Advice on living arrangements for father with health problems

[Lachrymose]

I can't really think of a better title than that.

I apologize ahead of time, because this is going to be extremely long. I also thank everyone in advance for taking the time to read and/or respond.

Background:

My father will be 70 next week. He smoked fairly heavily from the time he was 13 up until about 3 months ago.

About 13 years ago, he had a heart valve replaced due to a congenital defect that caused it to be leaky. It was replaced with a bovine valve because his body rejected a human cadaver valve and he didn't want a mechanical valve because he would have to had constantly remained on blood thinners. At the time, he worked in a steel mill and was constantly subjected to nicks and cuts here and there. He has since retired.

At the time, the doctors told him that an organic valve will more than likely only last 10-15 years and he would have to return to have it replaced once again.

Fast forward to April of this year.

He was taken by ambulance to the emergency room for chest pains. It was later determined he had a mild heart attack.

They stabilized him and also let him know that his valve is now hardening and constricting (stenosis).

They transported him about a week later by ambulance to a larger hospital that specializes in heart care.

He was prepped for open heart surgery, but the anasthesiologist (realistically) warned him that he only had a 75% survival rate due to his lungs being so bad.

This was enough to scare him (and us) out of the surgery at the time. This may have been our fatal flaw, but what's done is done.

He then came home after the hospital put a couple stents in.

Since then, he has been taken by ambulance to the E/R a total of six times. Four for chest pains, two for internal bleeding (he had a polypectomy on one of the visits after a lower GI found polyps.)

They finally cleared up the bleeding, but he was having some major trouble breathing. He had to be on a BiPap machine (like people with sleep apnea use. It forces oxygen in, but it's not as extreme as a ventilator. It's only a mask.) for two full days. During this time, we had talks of his wishes, and not wanting to be on a ventilator to survive, etc. etc.

The backup of the blood in his heart was causing fluid buildup around his lungs.

He was then transported this past Monday to a larger hospital who gave many options of heart surgeries for the valve, including a few fairly non-invasive ones. He was stabilized and in relatively good shape (off the bipap, eating solid foods, etc)

We were ecstatic. It seemed like it would all finally work out. With a less invasive procedure, they would not have to open his heart or put him on a ventilator for surgery.

However, we were just informed today that the surgeons there now refuse to do ANY kind of surgery since he's so fragile.

So, now it seems we are at a point where he will have to be put in a rehab or a nursing home and made comfortable for the rest of his days, however long that may be.

What I am asking for here is advice on what to do now. My parents don't have a lot of money, and my mom would really want to be with him. What would you recommend we do for living arrangements for them that could be as low cost as possible. They're definitely not below the poverty line, but both of them are retired. My dad draws a pension and social security. My mom is also drawing some social security. They bring home about 3300.00 a month, I believe. I know it sounds like a decent amount, but they have many bills, a lot due to my dad's poor money management.

I'm sure I left out a few things, as my mind is a bit scattered right now, so if there are any questions feel free to ask and I'll try to answer.

Thanks again for taking the time to read this.

[Amina516]

Your dad sounds like hes in heart failure. This is often cascade of symptoms and people often go back and fourth between feeling well or having issues like your dad. There's a chance he may still could bounce back, though not completely.

First thing I would do is check with your dads hospitals to see if they have a social worker available to you. They should be able to hook you up with affordable options. If not, call office of the aging or whatever other elder services you have in your area. Youd be surprised at how many options are actually available.

Also, is hospice or home health care a possibility (also something to talk to the social worker about)?They are pretty low cost for the most part. They would be able to provide care in their own home as often as its needed. You can also have home health come and see him, which is NOT hospice, but they provide care for him at home also. Seriously, they can provide almost any kind of care from the home nowadays.

Lachrymose..<<<<>>>>

Ill keep you and ur family in my thoughts and prayers. PM if you have any questions..this is something Im unfortunately, very familiar with.

[Bandit]

Lachrymose - first off - it's never easy dealing with an elderly parent. My dad is 85, so I know the feeling.

Now, while I do second what Amina said, I do think the most important person here is your dad and what he wants.

It's his life, and IMHO, it should be his decision as to how the rest of his days should be spent.

I see that with my dad and did see it with my mom when she was going. I do think it should be your dad who makes the call on which way to go. I'm sorry of that sounds callous, and I'm gonna stop before fraching, but sometimes it comes down to quality vs quantity of life.

B

[Aethian]

You didn't mention it and I don't want to sound weird but...Does your Dad, or in the fact, your parents have a will? Your going to need one or two...one being the Will and another being a Living Will. This should be done while he can do still things. Best place I know for one.

Some hospitals have living arangements for family to be near their loved ones. I would talk to the hospital of his choice.

[Der Cute]

I'll second Aethian.

MUST HAVE WILL AND POA NOW. If he's this sick/ill health, the legal things must be considered. NOW.

Talk to the social worker at the hospital. Ask them "how can I have my dad in a place where he's comfortable, doesn't cost arm & leg, and will help him/mom?"

Ask your parents about the will. Remind them (gulp) time is not static, and this must be dealt with. Ask them about Power of Atty. Ask about a DNR - does your dad want that? These are grim, gritty questions that are not fun, but must be dealt with.

Look up hospice care in your area. Ask if a care giver could visit 2 or 3 times a week to be with Dad so you and Mom get to take a break. From what I've read, being an adult under another adult's care is not easy - the person who's sick gets frustrated *aargh why can't I go do stuff like I used to* and the person who's caring for them gets frustrated too *arrgh it's awkward being their caregiver can't I have fun again?*.... so plan for time away. Now.

It really depends on your doctor's assessment of your dad. I think if your dad has a "short" time frame, he may want to stay home and rest at home. If your dad has longer than a year or so, it might be an idea to have him at assisted living - with full time med care available?

Have mom and dad go chat with the doc and find out exactly what's going on. It's up to them what to do, really - you can help Mom and Dad, but they're going to have to decide.

Take lots of pics now. Even with the hospital stuff. I took a pic of my dad's mentor, the last time I saw him. He was frail, elderly, had o2 tubes in his nose, but it was still his smile. Years later I showed Dad that picture and he snatched it out of my hands and kept it, for the memories.
Sit down with a recorder and talk to Dad- I bet he's got some stories, being 70 and all. Ask him about his view on historic events. Moon landing. Nam. The 50s. The 60's. Woodstock. Technology. How he met Mom. You'll be glad later, you'll be able to hear his voice when he's gone.

If he's able to, why not go for a field trip once a week, and make it your day? A stroll/roll to the closest park, with a chat about stuff in general? Even those trips, simple and short, will be good for morale.

And the days where Mom's off? Spend adult time with her too. She's going to need it.

Hugs
Cutenoob

[Caveat Emptor]

When my dad was dying of cancer five years ago, insurance covered most if not all of the expense for hospice care - a visiting nurse service to come in in the morning and help with hygiene and dressing. Insurance also covered the cost of a hospital bed to be placed in my parent's room for the final month. Make sure you understand whatever inurance there is and check with a lawyer that specializes in medical care if you need help.

[Lachrymose]

Thanks, all.

You've given good advice which I will follow up on.

I'll answer individual questions soon, I'm just too exhausted to deal with it at the moment.

[Lachrymose]

Your dad sounds like hes in heart failure. This is often cascade of symptoms and people often go back and fourth between feeling well or having issues like your dad. There's a chance he may still could bounce back, though not completely.

Yeah, he's doing okay right now, in general and relatively speaking. I mean, he's not dancing or anything and I think the general trend will be his getting worse overall.

First thing I would do is check with your dads hospitals to see if they have a social worker available to you. They should be able to hook you up with affordable options. If not, call office of the aging or whatever other elder services you have in your area. Youd be surprised at how many options are actually available.

We found out today he's supposed to have a social worked visit on Monday before he's discharged.

Also, is hospice or home health care a possibility (also something to talk to the social worker about)?They are pretty low cost for the most part. They would be able to provide care in their own home as often as its needed. You can also have home health come and see him, which is NOT hospice, but they provide care for him at home also. Seriously, they can provide almost any kind of care from the home nowadays.

Dunno, but I will check it out.

Lachrymose..<<<<>>>>

Ill keep you and ur family in my thoughts and prayers. PM if you have any questions..this is something Im unfortunately, very familiar with.

Thank you

What makes it the hardest is that I'm 31, and only child, and I've never lost anyone that close to me in my life.

The first death in my family that even made me cry was my uncle (dad's brother) back in February. And I'm pretty much over that now.

Lachrymose - first off - it's never easy dealing with an elderly parent. My dad is 85, so I know the feeling.

Thanks

Now, while I do second what Amina said, I do think the most important person here is your dad and what he wants.

Absolutely. We are doing nothing without his consent, although we may be forceful in our suggestions because he can be very stubborn. They live in a three story rowhome right now, and he really, really needs to be out of there and in a place where he can get assistance from someone in addition to my mother, who is also getting up in age.

It's his life, and IMHO, it should be his decision as to how the rest of his days should be spent.

I see that with my dad and did see it with my mom when she was going. I do think it should be your dad who makes the call on which way to go. I'm sorry of that sounds callous, and I'm gonna stop before fraching, but sometimes it comes down to quality vs quantity of life.

B

Yeah, and the sucky thing is he was ready to have this operation no matter what, because he truly feels he's not living right now. I mean, he can't walk 20 feet without becoming out of breath.

You didn't mention it and I don't want to sound weird but...Does your Dad, or in the fact, your parents have a will? Your going to need one or two...one being the Will and another being a Living Will. This should be done while he can do still things. Best place I know for one.

Yeah, taken care of officially as of yesterday.

Some hospitals have living arangements for family to be near their loved ones. I would talk to the hospital of his choice.

Hopefully the social worker will help us out here.

I'll second Aethian.

MUST HAVE WILL AND POA NOW. If he's this sick/ill health, the legal things must be considered. NOW.

Talk to the social worker at the hospital. Ask them "how can I have my dad in a place where he's comfortable, doesn't cost arm & leg, and will help him/mom?"

Ask your parents about the will. Remind them (gulp) time is not static, and this must be dealt with. Ask them about Power of Atty. Ask about a DNR - does your dad want that? These are grim, gritty questions that are not fun, but must be dealt with.

Look up hospice care in your area. Ask if a care giver could visit 2 or 3 times a week to be with Dad so you and Mom get to take a break. From what I've read, being an adult under another adult's care is not easy - the person who's sick gets frustrated *aargh why can't I go do stuff like I used to* and the person who's caring for them gets frustrated too *arrgh it's awkward being their caregiver can't I have fun again?*.... so plan for time away. Now.

It really depends on your doctor's assessment of your dad. I think if your dad has a "short" time frame, he may want to stay home and rest at home. If your dad has longer than a year or so, it might be an idea to have him at assisted living - with full time med care available?

Have mom and dad go chat with the doc and find out exactly what's going on. It's up to them what to do, really - you can help Mom and Dad, but they're going to have to decide.

Take lots of pics now. Even with the hospital stuff. I took a pic of my dad's mentor, the last time I saw him. He was frail, elderly, had o2 tubes in his nose, but it was still his smile. Years later I showed Dad that picture and he snatched it out of my hands and kept it, for the memories.
Sit down with a recorder and talk to Dad- I bet he's got some stories, being 70 and all. Ask him about his view on historic events. Moon landing. Nam. The 50s. The 60's. Woodstock. Technology. How he met Mom. You'll be glad later, you'll be able to hear his voice when he's gone.

If he's able to, why not go for a field trip once a week, and make it your day? A stroll/roll to the closest park, with a chat about stuff in general? Even those trips, simple and short, will be good for morale.

And the days where Mom's off? Spend adult time with her too. She's going to need it.

Hugs
Cutenoob

Thanks

When my dad was dying of cancer five years ago, insurance covered most if not all of the expense for hospice care - a visiting nurse service to come in in the morning and help with hygiene and dressing. Insurance also covered the cost of a hospital bed to be placed in my parent's room for the final month. Make sure you understand whatever inurance there is and check with a lawyer that specializes in medical care if you need help.

Thank you

I appreciate all the input, guys and gals.

I'm sorry if I missed anything, I'm a bit drunk at the moment.