November was a challenging month. What happens to a family when some members feel it is time for long term care while others are not yet ready to discuss the possibility? I write from Colorado and am relieved that there are others who are near to Nana who must make these decisions. In her October 31 email, my mom finally confessed “I am not sure how much longer the present arrangement will work.” The responses from our family were varied. Some family members remain unwilling to discuss the possibility that things have changed. Other family members proposed solutions to people who perhaps were not ready to hear them. Is it time to sell Nana’s house so that the financial resources are available to pay for her long term care? What would this mean for my mother who currently lives with her in the house? These were and are difficult conversations. Nana has her good days and her good weeks where the family can postpone these conversations. But the day is coming, inexorably, perhaps not this week, or this month, but soon.
November 1, 2007
I had no solutions for my mother, no answers. There are so many days where I selfishly think, I am so glad that I am away. I sent her the following:
Hi Mom, I wondered when someone would finally say this "I am not sure how much longer the present arrangement will work." I can sense and imagine from your emails how challenging it must be to live in this situation day in and day out. I am sorry for how difficult this is and has been for you. Cathy
My cousin, oh how I admire how direct she is, cut right to the heart of the matter. If Nana needs full time care, how will the family pay for it? Behold her solution.
J, Please know that I am not attempting to minimize how difficult it must be for you with Nana. I am also interpreting your message as a cry for help in this situation. However, there aren’t a lot of options for Nana right now. Based on discussions with my mother, it sounds like Nana cannot afford 24 hour care in her house. So, the next move from here is to place Nana in a nursing home.
If Nana goes to a nursing home, the house will need to be sold to pay for her care. Nana will need the equity in the house to get into a nice facility. If you spend all the equity on in-home care, most facilities won’t accept Nana as a Medicaid patient. She will end up going to a state facility, and I really wouldn’t wish that on anyone.
So, please be clear, are you asking for the family to start looking into selling the house and moving Nana to a nursing home?
My mom found my cousin’s email upsetting. I think in part my mom wanted some sympathy and support and was a bit shocked to get hit with such a dramatic solution. Many emails followed about money and the realities of the US health care system.
Finally there was some shared understanding.
November 3, 2007
D, even if I were young and healthy, I could not supervise Nana for twenty hours a day any more. Since Dr. L said that Nana should not be alone, and since you say there is no money to provide additional home care, then I guess that the house needs to be sold so that Nana could go to a nursing home. Is this a decision that the family should make? Or is A the one to make the decision because she controls the finances?
My cousin replied:
I think that you and K and my mother need to have that discussion. I don’t think it’s a decision that any one person can make.
I think if Nana is a danger to herself (or the house) when left alone, you should have that discussion as soon as possible.
I can set up a conference call if you all can’t be in the same location. Please let me know if I can help.
November 5, 2007
Last night A was here for about an hour to fix dinner for Nana. She does not think that Nana needs supervision 24/7. She seemed unconcerned about Dr. L warning that Nana should not be left alone.
November 16, 2007
A2 told me tonight that she thought that Nana had a good week. She felt that she enjoyed getting her hair and nails done today. Tonight Nana showed me her fingernails and said that she chose brown polish today. I told her that brown polish looked nice.
I was resting in my room tonight when R came to visit. I did not see him but I heard his voice. He had Piper (his dog) with him and I heard Fluffy barking. After R left, I went into the living room to talk with Nana. She did not remember the visit from R and Piper. Then she said that she used to have a brother named R. When I told her that her brother's name was B, she did not remember him at all. So one minute she seems fine, and the next minute she is very confused.
November 22, 2007
A took Nana and me to D’s house for Thanksgiving dinner. Everything was delicious, and the company was the greatest. A3 and E drove down from Boston to join the family. D2’s new puppy Rosie made the rounds with a greeting for everyone. Then she slept peacefully during dinner. D2 seemed happy to have E to play with before dinner. E was very tolerant of a little boy so much younger than he was.
Yesterday we had a surprise visitor. Barney's son S came to spend the afternoon. He brought Nana a huge bouquet of beautiful flowers. Unfortunately Nana did not remember him. But then today at D’s house, Nana kept asking me who I was. On the way home in the car, she kept saying that she did not see me at D’s house. Nana seemed to have a nice time there anyway. She went to sleep as soon as we got home.
November 26, 2007
M told me yesterday that Nana talked about our Thanksgiving dinner. She said that it was at D’s house, and that A drove her there. So sometimes she does remember things.
Tonight when I returned to the living room, I discovered that the green waste basket that is usually next to my chair, has disappeared. I do not know what Nana has done with it or why. Maybe I will find it tomorrow. Life here is always full of surprises.
