Managed, somehow, to get myself out of bed and up to the nursing home to sign the contract and write the deposit check. On the way there, a call from P - my father had had an extremely difficult night, lots of anger, big emotional outbursts, cursing at the staff, especially the non-white staff (which is interesting. Could be the disease, or something in his makeup we'd never noticed, or maybe a misinterpretation, since he's still new there). They'd given him an Ativan before realizing that he was listed as allergic, but it seemed to help. Could be that they'd given him too large a dose that time at Mt. Sinai, and maybe a smaller dose would be helpful. I'm open.
After the contract formalities, I was able to sit down with P and with S, the staff social worker who'll handle his case. This wasn't yet the official treatment conference - that'll happen a week from today. But since they're finding him difficult, they wanted background information, so we began to cover the ground that we'll probably have to re-cover during next week's session.
They're perceptive. They picked up much faster than anyone else to date on how complicated he is, and how much fear and anger there is under the simple, cheerful, jes-plain-folks exterior. There were references to his emotional "lability" (new word for me, but apt) and of course they noticed his compulsive, energetic, marathon talking. I told them the story he used to tell me - about how his father, who was probably a clinical manic depressive (or bipolar or whatever they call it now), used to fly into rages at his mother, and then there'd be hours of oppressive silence in the apartment, with only the ticking of the grandfather clock in the background. If you're a child, how are you going to respond to that? Obviously, for my father, the cure for fear is sound. When I was growing up, there was always a radio or a television on, and of course there was him, going on and on and on... Now, without much of anything to govern his behavior, the compulsive tendencies have taken over. He spent last night alternating between long bizarre genial conversations with other demented people and massive rages. At one point, they said, he went gray and looked like he was about to have a seizure, then got over it. They wanted to know if he'd ever had problems with alcohol (no, he barely drank) or if he'd ever seen a psychiatrist (no, that was never going to happen). I had a passing thought - my mother would be grateful to have the outside acknowledgment that he's not the simple, cheerful, small-town guy that he tried to turn himself into.
I find - maybe surprisingly, maybe not - that I'm not upset about any of his behaviors or his adjustment problems. I still have the sense, 24 hours in, that I've handed him over to professionals and now I can step back and just let them work. They don't want me visiting anytime soon and that's fine with me. I can use the break. They gave me the speech - the one everyone gives me, about how now I can relax and go back to being his son while they do all the difficult work. In this case, though, unlike all the previous ones, I get the feeling that it might just work out that way. They seem to be very good at what they do, and maybe that means that he can be their problem now, not mine.
We went over his and his family's medical history. And we started to go through the forms they'll need to put the advance directives into place. I requested a do not resuscitate order, refused extraordinary interventions and turned down a pneumonia vaccine, since there are worse ways to go. It all seemed pretty matter-of-fact. After watching my affect, or lack of same, they suggested that we have someone from palliative care join us at the meeting next Friday. Makes sense to me. I'm sure these questions are a struggle for a lot of people but they're not for me, not anymore.
I came home and went to ground. I'd originally thought that I'd see him Sunday or Monday, but at his current pace, that's unlikely. On Tuesday I need to go up to New York to start closing his apartment, and I won't be back 'til Thursday night. Odds are that the earliest I'll visit is a week from today. Fine. For the moment I'm happy to concentrate on the Phillies and Brett Favre's return to Green Bay, and to sit relatively still while my brain swelling goes down.
I know it may not feel like the worst part is over, but perhaps it could be. At least you have a chance to breathe. I'd offer to help with the apartment, but I have all manner of medical crap going on myself, so next week, it's doctors and day surgery and more doctors. Take good care of yourself!!!
XXOO,
nef
Posted by: Nancy Frank | October 30, 2009 at 04:26 PM
Congratulations on a successful campaign. Things will unravel a bit and then will improve (as best as AD allows). You have done awesomely and I was breathless following along on the journey, crossing my fingers and afraid to breathe! I know what you mean about having, essentially, the right people in charge of the care now. It does help to be able to turn over those sets of the reins. May things go well henceforth!
BTW, check out:https://moversguide.usps.com/icoa/flow.do?_flowExecutionKey=_cCA293115-0273-AC0B-BC74-4EFA4CAD5B66_kB8B857BC-5AE2-0135-1F29-26AFFEEB6DAA
and see if that is helpful with that task you were stopped on.
Breathing again,
Shu
Posted by: Shu | October 31, 2009 at 07:22 PM