Fresh Turbulence

My father didn't have a particularly good time during M's visit.  As in, he freaked.  I got to spend a half-hour on the phone with him last night, scraping him off the ceiling and entertaining my fellow passengers on Amtrak Train 175.

I'm not sure what went wrong.  Actually, I'm not sure that the word "wrong" applies here -- my guess is it's all just part of the process.  But reconstructing it... it seems she brought up the idea of taking him to new doctors (as in, a gerontologist, and maybe also an ophthalmologist and a dentist and someone to look at his persistent earache -- he's long overdue for some general maintenance).  He doesn't like the idea of going to doctors in general (can't blame him), and he doesn't like it when aggressive strangers come up with the idea.

So he took it out on her.  Said she wasn't the same person as last time (am wondering if he means this literally).  "She was flat and there was no life and there wasn't even any life in the handshake.  And she said she talked to Dr. R and I don't know where she comes off talking to him..."

I decided to use Dr. R as the pivot point.  He reveres Dr. R (again: the result of Dr. R's keeping my mother alive through more than 20 years of breast cancer).  Sometimes resists seeing him but will always listen to him.  So I told him this was all Dr. R's idea -- Dr. R wants him to see some other doctors the way he often does, and we've had good experiences with all of them.  And we'll be careful and talk to Dr. R and make sure that M is the kind of person we want to be working with...  This appealed to him, and he sent me off to take Dr. R to lunch and talk things over.  Lunch with Dr. R being an impossibility, I'll tell him tonight that I talked with Dr. R by phone, and that we've arranged lunch for next week.  Next week I'll have a fictitious lunch with Dr. R, and report back that Dr. R has full confidence in M, and we'll move on.

Obviously I'm shorthanding this -- there were a lot of emotional surges and there was a lot of backsliding, and of course the cell phone connection dropped at one point and he couldn't hang up the phone properly... which led to a small technology-based homecare farce (I called E and asked her to call her sister to get her to put the phone back on the hook -- I don't have the sister's cell phone number so I had to go the long way around...  E somehow called her sister at home... her sister called me later to ask me why E had yelled at her children... I said I really didn't have any insight into that...)  Just throwing that in for local color because in the end we got done what we need to.  I didn't even have any adrenaline rush or cardiac symptoms.  Am getting better at the whole detachment thing.  Burnout helps.

E, of course, took the opportunity to trash M, both to my father and to me ("I don't know, she really doesn't know how to talk to him").  That's nice.  And predictable.  And doesn't change the picture.

Maybe he'll do me a favor and have some short-term memory loss between yesterday and tonight.  I doubt it, though -- never happens when the emotions are engaged.

For the record, I don't think M did anything wrong -- I think this is a predictable reaction to a necessary series of steps.  Maybe she was a little brusque -- she has that quality.  It helps when she's slamming Medicaid applications through the system.  Might be a little disruptive here.  On the other hand, what's she supposed to do?  Can't accommodate him because at the end of the day she's got to take care of him, and that includes doing things he dislikes.  For what it's worth, I told her to use Dr. R's name as a talisman whenever she has to -- just say "this was Dr. R's idea" or "Dr. R wanted this to happen."  The resistance won't go away completely but it'll settle down a lot and we'll get where we need to go.

After the call, when I was slumped against the window staring at the refineries north of Wilmington, I found myself thinking that the second half of the year is going to be lively as hell, entirely in a bad way.  If he continues to fall apart at the current rate, we're bound to have a couple of acute episodes, and we may even have to line up a nursing home for him.  I have no energy for any of that.  But I also have no choice. 

So I guess I'd better get ready for more intensity.

Comments

[Julie]

Hi Alan,
I see you have fully engaged the therapeutic lying. It works and that's what matters. Also operating on a "need to know" basis is
helpful as you know. I'm thinking that this new gal, M, is getting to see the full picture which is important for her knowing exactly the extent of his damage. One would guess she
knows what she is dealing with if she does this for a living.
She doesn't have an emotional attachment yet so can do the things
that need doing without feeling bad about it.
I hope I can find someone like that.
By the way, your comments on the financing of home care vs nursing home were very illuminating for me. I had no idea
so that helps me. Thanks for posting.
J.

[Alan G. Ampolsk]

Need to know -- yes. A while ago I stopped telling my father in advance about doctors' appointments and just started stuffing him in the cab on the morning of the appointment, sort of like a KGB arrest. It worked. M might be able to use that.

I agree that her detachment is a plus.

If you're actively looking for a care manager -- I found M through the law firm. Am guessing that professional networks are a good source of referrals so you might want to pursue that.

Re: financing -- keep in mind that Medicaid terms vary from state to state. The program is federally financed but managed at the state level, and there can be major differences in restrictions like lookback periods. I'm dealing with New York State requirements (if I move my father closer to me, I'll have to shift him to Maryland, which will be its own adventure). Your situation may be quite different, so you'd have to explore with your local Medicaid office -- or, better, a care manager or a lawyer who can help you navigate.

Again, hope this helps.