Sunday, March 27, 2016


Joe's Imitation of Hemingway

It’s been a busy and difficult week, one I created myself but nonetheless, frustrating.  I spent most of the week trying to refine a care plan for Joe with serious attention to alternatives.  Not that things have changed greatly, but we know more now than we did almost three years ago when we started down this uncertain path.

Back then our plan was simple and probably naive.  After all, we had no first-hand experience with Al; we were still reading basic definitions of the disease, shaking our heads trying to understand what this monster was all about. 

We realized without long-term health coverage, costs could soar. We would need to down-size, cut expenses, and ready ourselves for the long haul.  I would be Joe’s chief caregiver so he could stay in our home.  If his care required more than I could manage, I would hire in-home services to fill the gaps.

Way back in the Middle Ages when I was working in high tech as a Project Manager, one of my jobs was “alternative planning”, a “what ifs” approach to managing risk in case bad stuff happened to original plans.  It’s like the old adage, “don’t put all your eggs in one basket”. You need a plan that leaves room for change if (or more likely when) things go sideways.

So I applied that same thinking to our care plan.  If at some point down the road Joe needs more care than either I or in-home care services can provide, we would look at (I can barely type the words) institutional care. 

This is when the tears well up.  Of course, institutional care isn’t what they call it.  It’s called a “memory care center” because that sounds much nicer. Last week I visited several centers, but I’ll only talk about the best one. Frankly the others are too upsetting.

I’m greeted by a very personable woman (I’m thinking young for this type of work).  We walk through what is clearly a new building with contemporary art lining the corridor like an upscale hotel.  We go through a double door entry where she presses a button and we await permission to enter a lockdown facility, made to protect the people inside from the real world outside. 

Someone in scrubs greets us as we enter a large common space lined with sixteen private suites decorated with front porch facades.  My guide explains they try to mirror the feeling of home, allowing each resident to furnish their own space.  To my right is a brightly colored room filled with a doll house, coloring table, various primary books and stuffed animals.  My first impression is that it’s a children’s daycare, but I’m told it’s a living room where residents can amuse themselves. 

Back in the common area several residents sit in club chairs in front of a fireplace.  My guide speaks to one of them, a frail woman with snow white hair, asking permission to show me her room.  I notice she’s petting a cat that’s sitting on her lap; as we pass, I see it’s actually a stuffed animal. I smile and thank her but she doesn’t speak.   

It’s a good sized room with a private bath and many personal items.  The guide tells me residents often put something outside their door to help them find their own rooms.

We continue to the back of the common space passing a man sitting at a large communal bar busily working with paints, creating his version of a Picasso.  We pass through another security door to an outdoor space encircled by a tall iron fence.  There are patio chairs and shaded areas and I hear a waterfall in the distance. I’m told the nearby raised vegetable garden is tended by residents.

The final stop in the tour is a dimly lit media room with stars projected onto the ceiling and a very large water bubbler to promote relaxation.  One wall is covered by a big screen television monitor proudly described as a new feature allowing residents (with considerable help) to view their picture files and even Skype with family.

I know much thought and consideration has gone into the planning of this nice facility.  But any way I slice it…I don’t want Joe to go there.

As we finish the tour, I ask about costs and am provided a sales brochure with center page titled “Supplemental Charges”, noting room rates beginning at $5,530 per month for basic services.  

With the predicted inflation of health care costs over the next five years those services could easily rise to $8,000 per month.  I’m told the average resident lives five to eight years in such a facility.  Do the math…I don’t know too many families that can sustain such costs.

I have the urge to shout, “WHY ISN’T SOMEONE DOING SOMETHING ABOUT THIS?”  It’s impossible to think 5 million families in the US are up against this.

I’m going to write letters to my Congressmen and Senators.  I’m going to submit articles to the Op-Ed section of the newspaper.  We’ve got to attack and defeat Al before he bankrupts our nation.  This isn’t some politician’s rhetoric, it’s a real and present threat with the generation of Baby Boomers who will soon be lining up for “Memory Care Services”.

Deep Breaths...

I’m going to calm down and get back to alternative planning for our life with Joe and Al at the edge of uncertainty.

Joe with daughter Juli