One Day Last Month

My father is 94. Although  deaf and partially blind, his overall health has been good. For the past four years, he has lived at home receiving help from paid caregivers, until one day last month.

Dad had a very bad urinary tract infection that would not go away. It had begun to travel to his kidneys. He could not sleep because he constantly had to go. He didn’t want to wear diapers; it hurt his dignity. So, he struggled dozens of times to the bathroom about 10 steps from his bed. His caregivers and his family all worried that he would fall. Again.

My brother, who oversees his care day to day, told me he had to be hospitalized and that his caregiving team was very worried. But my brother had just moved into a new house, had a new job, and was finding it difficult to manage it all.

So, I flew to Colorado to help. Dad had only recently been approved for VA health benefits and was admitted to the Denver Veterans Administration hospital. His condition was “touch and go.” The young physician I first spoke to was at first puzzled, but said he and his team were hopeful. I was worried that he might be receiving substandard care, but I shouldn’t have been.

I was by Dad’s bedside for two days and I don’t recall there ever being a time when a nurse, nurse assistant or doctor wasn’t visiting. At one point, a team of physicians including the head resident stood in the room and explained in plain language just what was going on.

During one of those team consults, I told them that I had transcribed Dad’s South Pacific diary and it could be read online. Every single physician read it overnight. I recall that a few of the nurses did too. In other words, they took extra time to get to know my Dad; he was not just another number on a chart.

My brother, who has visited Dad in other nearby not-for-profit and for-profit hospitals over the past several years, said this was the most positive hospital experience he could recall. Rarely have doctors elsewhere spent the kind of time these folks had. Rarely has a team of nurses and nurse assistants been so attentive to his needs.

Dad began to recover; the doctors finally figured it out. However, since he would need a permanent catheter and round the clock care, the verdict was in. He would need long-term care in a facility; he could not return home. I was given a list of the homes the VA contracted with. Naturally, I expected the worst. But, once again, I was wrong.

With a few clicks of the mouse, I found not only an Eden Alternative home but one with stellar Nursing Home Compare ratings. It was 10 minutes from the VA hospital on a quiet city street adjacent to the city park. My brothers and I checked it out and Dad subsequently moved in.

Dad now eats with others in a common area, not alone in his apartment. He is able to walk the halls with his walker and an aide; at home, he rarely went for walks. His caregivers were concerned about his falling and their inability to pick him up. He is receiving speech therapy now, something he had trouble accessing at home through Medicare. His ex-wife and their dog can visit anytime.

So far so good. Dad seemed content the day before I had to return to Northern Virginia. He described his room, which is filled with sunlight most of the day and accommodates his furniture, artwork and family photos, as like a stateroom. This US Navy veteran of years at sea should know.

My father passed away in July 2016. 

 

 

Long Term Care Too

As you listen to the drum beat of criticism and negative reactions to health reform and hear the loud screams from seniors worried about their Medicare, please note that the health reform law includes an important new benefit covering long term care at home.

Not many years ago, Congress in its wisdom passed what was called the Medicare Catastrophic Act, then rescinded it in lightning speed when certain seniors rebelled and called for its repeal. Sadly, this legislation would have protected millions of American families from the devastating costs of long-term care and was a missed opportunity to solve a vexing issue.

The late Sen. Kennedy sponsored a bill called the “CLASS Act,” which Congress in its wisdom rolled into the final health reform package. This move will mean that over time those who opt to pay a premium to the government will have coverage for long term care at home. It does not include payment for care in a nursing home.

For those like me who purchased long term care insurance, we are waiting to see how insurance companies will react to this. My policy, like so many others, covers home care. It is likely that many companies will develop what is called wraparound policies similar to Medigap, but we will have to wait and see.

For someone who has been involved in more than one national campaign to secure long term care coverage for older Americans, this new benefit is truly incredible. And, like health reform itself, something that I thought I would not live to see.