am having a hard time facing realities now that crux time is here. I really don’t want to go through being Dad’s grim reaper. Most of all, I really want peace and some joy with my husband. I know that sounds like a no-brainer, but I don’t have a reliable brain right now. I feel very alone, as my co-POA sister is very ill and wants me to make all decisions.
I am going to update you but may be unable to be on computer next few days. I had insisted on rehab care conference, which was set for 1 p.m. yesterday. 1:15 p.m., no call. I phoned social worker (SW), left voicemail. I phoned PCP care coordinator and she said call switchboard and refuse to hang up until you get SW. SW convened care conference with only PT present, no doctor. She was unable to provide assessments (I had asked her last week to keep me copied or informed on assessments). So much so that I shook the universe in asking about MROC, which I doubt was given, because our witness-plant said it was a three-minute "interview." So I asked for congnitive assesment (not that I don't know Dad is pretty much gone except for his emotions and habitual attachments). SW said they didn't have report and would have to contact psychologist (rehab's own doctor apparently hadn't yet documented his assessment either). I burned rubber to track down psychologist. Her office stonewalled me. Finally, I got her cell phone and she was in transit. I told her that as a POA I needed written or firm confirmation as to Dad's cognitive recommendation (ALMC's rates depend on this). She bluffed and blurred and finally said frantically, "I can't believe you are asking this you know your father is in bad shape." She wondered how I got her number. I wondered how rehab didn't know how to reach her. So on. Shame on me, eh? Anyway, I rested easier to learn that it will be documented.
Dad's caregiving agency (yes, they are indeed angels and some kind of vicars on earth) are emotionally pressuring me to bring Dad home. I know better.
I am frantically packing Dad's files and trying to anticipate what to bring before my 150 mile one way trek. To my horror, in my brain overload, I realized that by paying Dad's caregiver to be my rep at the rehab, I effectively zero'd out the last of his life savings. Luckily I got Dad a home equity line of credit (HELC) a few years ago, which may see me through. Thus far only $10K on it for huge plumbing and roofing jobs, required by homeowners insurance. Dad's old house, among the least modern in an affluent area, might bring in maybe $150K as is. There's no way any improvements are going to be done.
This a.m. am seriously thinking about resigning my POA sometime after Dad is placed. I get that he may have to move again unless house proceeds can become available. But elder care lawyer is being cagey about that and wants $3500 retainer for medicaid application. I know Dad will wind up on Medicaid, so what's the problem? Well, there's only one AL/MC with a space and they won't guarantee inflation rates and who knows, Dad may never be rushed to a hospital again. In 2011 lawyer created to two deeds for the house "if your father ever had to leave it." He will not broach the immediate "sell house" question without Medicaid application retainer. The $3500 onto the HELC? New lawyer?
I cant remember if I shared this, but one fairly good ALMC offered $4500/month fixed for Dad's life. That is exactly $24.16 per month less than his SS, work pension, and VA Aid and Attendance combined. So if I write the check for placement May 29 and pay his caregiving bill to date, it wipes out Dad's "reserve" of about $7K. Hello HELC. I refuse to kick in. Area Agency on Aging 1B -- surly, no help whatsoever.
VA -- surly, no help whatsoever.
That's this a.m. May 26. And it's going to be near 100 on May 29. Niiiiice.
That should read: "Well, there's only one AL/MC CONTINUING CARE with Medicaid units..."