Friday night he seemed wonderful - "wonderful" being a relative term under the circumstances, but you know what I mean. He was relaxed and genial and there was a substitute attendant he really liked - an East European woman who was warm and maternal and seemed to have a sense of humor (always key in working with him). I talked to her by phone and liked her too. I have a weakness for Eastern Europe - something genetic at work, possibly. I sent a favorable e-mail to M. I usually complain about the rotating attendants, and here was a good one, maybe worth keeping.
Saturday morning I woke up to a voicemail that had been left on my cell phone at 1 a.m. Thankfully the phone didn't ring. On the recording, warm maternal East European attendant was pleading with me - "Please call, please call, I don't know what to do with him, I can't control him..." In the background he was ranting along the lines of, "Now, listen to me, you goddamn bitch!" And then she was talking to him - "You don't talk to me that way, no one talk to me that way, No! You do not hit me! You do that again, I call 911! My husband is here! My husband is here!" End of message.
I decided not to call back. It was after 8 a.m. and there were no follow-up calls, so I figured one of two things had happened. Either she'd gotten it resolved somehow, or they were both dead on the floor. If the latter, E would probably call me as soon as she came in. But she didn't. So I decided not to stir things up and wait for evening. Once I would have rushed to intervene. You live, you learn, you get diminished...
By Saturday night he was calm and cheerful again. The reason? E had decided to go without the evening Seroquel dose, and cut him back to 25 mg. M was a little peeved that she'd done that on her own, without consultation. I can understand that. But it seems that he'd been trying to hit East European attendant with his walker - which is a fairly heavy model that could do some damage. Improvising the dose seemed called for.
So now we're a bit stuck. He gets violent on the 50 mg Seroquel. But he gets agitated and almost as violent on 25 mg Seroquel. Since July, Dr. B has moved him up to 50 mg twice, and the on-site caregivers have cut him back twice. M suggested that 37.5 mg might be right - we could manage that by cutting one of the tablets in half. But a decision will have to wait for Dr. B, who's on vacation, this being August in the world of medicine...
Meanwhile, I'm swimming in paper. This will only get worse. Yesterday I finally caught up with the accountant. We spent 40 minutes reviewing the Maryland elderlawyer's plan for setting fire to the assets. The accountant, of course, has an alternate plan - so I've had to take that back to the elderlawyer. Meanwhile, my wife needs to meet with her agency's ethics office to make sure we're taking the right steps to blind the trust. Until I hear from them, I'm holding off on the nursing home application. I think it's highly unlikely that I'll be told it's impossible for me to burn the funds to the ground - it's more a question of how best to do it, and how to satisfy the requirements of all the parties involved. But until I know for sure that I can draw on the accounts, I can't commit to a nursing home transfer. I can't move him unless I know I can pay his way through to October 2012 (after that, Medicaid can pay for him for the three months before the world is destroyed at the end of the Great Cycle of the Mayan Calendar). I'm sure it'll all work out. Until I'm certain, however, I'm going to be conservative. I want to wait 'til the path is completely clear.
Until then, it's back to the evening phone calls, and a dinner visit next Monday. And, of course, the ongoing game of Seroquel roulette.