Follow The Money

I have an aging parent in a nursing home. Dad left home 88 days ago for Methodist Hospital Emergency Room, because… he said: “I don’t feel well”.

Dad, 87 years old, needed prostate surgery. Once we identified the problem, we had direction. He needed to repair a hole in the bladder and rid him self of infection before the operation. After the operation, he would need time to repair from the operation, rebuild strength and then go home. All very simple.

How long could that take? Oh and by the way, the cost of all of this was never a factor.

Now don’t get me wrong. I never gave cost a second thought. When we first signed in at the hospital resignation desk, the Blue Cross Blue Shield insurance card was laid out on the table. She typed the numbers in to the computer and off we went to be fixed.

At some point I was introduced to the term “Medicare.” Now remember, I am a guy and I have not been sick. So, the word Medicare was not a word that meant much to me. I then began to slowly come to understand Medicare has something to do with Social Security or it is some how related to Social Security, I think. You know I am still not sure how it really works. Because Dad is 87 years old, I started to believe Medicare was paying all the bills. Keeping in mind, no one is telling me or Dad anything about what this process is costing. The doctor comes into the room and says to Dad and myself… “We need to do this procedure or that procedure.”

Excuse me Doctor, what is “this or that” going to cost? No… No… No… You sit around with Dad in his hospital room and talk about anything other than what it is costing. I mean let’s face it… you know it’s costing an arm and a leg, but hey, that woman downstairs typed in the Blue Cross Blue Shield insurance card number in to the computer, and between insurance and this Medicare thing, it’s covered.

Sixteen days at the hospital and Dad is now stable.

“You can’t stay at the hospital, any longer. You need to go away and then come back”

I now discover I need to move Dad to an Extended Care Facility so Dad can re-gain his strength and be ready for a prostate operation back at the hospital, a date to be determined at some point down the road. So, where do I take him? “What is an Extended Care Facility?”

Enter hospital social worker. Why we have all kind of options for you and your Dad. You can take him to Shady Trees Retirement Home or better yet what about Whispering Sheets Convenience Nursing and Health Care / Rehabilitation / Long Term Care Center… Tell you what honey, I will see if they have any room…

“I’ll put in a good word for you, (as she winks at me) maybe we can get your Dad in there… Oh, Steve, they are good people. And care about what they do. Your Dad will just love it there.”

I have but a few days to decide. There is no time for dilly dallying. I run here and I run there, trying to decide where to take Dad. They all ask the same question up front. The most important question of all… “Money.” They ask it in different ways. But they always ask…

“How old is your Dad? What type of insurance do you have?”

Loosely translated it means… do we have a blank check book? It became clear real quick, it did not matter where I took Dad, they all could smell Medicare, and Blue Cross and Blue Shield money. They know how to work the system and work it they will. So… I could take Dad to Down and Dirty or Lush and Plush and it didn’t matter, D&D or L&P were going to charge Medicare and Blue Cross and Blue Shield the same. So, I choose “Lush and Plush.”

I want Dad to stay in a nice place… Right? So I choose Marquette Manor. I was told up front, Marquette Manor had it all, and I want it all… for my Dad, and I want style too. TV in every room, great food in the dinning room.

“Steve, did you check out the stemmed glasses sitting on the white table clothes in the dinning room? Did you notice the number of pieces of silver wear we set out at each meal, the small vase of freshly picked flowers in the center of each table? Did you see the waiters and waitress in white shirts, black pants, all wearing a black bow tie? And our care givers are professional in every sense of the word. We here at Marquette Manor have a physical therapy area too, then at some point Steve, (His voice lowers and he becomes serious and very focused) we have an upstairs where we can move your Dad into “Long Term Care.”

The sales pitch was good. We here at Marquette Manor can do it all. I missed the emphasis on the “long term care” part and the de-emphasis on the physical therapy part. Here is another little rule I forgot that applies to life.

Let’s say you want to change your life style. What ever it is. Let’s say you want to stop smoking, or you want to loose weight. In order to adopt a new life style you have to change your habits for at least 21 days. You can change almost any life style, if you give it at least 21 days. 21 days is needed to adopt any new life style. Now let me say this about the 21 day thing, it works about 80% of the time. But, is the glass 80% full or 80% empty? It works for about 80% of the people who us it.

What I forgot was… it will also work in the health care industry. If you can get a guest in your nursing home to lay down in your bed, for at least 21 days or longer, you have a greater chance to keep that person “long term.” Remember Marquette Manor needs to fill beds and keep them full. They don’t make any money putting people in physical therapy or sending them home.

Now the sweet part of the health care industry. Medicare is going to be a partner and give the nursing home the opportunity to reprogram this patient. The nursing home gets 100 days to do it! The care giver, in this case, Marquette Manor, has 100 days of Medicare money to get my Dad reprogrammed and accustom to staying at Marquette Manor, long term, and Medicare picks up the tab for the re-programming.

The folks in physical therapy need to draw out the process. We can’t get our guests feeling to good to fast. The guest will want to go home. And if, like my Dad, the guest refuses therapy because it hurts or it is painful or causes discomfort… we at Marquette can justify in our report to Medicare and insurance why it’s taking additional time to rehabilitate. Life is beautiful, and the money keeps flowing.

Listen, I could be wrong about all this… But, I have been looking at the bills coming in and I can’t believe my eyes. When Dad went to Methodist Hospital, February 12, and was then released to Marquette Manor, Dad’s stay at the hospital the first time was sixteen days. The hospital invoice only, came to, one hundred sixteen thousand three hundred dollars.

I opened a bill from the company that transported Dad from Marquette Manor to Methodist Hospital for his surgery on April 16^th. The vehicle was a wheel chair van and the cost to transport down to the hospital was, four hundred ninety seven dollars. By the way, the cost going back a week later was the same, four hundred ninety seven dollars.

Health Care is big business. And I am hopeful Dad will be one of the 20% that won’t reprogram into the system.

Placing the Call

I have heard it said “A wheel in motion tends to stay in motion.” When did I first hear those words of wisdom? Back when I was in the mortgage lending business? The other truism is, “You become what you focus on or think about…”I don’t even want to go there.

Dad had prostate surgery and I have Dad in a nursing home, a nice one, Marquette Manor. The problem with this nice nursing home is Marquette Manor and I are not on the same page. With 365 people in the Manor there seems to be this mindset of, this is your new home, and your last stop. We here at Marquette, are going to make it as nice as possible for you. And believe me, the Manor is nice. But, I am having problems buying in to that “Wheel in motion and this is your last stop thing.”

I was thinking we were going to rehabilitate Dad and go home. But that plan doesn’t seem to be in the Marquette Manor play book. Let me go back to a meeting I was involved in and and share the experience.

I was asked to attend a meeting with staff about three weeks after Dad arrived at the Manor. I think it was middle March perhaps. In this meeting were the heads of each department, Health Care Professionals all and all were women. They motioned for me to take a commanding position at the end of the table. I took my place at the bottom of the table. I’ll will call it the six o’ clock position. I must admit, it reminded me of when I was manager of my mortgage lending operations years ago and this felt like a Monday morning sale meeting.

In this meeting was the Activities Director, she is sitting at the twelve o’clock position at the table. She is sitting directly across the table from me. (Miss happy, Oh yes, I remember her, she walked into Dad’s room when he first arrived at Marquette and with a big cheerful, bubbly smile said, “Are you ready for a fast game of Bingo Mr. Duncan, the game starts in ten minutes.) Dad is died in the wool American Baptist, and Dad went off like a fire cracker. I could hear him mumble under his breath, “Gambling, it’s nothing but gambling!” And Dad made it very clear to her how he felt about this activity by saying it loud and with authority “NO!” So, the activities director made zero points with Dad the first day. The head nurse was sitting at the one o’ clock position of the table. The dietitian was sitting at eleven o’ clock. The lady in charge of physical therapy, she was on my left arm and the woman from finance and the social services director were scattered in between the rest. They were all looking very professional and I was sitting in my chair watching them get settled around the conference table for the meeting. I was looking at them and they were watching me out of the corner of their eye. I remember putting my hands together, folding my fingers and placing both my hands on the shiny dark wood conference table.
The room had professional lighting in the ceiling. The lights were up in the ceiling, hidden, casting stripes of light on the beautiful wall paper. Other light from above was placing spot lighting on the paintings hanging around the walls. This is a very rich looking conference room. They all were wearing their starched white full length smocks, with names tags hanging off their collars. They all had their paper work and notes in front of them and piles of paper in the center of the table that they would adjust and move as the beginning of the meeting came closer. They were ready. I am not sure what they were going to tell me but I felt they were ready.

I waited for some one to “be in charge “and start the meeting. There was this pause and I was looking at them and they were looking at me. The Social Services woman spoke up. Is there anything you would like to know Mr. Duncan?

There are times in life when your mind goes totally bland at the wrong time. This moment happen to be one of them. I looked around the table, all of their eyes were glued on me. Were they waiting for some pearls of wisdom to come forth from my mouth? I felt flush. I tried to regain my composure. I decided to fall back on my mortgage lending sales meeting experience from years ago. I lowered my head as if I was getting ready to balance my clear razor sharp thoughts with my impeccable delivery. My mind was still a blank. My experience over the years, with that many people in the room like this is, more than likely they all don’t have a clear understanding of how Dad make it to Marquette or his personal story. So I simply decided to bring everyone up to speed.

I began. On February 12, 2007 Dad was admitted to Methodist
Hospital with abdominal pain. Methodist ER discovered Dad’s prostate had enlarged and closed off the urethra tube and urine having no where to go started filling his bladder with urine. Dad’s bladder filled with urine and enlarged to about three times its normal size. The bladder finally gave way and tore a hole in the wall of his bladder. Urine then spilled into his body. He was diagnosed with a urinary tract and blood infection. While in the hospital healing from infections, they discovered Dad has a hymnal hernia and they continued to treat bed scores on his bottom and back. Lying in the hospital bed day after day, doctors discovered Dad got three blood clots in his right leg. His heart started acting up again, so they shocked it and his heart returned to a normal beat. The doctors wanted to perform a heart cauterization to get a good look at his heart before they would operate on his prostate. They found his heart to be in great shape.  They liken his heart to that of a 40 year old man. Dad has arthritis in his left shoulder and left elbow. His knees are worn out and it is hard for him to stand on them for any length of time. Before he went to the hospital Dad was living alone in his own home. He was going to the bathroom and taking showers on his own. He fixed his own meals in his kitchen at home. He was able to get in and out of the Buick by him self with out any help. He was able to stand in church for a short period during the service. He was able to get in and out of his wheel chair and into a booth at his favorite restaurant and back to the car and home.

Now, the reason we are here at Marquette Manor is to give Dad time to heal the bladder and get Dad’s strength back so we can under-go prostate surgery and then go home. Dad has been in the care of Marquette about three weeks. I have noticed Dad has not gotten out of bed yet. I did notice while we were at the hospital that folks who had surgery were up and walking the halls a couple of days after surgery.  You have folks have had my Dad for three weeks now. When do you think you will have him up and about?

There was silence.

I decided to continue. I have come to understand, and correct me if I am wrong, that Dad at 87 years of age is eligible for Medicare. I understand Medicare coverage will pay the bills for 100 days. I am getting a funny feeling there is no real motivation for Marquette Manor to get Dad out of bed. The motivation for Marquette Manor, it would seem, is to keep Dad around as long as possible and collect as much of the 100 day paychecks as possible. Why get him up and miss out on the full 100 days.

Please inform me as to how a hospital have their patients up and in the halls walking a day or two after an operation, but here at Marquette, three weeks into Dad’s stay, he is still lying in his bed?

This little outburst of mine, I discovered, would make people scatter when I walked into the Manor from that day forward. I would get no eye to eye contact from this crowd again. The nurse’s aids and a handful of the nurses that worked with Dad everyday would talk with me and were comfortable with me being in the room. But Dad was still in bed.

I then called the Urologist and asked for help. “Doctor, can you write an order to Marquette Manor for Dad to get out of bed a couple of times a day?

The Urologist said, “I can do better than that. I will write and order to have him out of bed for each meal. He really needs to be sitting up eating instead of lying in bed eating.” Now with an order from the doctor I discovered the nurses were not getting dad up and out of bed. I questioned the reason why?

“He is not getting up because your Dad is refusing to get up!”

“Your Dad has rights you know! Just because you want him out of bed doesn’t mean he has to do it. He can refuse to get out of bed and there is nothing you can do about it. He can refuse to eat and you can’t make him eat and we, staff, can’t make him eat. He has his rights!” 

This little outburst of emotion caught me off guard. They don’t like the son coming into the Manor forcing my Dad to get up. They don’t like anyone telling them what to do. I had the good sense to keep my mouth shut at this point. I did not say anything. I just listened. But on the inside, I was exploding. The staff has this little legal rule down pat. They can justify anything with “The patient refused!” With this revelation I realize, my hands are tied. The staff has a mind set that Dad will perform like all the rest of the people at Marquette.

Carl Toug (1875-1961) once said, “What you resist, persists.” So does that still mean a wheel in motion tends to stay in motion? If
Marquette is resisting getting him out of bed and Dad is resisting going to physical therapy then there will be no change. If I buy into this program and allow this forward motion to continue, Dad will be in a bed the rest of his life.

I wrote an article a while back called Adapt, Move or Die. If we will not Adapt and change our attitude, then we must move, or die.

Should I think about a Move, and a new health care facility? Will a change in location with fresh people and attitudes make a difference? When Dad was in the hospital the first time, I was encouraged to take Dad to Westpark Rehabilitation and Health Care on the west side of town instead of Marquette. Methodist Hospital recommended I consider Westpark. The Westpark name has been brought up again by others as a possible positive place for Dad. The location of the home in the city is suspect.

My next door neighbor Mr. Hughes and I decided to take a drive last Friday night in his vintage 1970 Olds Cuttlass convertible. I told Jeff I wanted to check out a new Health Care Center for Dad.  The closer we got to the Nursing home Jeff started laughing saying things like, 

“Dude, this is in a real bad part of town. You’re not serious?” 

I told Jeff to just hush up and pull into the parking lot and let me see if I can get inside this late at night and look around. I jumped out of Jeff’s convertible and pushed the night door bell. It took a minute or two, but lights started coming on and a nurse opened the front door. I explained to the nurse at the door I was thinking about having my Dad stay here and is it possible I could look around? She smiled and looked over my shoulder at Jeff sitting in his bright red 1970 Oldsmobile convertible. She invited me in.

The place is clean, not fancy. There is a lot of clean very shiny tile floors. I talked with the on duty nurse staff and they were very positive about the rehabilitation director, Dwight. She said they sent three patients home today. Long term care in not our focus here at Westpark. Our goal is getting people back home. I was shown just about everything. I thanked the nurses and left the building.

My first reaction was mixed. The best way I can describe my overall feeling about the two places is Marquette Manor is like a formal living room. Westpark is like a kitchen. I was quiet on the way home. What to do? I took the brochure that I had picked up and called the number on the business card of the admissions director. I was going to leave a message. She answered her cell phone and I told her what I wanted. I asked her what would be the steps to see if there was room for Dad at Westpark? She told me she would need to look at Dad’s medical records at Marquette. I told her I would call and ask the admissions guy at Marquette, to allow her access to Dad’s files. I asked her when she thought she might be paying a visit to Marquette Manor? She informed me she would be there on Monday.

SUNDAY, Day 84

Sunday, after church, I made my normal trip to Marquette. I was talking with Dad when Danny Sack walked into Dad’s room. Danny and I went to Pike High School together. Danny talked about his mother who was in a Masonic Home Health Care Facility in Franklin 30 miles south of Indianapolis. He was talking about how she had to give everything she owned to the home and in return they would take care of her for the rest of her life. Danny was encouraging Dad to do what ever he had to do to get back on his feet.

After his visit I decided to walk Danny out to the front door. On the way out I noticed the Lopez family walking toward Dad’s room. I informed the Lopez family I would be back in a few minutes. I finished my visit with Danny and his wife who was waiting outside and returned to Dad’s room. Guemalli and Merlin, Merlin’s Mom and son Eric were in the room talking and laughing with Dad. The room was getting crowded and I made the mistake of moving things on Dad’s bed side tray. He snapped at me, “Stop moving things around!”

For some reason his words today were like a knife. I took them way to personal. I know from having lived life and having made this mistake way to many times, by talking back. To simply keep my mouth shut. I know words expressed in anger can never be taken back. I picked up Dad’s laundry and told him I would talk to him later. I hurriedly left the room. The Lopez family called me on my cell phone as I was leaving in the Buick and told me they wanted to have lunch with me. We figured out a place to eat and we all talked about what I should do about Dad.

Monday Day 85

Monday morning I am driving my school bus with a full load of kids. I pass by Marquette Manor all the time on this first run. I found myself pulling on to the Marquette Manor grounds with a bus load of students. They were jumping up and down, wanting to know where I was going? I realized I was thinking about Dad and was not paying attention. After my morning bus runs I jumped into the Buick and headed for Marquette Manor. I had Dad’s laundry clean and folded. I walked into his room and his bed was made and he was no where in site. I loaded clean clothes into the clothes cabinet and headed for the physical therapy rooms downstairs. I could see him in the room from the hall. I decided to watch him from afar. He was doing arm lifts. His back was to me. He needs a hair cut. The therapist noticed me in the hall and said nothing to Dad. The therapist got up and left Dad for a few minutes and I walked into the room. I grabbed a little stool with wheels, sat down and wheeled my self up to him.

“I was just thinking about you!” Dad said.

“That’s because I was standing in the hall behind you sending good vibrations your way.”

Dad said, “Look, I would like to say I am sorry if I snapped at you yesterday

I sat there and didn’t know what to say. I placed my hand on his arm.

“Dad, you get upset from time to time, and I guess I have a little you in me. But remember one thing, even if we fight and yell at each other, you must always remember, I love you.”

He smiled and his face relaxed. I held up my hand and he gave me a very gentle high five.

I left Marquette Manor and headed for Westpark. I drove to the 1300 block of Tibbs Ave and into the parking lot. All the parking spaces were full. I found a space on the side. I walked to the front door.

I asked the receptionist if I could meet with the dietitian and the physical therapist. Dwight, physical therapy came out from the back and we had about a 20 minute talk in the dining room before he had to go to a meeting. Dwight might be pushing age 50. He has been a Westpark for 13 years. He told me he would do what he could to get Dad back home. But… the owner of Westpark, has the final word if Dad will come to Westpark. I talked to the dietitian and she is willing to do what ever we need to do to give Dad hot soft food so he can start putting weight back on. She has been at Westpark for 18 years. I left Westpark with mixed emotions again. People will say anything, won’t they? They seem like they enjoy their jobs. Will Westpark be more to my Dads liking? Should I make this change? Trying to decide where Dad will feel comfortable. It’s not easy.

The Right Thing To Do

I walked into the Marquette Manor nursing home not expecting Dad to be in his room. I decided to check his room before I went down stairs. After all, it is ten in the morning. I suspect he will have had his breakfast and will be down stairs in physical therapy. Much to my dismay he was lying on his bed asleep in what appeared to be a very uncomfortable position. His Television was tuned to a television preacher. I turned around from the television and surveyed the room. I was trying to come to a decision if Dad had been out of bed today. I placed a vase of flowers I had brought on his bed side table. The flowers were a gift from the McCoy’s. Monica and Larry had placed flowers in a vase and had taped miniature Three Musketeer candy bars to small wooden rods rising out of the flowers.

As I was standing at the foot of Dad’s bed. A nurse’s attendant walked in the room and woke Dad up. She told him it was time for him to get up.

“For What?” He barked.

Dad then noticed I was in the room, at the end of his bed. I am thinking to myself. Who noticed me come into the building and who told this nurse’s aid to get her rear-end down to Mr. Duncan room and get him out of bed? The evil son just came into the building? The nurse’s aid wants to change Dad’s personal under clothing before she helps him into a wheel chair. I leave the room to be respectful.  

As I am standing out side his room in the hall waiting for dad to be changed and placed into a wheel chair, I am invited into a side office for a quick private conversation. The conversation goes like this.

“Steve when you had the meeting with the staff back in March, you hit the nail on the head. Marquette wants to keep your dad here and move him up stairs, on the second floor into long term care. Marquette is not interested in getting your Dad back home. Marquette wants to keep your dad and move him in to long term care. When the Medicare money runs out at the end of 100 days, your bill here at Marquette will jump to three hundred dollars a day. You need to think about getting him someplace that will help him get back on his feet and encourage him to focus on going home. This place doesn’t have that goal.”  

I did the mental math. Three hundred dollars a day… times thirty days in a month… three times three equals nine. Is this well meaning person telling me it will cost nine thousand dollars a month for Dad to stay at Marquette? My mind reviewed another conversation I had with another staff member. I was told Marquette will want five thousand dollars up front to go upstairs. My personal and very close friend in
Tacoma Washington, Jack, called one night and told me to plan on a monthly bill of at least three thousand a month.

I was standing in the hall again, my head swimming with information. Money aside, I still have a problem with the goals Marquette Manor has for Dad. The Marquette Manor long term goal seemed to be… let’s get Dad upstairs into long term care. I was thinking as I was standing there in the hall. I have been in and out of this building several times this week. I don’t think Dad has been in physical therapy at all. I can’t be sure. I could be wrong, but, I am getting a funny feeling Dad is or might be refusing physical therapy and they, staff, are not going to fight him.

Come on Duncan think about it… what is easier for the staff? Leave this grumpy old man alone in his room and move on to other things that have got to be done… or take extra time to encourage Dad to get out of bed into a wheel chair then encourage him to go down stairs and make him feel positive about embracing pain in physical therapy?  

I even asked Dad earlier this week if he had been to physical therapy. He hesitated and stumbled answering my question.

“Yes… yes… I have.”  

I didn’t get a real warm feeling he wanted to answer that question or he did not want to tell me he has been refusing to attend physical therapy.  

I had a frank discussion with one of the nurses in the hall about 3 weeks ago. I was informed, “Your dad has the right to refuse physical therapy if he doesn’t want to do it you know. Your Dad has the right to not eat if he doesn’t want to eat. It is not up to you what your dad does or doesn’t do… he has rights you know!”

Oh yes, I felt the stinging tongue of this informed and legally educated nurse. I get it! I am the bad guy. I am the pain inflictor. I am “Lording my power” over this defenseless, kind, old man. I got it!

I guess I need to ask some real hard questions of myself… what is the right thing for this son to do for his father? Do I as his son, let Dad have total control over what life he has left? If he doesn’t want to get out of bed, or sit in a chair or sit in his wheel chair or go to physical therapy or go to the dinning room to eat, then should I buy into that program? If he wants to keep the window curtains closed and the room door shut all the time and doesn’t want to talk to anyone anymore… is that normal? Is that to be expected? Dad used to be a social animal and now he is a recluse. Is this what I should let him do? Should I just buy into the idea Dad will be spending the rest of his life in a bed in a nursing home?

Or, should I believe he has lot of living left to do before it’s his time? I say to my self… Think about it! What do I know for sure? I know while he was in the hospital we were reassured he has no cancer. Dad’s heart is sound as a dollar. His knees hurt and he has arthritis in his left shoulder. Before he went into the hospital on February the twelfth, Dad was living alone. Dad was able to stand in the kitchen and put his own bacon in the microwave. He was able to use the bathroom by him self and shower by him self. Dad was able to get in and out of the Buick by him self. Dad wanted to stand in his church pew on Sunday morning by him self. Dad was also able to slide himself into a booth at his favorite restaurant. Dad laughed and sang and enjoyed the company of other people too.

So… what do I do? 

I walked into his room. He was sitting in a wheel chair. He had on sweat pants and a sweat shirt. White socks with no shoes. His hair looked dirty. The nurse’s aid must have combed his hair putting a part in his hair. Dad looked tired. I walked into his room and pulled up a chair. I looked down at the floor. I was not sure I wanted to tell Dad what I had been talking about. I decided to keep the conversations to myself, at least for now. Dad informed me he went through all the mail I brought him to review and I should take some of the mail back home and file it. I looked over at the mail on the floor. There was a pile of unwanted magazines and junk mail on the floor. It looked to me there were only a couple of letter to go back home. No bills to be paid this time.

I was bent over with my elbows on my knees. I looked up into his face. I did not know what to say. I was speechless. I placed my hand on knee.

“I love you Dad.” 

Dad has never told me he loves me. He grew up in a different time. I have come to know It is hard for this man, my dad, to cry, to express love. He just sat there looking at me. I smiled and sat up as I placed my hand on his back and gave him a gentle rub.  

He wanted to know if I had been praying for him? I told him “Yes.” He told me he had been asking the wrong prayer of God. And began to explain how he should be praying and what he should be expecting from God when he prays. He became alive and almost passionate talking with me. I became the student, and he was the wise teacher. He continued his sermon for a few minutes and I listened and watched him become focused and ardent about his teaching. He believes strongly in his Lord.

We sat still for a few minutes… I placed my hand on his knee again. He then said in a soft voice… I don’t mean to be mean… but your breath is bad.  

I stood up, went over to pick up the discarded mail lying on the floor and placed it in the waste basket sitting against the wall. I then retrieved my digital camera and the mail he wanted filed. I studied him again. Do I tell him? Do I need to tell him right now I am thinking about moving him to another health care provider? The answer was pretty clear in my head; you don’t know what you are going to do. You don’t know where he would go next if you were going to move him. There is nothing to say to him just yet… Duncan… You don’t know anything yet… no need to say anything at this moment. 

“My back hurts I am calling the nurse… I want to get back into bed” He said…  

I walked slowly down the long hallway toward the parking lot. I looked at the individual rooms on each side of the carpeted hall, beds with so many sick people in them. I stopped and looked back at the long hall I had just walked.

Again, I said to myself… What is the right thing for this son to do for his dad?

Adapt Move or Die

PBS radio was reporting on climate change this morning. They made the point in their story that England was very warm at one time, and slowly got very cold, and now they believe England is in for a long slow warm up and England will continue to get warmer and warmer.

They are digging very deep and looking a long way back in time.  As they dig, they apparently discover changes that occurred in mother earth in terms of thousands, and millions of years. The word that they kept using over and over was the word change. We living things, plants, animals, bugs, sea things, humans, live on this earth, or have chosen to live in certain areas on this earth because of climate. They discovered, we live and then we change our location as the climate changes. The conclusion is we adapt, move or die.

So… let’s say you live in a warm climate for years and years and it gets very cold. You have three choices, adapt to your changing climate, move to a friendlier climate, or die.  One of the points the PBS radio story was trying to make was plants and other growing things didn’t make it when the climate changed to cold. Some animals did not make the transition to cold either. And man, sometimes made the transition and sometimes didn’t.  But what struck me was the tag line on the PBS story, adapt, move, or die.  

I know of folk who have lost jobs, relationships, and health and continue to fight trying to keep things the way they were. I know of church congregations that fight chance. It seems we all put our energy into fighting change and not embracing change. But change is unenviable.

I turn my thought to my Dad who is currently in a nursing home. Yes, Dad has been very sick. He has been forced out of his warm comfortable home and placed into a cold and sterile environment. He’s had surgery and is feeling physically and emotionally punk. He’s been lying in a bed for 79 days. Dad hates “change.” And Dad continues to fight “change.”  If Dad is not willing to ADAPT to change, and he won’t get out of bed and MOVE, there is but one path left open to him.