Friday, January 09, 2009
Today I spoke to the study coordinator in Palo Alto, who emphasized that many people are helped significantly by valvuloplasty -- although for varying amounts of time -- and that there's minimal recovery time; also, she said to tell Dad that if this buys him enough time, he could get the new valve after it's approved.
So he's scheduled for the procedure next Friday. We'll be driving down Thursday, and, with luck, driving back home sometime over the weekend. I don't start teaching until the following Wednesday, so there's a little wiggle room, although weather could throw a real wrench into the works. But we'll have to deal with that as it comes.
I felt more cheerful about the whole thing today, and so did Dad, who was delighted to learn that there's some chance -- however slim -- of getting the valve at some point.
My friend Sharon and I visited five assisted-living places today. (Sharon's been one of my rocks through all this: thank you, Sharon!) Three of them were quite grim, all dark with small yappy dogs. I don't know why these creatures correlate with lack of light, but there certainly seems to be a connection. One, in addition, stank of urine. Yuck.
However, two of the places were very nice. One's a private home with a maximum of eight residents and one current opening, where Dad could have his own room with a door leading out to a lovely patio. I was impressed by the questions the administrator there asked about his medical care and needs. The place was clean, bright, cheerful, and had no animals at all.
Upsides to this place: a homey, intimate environment, lots of personal attention, and they take Medicaid waivers (which I still have to research). Downsides: Dad would have to pay down his limited assets to become Medicaid eligible, and he'd have to get rid of almost all his own furniture. His room would be cheerful, but small.
The second place is one of those huge, fancy assisted-living facilities that look like swanky hotels, and where each resident has his or her own apartment (a studio, in Dad's case). There's transportation, an activities calendar, gorgeous grounds and amenities, a LifeLine included with the price, etc. This is the kind of place that I would have considered unaffordable, and that would be if we were paying the full price. Luckily, they have a low-income program.
Upsides: Dad could keep his own furniture and would have a lot of privacy, including his own bathroom and kitchenette (with a small microwave and fridge), although three meals a day, with a restaurant-style menu, are included in the price. Also, he could keep his assets.
Downsides: Somewhat less personal attention and extra fees with mounting medical needs. And they don't take Medicaid.
The price for both facilities would be $2,000/month. (Yeah, that's a lot, but at the swanky place, non-low-income folks pay a $4,000 registration fee, and their rent starts at $3,750/month.) For the first, Dad would pay out of his assets until Medicaid kicked in, however much it would kick in (again, I have to research this). For the second, he'd pay $1,500/month -- almost his entire Social Security check, although he does have some savings) -- and my sister and I would each kick in $250/month.
When Sharon and I went over to discuss the options with him, he was surprisingly open to the idea: willing to consider it, anyway, although he'd prefer to stay in his own place. It sounds like he's leaning towards Door #2, where he'd be able to keep a lot more of his own stuff. I told him that I'd be happy to live there, and I meant it. He's feeling guilty about the fact that Liz and I might have to help, but I told him -- and meant it again -- that it's easily worth $250/month to me to know that he's safe and well cared for. And my sister's fine with this plan.
So he and I are going to go look at both places sometime early next week. Sharon pointed out, gently, that choosing one of them now would be easier than having to go to one of them if something happened later.
Gary's balking at all this. Last night, when the only place I'd seen was one of the dark houses with a yappy dog, I'd decided that I'd support Dad's efforts to stay in the apartment as long as humanly possible: falling in a place where he was at least somewhat happy would be better than being protected in a place where he felt suffocated. But tonight, when I've seen nice assisted-living places, I have to confess that I'm leaning towards that option, partly because of the peace of mind it would bring me. Gary wants Dad to be able to stay in the apartment, though, if only so he won't be subjected to another move.
Ultimately, it's up to Dad.
We'll have to see what happens; the valvuloplasty could make a big difference. But in the meantime, I can breathe a little easier knowing that there are acceptable options out there!