Friday, April 24, 2009

“O How the Mighty Have Fallen” a story of The Fall and Rise of the Edwardian Empire

Edward, my 94 year old father, and the hoary patriarch of the Wisniewski/Stanley clan, fell and broke his hip two months ago. He doesn’t remember any of it, not the 4 day hospitalization to repair the damage, nor the subsequent stay in an award winning rehabilitation facility; which, in reality, is just a pretentious marketing term for a nursing/old people’s home with a meager physical therapy department with a few friendly, but overworked therapists (I’ve donated more and better ‘gently used’ exercise equipment to Goodwill Industries in the past year). Not surprisingly, these senior citizen warehouses are one of the few growth industries left in Florida. Most post-hospitalization convalescent stays in these types of facilities are paid for by Medicare or private insurance. So the patients are usually warehoused in and out as quickly as possible; unless the administration can ‘sell’ the family on the idea that their relative would be better off in their long-term custodial care for the low, low price of only $7,000 a month. Kind of like a geriatric bait and switch scam run by the health care industry. So unless you are a good sport and agree to eventually die in their award winning facility, a few days to a few weeks is the most you can normally expect to stay before they send you packing and they bring in the next batch of maimed prospects from the busy hospital surgical wards. Dad, however, was there for six long weeks. His operation, while successful, left him in an anesthetic fog. Anesthesia, while gratefully putting us into the sweet arms of Morpheus during surgery, apparently destroys brain cells in the process. Usually a fair trade off, but Alzheimer’s patients need all the brain cells that they have left just to stay alive. We, on the other hand, have plenty to spare and expend them with reckless abandon with our alcohol consumption, recreational drug use and the banging of our heads against the wall at our recent economic losses and our future prospects.

Dad spent most of his recovery in a post-operative stupor that the doctors were predicting would probably be permanent given his age, poor health and advanced Alzheimer’s disease. But slowly he began to awaken from his stupefied condition. By then they had transferred him out of the general rehab wing into a secure Alzheimer’s unit, in the hope that he would soon go on Medicaid and become a permanent (till death do us part) resident, thereby enriching the stockholders and ensuring the job security of the dispirited staff. There were only 19 other people in this locked ward (the maximum) and one could see firsthand the dehumanizing effects this disease has upon its victims during its final assault upon the human mind, body and psyche. Dad is currently in stage 6 of the 7 classified stages Alzheimer’s disease. To me, it appeared that most of those folks had to be in a yet unclassified stage 8 or 9. The administrators touted this special unit for its ‘home-like environment’ and where its residents were ‘one big happy family,’ and it was - if you had been raised by a family of addled sloths. Their acclaimed activities program seemed to consist of a once a day gathering of frightened looking, wheel chair bound patients drawn together in a tight circle, like miniature two wheel Conestoga wagons fending off an impending Indian attack, and then throwing a beach ball at them and watching it bounce off their head or chest. Some lucky residents would actually bat it back on occasion, but I wasn’t sure if it was intentional or a lucky coincidence of the attendant hitting a patient’s flailing limb during an involuntary spasm. In spite of the daily quasi-sadistic, geriatric dodge ball, Dad slowly started to recuperate. Very slowly. I calculated that at his current rate of progress he would be back to his pre-fall condition within 9 to 12 months, if he lived that long. But the administration soon informed us that Medicare would no longer cover his bill because he wasn’t making the ‘recommended’ progress. HELLO? What do you expect from a man who has been in a near coma for weeks, who almost died before and after his partial hip replacement surgery from atrial fibrillation, who is 94 years old, nearly blind, lost and confused as to who he is, let alone where he is and is subsisting on meager portions of mushy institutional food? But rules are rules and since Mom and Dad were unable to pay the $233 a day tab out of their meager savings or willing to suffer the economic tsunami that Medicaid would wreak upon the last of their hard earned retirement nest egg and modest monthly income, he was politely given the bum’s rush and asked to forsake his new ‘one big happy family’ and vacate their prestigious, award winning, compassionate long term health care facility-with crappy rehab equipment.

The day before his scheduled release I informed my forlorn father that he was going to be coming home tomorrow and immediately his countenance brightened like a newly born-again convert at a Baptist tent revival. If there had been a baptistery nearby he would have no doubt leapt out of his wheelchair with joyous abandon and used that insidious beach ball as a springboard to launch himself into the water. (Praise Jeeeesus. It’s a miracle!!) When I came to pick him up the next morning he was sitting in the dayroom with the anxious demeanor of a hopeful parolee waiting in line to be released from prison. “Let’s blow this joint,” he said with incisive conviction. I was the one blown away by his sudden onset of lucidity and humor. When and where had he last used that phrase? And with neither a smug look, nor a sorrowful glance toward the other convicts on death row, he quietly departed out the locked doors with his newly re- found son and redeemer at his side.

In the car, during the short trip to our double wide chateau, he asked me in all sincerity: “What kind of jail was that place?” I tried to explain, but he was too excited by the simplicity of the fresh air and the kaleidoscope of scenery cascading before his eyes to listen to such fanciful tales of broken hips, anesthetic fog and carnivorous administrators. At home he made such rapid improvement that I began to fantasize that our long family nightmare was coming to an end and that things would return to a semblance of normality for him and autonomy for me. It was, of course, not to be. His hard fought gains quickly became losses as he stoically slid down that slippery slope of dementia. He still has his lucid moments and he does seem to be happier at home in a familiar environment, if for no other reason, than not having to watch 19 other human beings fall silently into the crevasse of nothingness. Now, once again, he has only me and his wife, who has Stage 4 Alzheimer’s, to watch over him and comfort him. My mother is relieved and grateful that her husband of 66 years is once again able to recognize and acknowledge her presence when she comes into the room. These two venerable luminaries whose light was once a blazing sun to their family and a North Star to their students and colleagues is slowly being dimmed by dementia, but when they are together they can still light up a room with their love.

1 comment:

  1. I can't say I've ever heard a more honest and succinct description of the facility. Kudos on getting your family member out of there and bringing him home to die with dignity as he deserves. Thanks also, for reminding this dispirited staff member that each resident has a life, a family, a past and an identity outside those walls. I needed to remember that. It's been a privilege to work with your family.