why the open face?

I hadn’t lived with my father since I was six.  It’s not that I didn’t know him, it’s just that I knew well enough to know that trying to assimilate him into our house, he with his bachelor routine of timely meals, crosswords puzzles at lunch and Fox news for dessert, was not going to be easy on a good day.  And he hadn’t had a good day in a long time.

My three boys were busy with their homework, friends and teams and were not quite aware that I spent my days trying to console and counsel their grandfather.  They knew he was in town, knew he arrived suddenly, and my oldest, the most protective of the bunch, was angry that I was in pain.  He was starting to ask me questions, starting to wonder when I was going to leave well enough alone.   And my youngest, then seven, would cry about my seemingly constant absence. 

“You just saw him yesterday.  Why do you have to go again?”

I couldn’t tell him that it was because his grandfather was a mess.  I couldn’t explain that he up and left his life with only two shirts, a pair of socks and his passport in a duffel bag.  He wouldn’t understand that I couldn’t trust the words that might come out of his mouth, painful, biting and ugly.  I would have loved to embrace my elder as they do in other cultures, other homes, to bring him in to our house and let his wisdom enlighten my children, but at this time in my father’s life, it was I who had to muster up the wisdom, the reverse psychology to get him to eat a meal or wash his clothes.  I had to find the courage to help and the sage-like foresight to let some of the responsibility to still be his.

This was no easy task.  Yet as a sandwich, we all face it - the struggle of the balance between respecting who they were to us and who they are on the verge of becoming.   And, courtesy of Father Time, our children are on the verge of "becoming" as well.

Some days my sandwich is an open faced mess.

step back

My father has always referred to himself as a child of the depression.  Born in 1938, he was, in fact, a child of the recovery, but his mindset has always been one of frugality and rationing.  Couple that “a penny saved” outlook with a lifetime of skepticism and what you’ve got is a man who, not unlike other older folks who have been in rent controlled apartments or who have “just always lived there,” lived in an apartment in someone’s house for nearly twenty years without a lease.  He’s from the days where a handshake and a person’s word were good enough to make a business deal.  Unfortunately, that doesn’t translate to today’s thirty page lease agreements and financial disclosure paperwork required by most apartment companies.

I had to get my father a place to live.

When I asked him about his plans, his intentions, what he envisioned for himself, he said he was staying here, that he was never returning to New York.  He had made a rash decision, if it was a conscious decision at all, to get on a plane and come to my house, but he was going to live with it.  What that meant, of course, was that the consequences of his actions became mine.  And I had to find him a place to live.

There are two apartment complexes in town, neither of which was up to his standards.  One is newer construction with screened in porches and a large pool and the other a bit older, sturdier, and closer to my house.  Both are sufficient.  Neither, of course, would do.  He wanted to live as he had, in an apartment without a commitment of a year or more, without people with dogs, cats, kids and cars missing mufflers.  He wanted to be left alone and yet he wanted to be taken care of. He was in regular contact with his landlord in New York but refused to tell them he was not returning. No option was taken off the table, yet nothing was there from which to choose.  He was a mess and, quite frankly, so was I.  Learning to change roles was difficult, particularly without warning.  I went from daughter to care-giver, solver of problems, fixer of things, jumper of conclusions.  I was always trying to stay one step ahead of what might come next, trying to fix the unfixable before I even knew what it was.  I lived my life as one giant “what if.”

What if he leaves again?

What if there is something really, really, wrong?

What if I can’t get him an apartment?

What if he disappears?

What if he refuses to sign a lease?

What if he needs more than I can give?

I was a wishy-washy, grasping at straws kind of care-giver in the beginning, primarily because I had no idea how to care for him.  No diagnosis had been given, no illness identified.  There was just this man who I felt I hardly knew, who had arrived at my house without a plan, who clearly needed help.  The one thing I knew in my heart was that I could not let him move into my house.  And that was tragic.

step one

It was imperative that I get my father to a doctor.  And as if we weren’t facing challenging enough circumstances, this is where things got more difficult. 

Florida, Arizona, the South Carolina low country and Northern California wine country – all places retirees are commonly found.  They leave their chillier climes for promises of sunshine and bliss and often spend years enjoying just that.  But as our parents age and their needs become greater, they often find themselves returning to familiar towns and cities, drawn to adult children or long-time friends.  It’s called reverse migration and while it was not my particular set of circumstances, this moving of the aging from one place to another can get muddy.

My father did not have a primary care physician.  Ever.  He was a ‘wait it out’ kind of guy who used urgent care when it was, well, urgent.  Arriving on my doorstep without so much as a referral from another doctor meant that we had to find him someone who would see him, and for those of Medicare age, that is no easy task. More and more physicians are not accepting new patients if they are on Medicare because of the lower rate (78%) the government pays the doctors.  When doctors compare patients with private health insurance to those on Medicare, the payment is greater and thus, more appealing – which is appalling, but I get it.  What it means, however, is that the common practice – and let’s face it, need – of reverse migration, brings with it circumstances that an already stressed family must face.

The advice from the medical community is to work with an aging parent’s primary care physician prior to the move.  Allowing the doctor to use his or her network to help find a new doctor is advantageous not only in that you are, in effect, getting a referral, but with any luck, the doctor will take into account the needs and particulars of their patient, someone who, presumably, they have had a working relationship for quite some time.

I called several places in my area, none of whom would accept a new patient on Medicare.  I hadn’t wanted to blur the line between patient/doctor and daughter of a patient/doctor, but as a last resort I called my doctor. He was not accepting new Medicare patients accept for those affiliated with the practice already – as in, I am a patient, he is my dad, the doctor would see him.  Phew.  I was nothing but lucky on that one.