I've been quiet here for the last few weeks because life with Dad has lacked the isolated elements of drama that typically push me toward the keyboard. Instead, there's been the daily routine of an hour of gin (as in cards, not Bombay Sapphire) with him before lunch, and a check in with the nursing staff on any potential medical issues. On the surface, all seems stable and just a little boring, but nagging financial issues have been slowly burning under the surface, in the way forest fires can stay alive on underground roots before breaking ground in a tree-sized whoosh.
First, there's been the daily/week/monthly responsibility of managing Dad's finances as well as my own. "How big a deal can this be for a 90-year-old in a nursing home?" you might ask. I didn't think it would be an issue, myself, back in November, when I first started signing the monthly checks for his cell phone, credit card, Medicare Advantage plan and various doctor co-pays. (FYI - I've been a co-signer on all his accounts since he moved in with me.) Then all the niggling, confusing correspondence and phone calls began with these various companies. The billings for his hospitalizations and ambulance rides were especially annoying, because the bills might show up more than a month after-the-fact, with follow-up invoices maybe 2 weeks later. I soon learned to hold onto invoices after I paid them, to double-check whether those bills were duplicates or new notices. Then there were the two afternoons I spent on the phone with Sprint's "customer service" (full irony intended with these quotation marks) disputing the hot-chick text-message service charges on Dad's cellphone bill.
Then there's been the need to preside over the slow dismantling of Dad's assets to pay the monthly nursing home bill. Some of this I've been able to do under my own authority as a co-signer. But the most significant transactions have required Dad's own signature, since he's still capable of making these decisions on his own. For each of these signings, I've had to get the paperwork organized and bring the required forms in for his formal approval - generally with time spent re-explaining the reasons why an account has to be closed and estimating again for Dad how much of his minimal life savings still remains before the balances drop to near-zero. And, also, re-explaining why we can't just change the account to my name and pretend to the state that the assets don't exist anymore. Just thinking about those visits can make me wish to replace the card game with gin of the Bombay Sapphire variety.
And now I'm in the middle of preparing the application for MassHealth, the administrative arm of Medicaid in the Commonwealth of Massachusetts. We can't submit it until Dad's assets get below $2,000, but it needs to be ready for submission as soon as that date arrives, which is likely to be sometime next month. Then there will be a new series of regular accountings, I believe, to ensure all expenditures fit into allowed categories the state has established for its Medicaid beneficiaries.
Aside from the periodic required signatures, I keep these financial concerns below the surface when I step into Dad's room for the daily hands of gin. But worries over bills and deadlines and spend-down compliance have taken up small quarters in that corner of my brain reserved for anxiety, and they can flare up like one of those Western forest fires in the middle of the night, burning up any hope of returning to sleep. Of course, medical issues still can add fuel to these blazes - yesterday I learned the nurses had spotted a potentially cancerous growth in Dad's left ear that may need removal. Dad bleeds like a stuck pig with even a shaving cut, and is prone to wound infections, but this growth has gone from small scab to possible ear blockage in just a week, so doing nothing might not be an option.
To shift analogies from forest fires to baseball - It ain't over 'til it's over. It appears the fat lady wasn't singing a final aria when Dad settled into the nursing home, she was just serenading the fans during the seventh inning stretch.