"I should not talk so much about myself if there were any body else whom I knew as well."
-Henry David Thoreau

Thursday, December 15, 2016

Care Plan Meeting

Big dog in a little bed.  

Eleanor woke up icky yesterday.  She was snotty, threw up once, and wouldn't eat anything, so we stayed home all day long.  She was pitiful, but I got lots of snuggles. 
 By the end of the day we had a few more smiles and a little less snot. 
Eleanor never ran a fever, so we were back at 'em this morning. Grandpa's first Care Plan Meeting since being in the rehab facility was this morning.  I don't like to be late.  Ever.  So I was 20 minutes early for the meeting they set.  They were 20 minutes late.  It happens, but Eleanor wasn't impressed with the waiting.  I bought her cooperation with graham crackers and taking selfies on my phone.  Own it. 
 I wish I had gotten a better picture of her outfit, because the Christmas pants (courtesy of Sophie) are adorable. 
Oh yeah, the Care Plan Meeting.  What is it?  Well, let me say this.  If you are in a profession that requires you to deal with the public, don't make assumptions.  You may do this every day, but I don't.  I've had to do a lot of un-fun adult things in the last 14 years, but I've never done this exact thing and I do need you to explain some things.  Don't assume that I magically know what's happening.  Also, introduce yourself.  If we haven't met, tell me who you are and what you do.  If we met once in passing, maybe casually introduce yourself to me again or at least wear your name tag where I can see it.  There are lots of people to deal with in this situation and chances are I don't remember your name.  Now, this is not to say that anyone was rude, I just felt like I didn't completely understand our objective and was just trying to put the pieces together as we went.  That being said, here's the scoop on Grandpa:
He's making some progress in therapy.  It seems to depend on the day, but overall he's gaining a bit of strength and tolerance for standing and transferring (like from the bed to the chair).  He's not having much success in walking and that seems largely due to the pain in his left leg.  The x-rays from the hospital showed no fractures, so it must be a muscular thing.  Whatever the cause, it is preventing him from taking steps.  What does that mean?  It means he's making enough progress for now that Medicare will allow therapy to continue.  A new update is made every Tuesday so that Medicare can decide if this is all worth their expense.  For now, we are good.  For how much longer?  We don't know. They said I would get at least a 48 hour notice of when he will be discharged and then they asked me if my house was wheel chair accessible.  Um, no.  You know what's awkward?  Having this conversation in front of Grandpa.  I don't think he was picking up on much of it, but it's still no fun to say it all out loud.  I had to be honest and tell them that the best case scenario would be that he regains physical function to care for his own personal needs (bathroom & showering) independently and comes to live at my house.  I can be around and prepare meals, etc., but that I'm not prepared to be his physical caregiver.  My impression from the staff today is that that may not  be a realistic expectation of what can be accomplished.  I told them that if that can't happen then we will need to discuss transition to long term care.  His mental status is still off and that's a concern to me as well.  (They are calling it vascular dementia.) He knows who I am and he can tell me details about the farmer's co-op from 20 years ago, but he doesn't remember that Kyle came to see him yesterday.  He is happy to see Eleanor for a while, but then he gets on to her for not minding. (Spoiler alert: she's a toddler & he isn't usually put out with her.)  I don't feel like I could keep him safe, be on call for him 24/7, and still care for myself & my own family.  That is the truth and I have to own that.  Next week I will talk to the finance office and try to begin preparing for what will be required if we do need to transition to long term care.  Grandpa has only so much money in the bank and nursing home room & board is anything but cheap.  I'm talking $170 a day.  Medical insurance doesn't cover that.  The only option will be to private pay until he runs out of money and then apply for Long Term Care Medicaid.  I think the system is broken and flawed, but at least it's there.  We will have to jump through their hoops, but it should provide a way for us have him in a place where he can be properly cared for and we can just be his family instead of his caregivers. 
So that's the current status on Grandpa and my impression of what may happen from here.  Please keep praying that God will provide and show us what to do. 

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