In Search of Ice Cream

 Few things will sum up the past two years of our lives better than this story.

Last weekend was one of those lingering summer weekends.  We didn't have plans, for once, other than a visit to the father-in-law.

After our visit, we both commented that it felt odd not to have something looming above us needing to be done.  I mentioned that it felt like too nice of a day to just head home.  This started the never-ceasing-in-a-marriage "Where do you want to go?" conversation.

Something in my head said "Ice Cream"  I phrase it like that because I'm not a big fan of ice cream.  I mean, it's not terrible.  It's just not my favorite.  It IS Kevin's favorite though.  So he readily agreed.

There is a big farm stand/ice cream shop/tourist place out on an island that is known for good ice cream.  This island has bridges to cross and is accessible two ways, both rurally.  The closest route is about fifteen...maybe twenty minutes away heading south.

That was the plan, until we go down the big hill from the hospital and spot two things: the freeway is at a near standstill and there is a freight train going through town.  (you have to love small towns)  We discussed it and decided to go through town, once the train was through, and take the backroads.

Then we sat in traffic.  Because train and freeway, that section of town was a mess.  It was safe to say that when we arrived to the even smaller town where the bridge to the island was, it would probably also be a mess. Because that is where the train is heading and  that is the direction of the slow traffic.

Instead of just going home or finding ice cream elsewhere, we decided to take the other route.  This includes going through miles of farmland and way out of the way.   But: ice cream.

Finally we arrive and the parking lot is full.  FULL.  Because it's a nice Saturday afternoon at the end of summer.  Not to be daunted, we parked then walked to the ice cream portion of the farmers market. 

The line ran outside and circled along the building.  It would be every bit of a twenty minute wait and then no where to sit.  Sidenote: eating in the car is one of my least favorite activities.  Also, we're both feral when it comes to crowds now AND we're again trying to lessen our exposure so we don't put anyone at risk visiting Dad.

After petting a dog and taking a family photo for strangers, we reluctantly and frustratedly returned to the car.  The option for ice cream is now a Dairy Queen or an ice cream shop way back where we began when we decided ice cream was a good idea.  Except, there was one other option.  In a whole other town, an additional 15-20 minutes away, west. Further away from home.

We discussed that maybe ice cream wasn't an option for us and we headed back home.

We decided to cut across farm land to go home versus backtrack into town and get on the freeway.  At the intersection of the highway and the farmland, Kevin actually said "Eff it. I want ice cream. I'm getting ice cream." and turned on his turn signal.

I just laughed because this is ridiculous and right on par for how everything was going this year.

We traveled on the highway, going over a big bridge because this town is also technically an island, and went through town along the water.  The ice cream shop is way at the end of this town, near a marina and the street dead-ends a block away.

And it was closed.  Of course it was.  The interwebs said it was open but the locked door, closed sign, and no lights would indicate otherwise. 

Now we're in a whole other town.  There is not even a Dairy Queen.  I searched "ice cream near me" and it said that there was an ice cream shop at the opposite end of town.  This is where I say that I'm terrible at reading maps. My brain really struggles with that processing and in my jumbled brain, I didn't think to click "Directions" instead of "Navigation".  The nav app stated it was 13 minutes away, which didn't make sense to me.  This is a five minute town, end to end. But Kevin started driving back out of town so that maybe the map would reroute and give us a better idea.

Yeah, so about that.  This other ice cream shop was on Another Highway further West, and nearly onto Another Island & County.  At this point, we came to our senses and said "Maybe ice cream is not in the cards for us but like, for real" paired with "HOW HARD IS IT TO FIND ICE CREAM"

Finally Kevin asks where the nearest McDonald's is, he would just get ice cream there.  The likelihood of that was low but he was IN IT now.  As we were waiting at a stoplight, I'm trying to think of any alternative to fast food.  There was a grocery store next to us and I said we could go into there and buy ice cream.  "That is not the point. That is not the ice cream we're looking for." he says.

I said only in my head: "These are not the droids you are looking for" because while that's funny to me - a nerd - it would be lost on Kevin who has never watched Star Wars.

Years ago there used to be an A&W drive-in, like in the 1900's but it was completely closed now.  Looking right, I noticed we were next to a coffee stand. Because: of course, we're in the Pacific NW. I said "There's a coffee stand right there and they almost always have shakes..."  After a tiny muttering of wanting ICE CREAM, NOT SHAKES, he turned at the light.

We pulled into the driveway and of course there was a wait.  The person ahead of us only bought two drinks but it took forever.  This was not boding well for us. We persevered and finally it was our turn.  Kevin announces that he wanted ice cream but the ice cream shop was closed and does she have ice cream. All in one breath.  The barista laughed and was puzzled that the shop was closed. "It's a Saturday!  The Farmer's Market was this morning!"  "I KNOW RIGHT!?!?!" Kevin replied at medium-to-high volume with an accompanying throwing of hands.

Finally, Kevin gets a strawberry shake and I get a blended mocha.  A win for me and a half-hearted victory for Kevin.  We could have just gone home and stopped at our friend's coffee stand for this. And it wasn't until days later that I realized that we should have checked to see if the ice cream place was just temporarily closed.  Like they just ran to the store or whatever.  

But then we wouldn't have had an adventure and a break from reality.

Ice Cream Shop...closed
This was from a different trip...I was actually working on this day

        

Not Prepared - A Guide to the Not-Quite-The End of Raising Parents

Here is a little To-Do or What to Expect When You're Aging post for those of you who are interested.  

Summed up:  the Entering a Facility and Medicaid process is slow and excruciating. It is out of our control.  NONE OF THESE THINGS WE ENJOY NOR LOOK FORWARD TO.

In this situation, and all aging parents in skill nursing facilities (SNF), there are many moving parts:

Who is paying?  State? (Medicaid) Federal (Medicare) or Private Pay.  

 What are the Current Issues?  What landed them in a SNF

What are the Permanent Issues?  These are things that cannot or will not improve.

Has the baseline been met?  As in, has the patient gotten to the point of No Improvement?  Because sometimes a temporary stay is enough. However, start working on the Medicaid process even if they return home. Because at that point, it's only a matter of time.

Are there underlying issues?  Mental Health is also considered an underlying issue. These can waver between Current and Permanent.  AND there will be discoveries of issues you are not aware of.  I mention that to prevent others from being surprised.  I knew his medical stuff by heart and there were still things that were discovered.  

Also people have the tendency to Fake It Until They Make It.  Or Mask.  Once they are at the point of being in a hospital or SNF, they are no longer able to mask.  This was a surprise to us.  Expect what feels like a "sudden" decline.  While yes, there is obviously a negative change, what you are seeing is the person's inability to fake it any longer.  Examples: memory, speech or physical loss.

All the Housing/Care Options: 

• Home or Home with a Health Aide either part time or full time. This is almost always private pay and nearly no one can afford that kind of situation.  Medicaid will pay for it in situations.  Also, finding someone consistent is nearly impossible.
• Adult family care homes, basically a boarding home for the elderly that provides some care.
• Assisted Living - independent living but with nursing staff on site and other services.
• SNF - mostly known as nursing homes.  These also have levels of care: rehab, long-term, hospice.
• Memory Care Centers - these are SNF for people with active dementia.  Lock-down facilities and it is permanent.
• Finally, literally, is Hospice.  Hospice can be utilized in any of these situations.                               

This is where I say that commercials on television are so very misleading.  They make is seem like housing is readily available and affordable for everyone.  This is not the case.  We learned that most facilities will work with the family if they know that the Medicaid process is underway; however not ALL will.  AND most SNF's are hospital-like settings, not cozy apartments like they show on television.

This also has to be acknowledged: people who say "Oh, I would never put Mom in a home."  I won't be bold enough to say "Yes, you will" but I will say - gently - You don't know what you're saying.  Caring for an elderly loved one is exhausting and sometimes impossible.  As much as you don't like it, it is necessary to keep your loved one SAFE.  Most people cannot afford and/or have the needed training, equipment and fortitude to care for a person.

Medicaid:  To qualify for Medicaid, a person has to be destitute or nearly.  An option is to sign over any/all assets that will then be liquidated upon the person's passing.  It feels like not enough people know this. We did not know this  This can leave nothing/little to the estate; so if family members are banking on an inheritance,  this puts it at risk.

Timeline:  We are approaching 90-days wait for the Medicaid approval.  It's my understanding that this is considered a usual wait time.   The process is painfully slow and invasive. They ask for a ridiculous amount of information. Sing it with me: Please have Power of Attorney and access to financial and medical records.  What is disconcerting is the SNF staff are nonchalant about this process. It is their every day and they're not worried about it. They know eventually the Medicaid will be approved.  Because most likely it will, although it may take several attempts or delays.

The Patient:  The patient, unless legally deemed incapacitated, has final say.  If they are borderline, they can refuse to stay.  The SNF can try to convince them.  They can call EMS to try to convince them, if they try to leave the building unattended. The family can try to convince them.  But if in right mind, they can opt to leave.  Even with a Durable Power of Attorney, the patient has the final say.  To circumvent this situation is very simple: you have to lie.  You have to say it's "only until you get stronger" or "we'll work on that tomorrow" ad nauseum.

The facility encourages us to "join him in his reality" and passively agree when statements about going home are made.  They also said that there will come a time for the family to say "This is your home now" and to expect a sudden decline shortly thereafter.

The Five Stages of Grief is VERY MUCH at play at this point of the process; for the family as well.

Advocate:  Bottom line is you have to advocate.  Advocate for the Medicaid process, advocate for the loved one. Advocate for yourself.   During one financial review (I'm on 2 of 3 now) I had to tell them that this is Daunting, Stressful and placing an Undue Burden on me and the family.  I will say, for me, the tone changed once I said it.  I will whisper-shout to you  that "undue burden" can be a helpful buzzword. Do not allow caseworkers make you do their footwork. Call for an update. Call with Questions. Call to confirm receipt of requested documents.  Request a different caseworker if needed.

Ask the staff of the SNF for help, to answer questions, to provide any available accommodations or services. We have told them "We have never done this before and you have.  Please help guide us through."

This has taken a month to write and has been three different formats and varied topics therein.  I hope that this version is a helpful How To for something you're experiencing or planning for. We thought we were prepared and we were very much Not Prepared.

Whimsy

 You know a development that I've enjoyed now that I'm older?  WHIMSY

I credit the interwebs for this as we discover that it's National Dog Day or Daughter Day when we log into social media.  For all its awfulness, it has also created whimsy.

I like that in this current timeline there are such things as:

Fat Bear Week.  If you don't know about this, let me share:  Each year the Katmai National Park in Alaska has a contest to guess/vote for the fattest bear.  That's all.  Simple. Pure.  You vote online HERE  Then you can watch the progress narrow down like a March Madness bracket.

Pi Day (March 14th) or 

Star Wars Day (May 4th) or 

The day Marty and Doc visited in the future (October 21st) or 

Ferris Bueller took the day off. (June 5th)

The Best Day of the Year is April 25th

Yesterday was Mean Girls Day  and on Wednesdays, We Wear Pink.

Maybe it's because I'm a nerd that I know of these dates. I hope not.  

I hope that everyone takes a moment to have a piece of pie on March 14th or take the day off from responsibilities on June 5th

Every Day is International Dog Day