Saturday, May 30, 2009
Elder Care Part 2
So it begins...
My father-in-law had a massive stroke Wednesday night. My mother-in-law found him the next morning lying near his bed. He must have been getting ready for bed when he collapsed. The time frame between the incident and the ambulance arrival was too long to administer the medicine they give stroke victims to minimize damage. That has to occur within 2-3 hours of the stroke. As such, he's in ICU. His CT shows damage to 25% of his brain. His right side appears to be paralyzed. For the past 48 hours he's been in and out of consciousness.
My 83 year old mother-in-law cannot take care of him if he survives nor can my husband and I. He will require skilled nursing round the clock. We will look to Medicare or Medicaid for assistance. With an uncertain prognosis, we have to prepare for any eventuality..
If he lives, he will be put in a private, nearby nursing home for the first 120 days. After that, we are told Medicaid kicks in and he'll be moved to a state run facility at least an hour or more from here. We know that scenario. It's the same everywhere. If you're lucky, the facility is clean and decent. The help is always questionable. There are many dedicated people who work in this field. There are also many not vetted and uncaring as well. I think of the many issues, the bedsores, the neglect, the cleanliness or lack thereof. It's depressing. Of course, if he rallies and can be rehabilitated, that's another scenario in itself.
If he dies, his 90 year old brother wants him buried in the family plot in Kentucky. We'll have to have him transported. Having been through this with my dad in '07, I know what caskets, preparation for the deceased, funeral services and transportation cost. My father wanted to be buried in a military cemetery several hundred miles from where he lived. His plot was paid for by the government thanks to his military service. Still, when it was all said and done, we spent almost $5000 for a modest casket, embalming and preparation for an open casket, services and transportation.
I haven't looked in to transportation to Kentucky but I know it will be sizable. The death industry is not cheap. It's a business. Many of these places manipulate the emotions of the surviving family. Just picking out a casket was an incredible experience. I did it online as I was 3000 miles away and had to make a decision before I got out there. Luckily, I did a good job with my brother's help. I think the more modest one we chose was at least $1200.00. It was perfectly nice but not fancy. I think the cheapest one was $400-$500 but I never saw it. We actually got a discount on the whole procedure. Weird.
My brother and I were in synch on pretty much everything. There was no family discord, only cooperation, and boy did that help. When siblings or remaining family members disagree, legal wranglings can occur, particularly if there is no medical power of attorney and durable power of attorney. Those are two of the most important documents to get from each member of the family. Something to show the hospital with regard to the wishes of the patient as well as who is the designated LEGAL decision maker in these matters. A living will also covers these things.
In the end, someone has to make the hard decisions.
Post Script: My husband just called from the hospital. His father opened his eyes and recognized him and seemed to understand his son when he was told "I love you." My husband's relief in getting to speak to and be understood by his father was palpable. I am so grateful.
P.S. #2: I started this train of thought in April with my post Elder Care.