Looking ahead

I've kept planning to provide an update once I've had a chance to talk with Dad, but after last week's flurry of phone activity, I hadn't been able to connect with him. I finally got through. It turns out the ringer had been silenced on his room phone.

It was not the most encouraging call. I'm hoping that he was just distracted by the TV news in the background, but he was very quiet, and what he did have to say was, in essence, "I want to leave," and, "Therapy isn't getting anywhere." Of course it's natural that he wants to leave and that he should have times when he is discouraged. Hopefully, though, this is just a down morning, not how he's been feeling for the last week.

But as far as leaving goes, that is scheduled for June 2. We are making the arrangements for him to move into a residential care home, a converted house with as many as seven other residents. Everybody has their own bedroom. There are two caregivers there during the day and one overnight. The food is all prepared there in the house, and all medical/therapy care is provided there. Speaking with Dad's therapists and case workers, as well as some friends with elderly parents, the clear consensus has been that a home, with a higher caregiver ratio, would be a better fit for him than a larger care facility. And I also think Dad will be more comfortable in a house. It won't be his house, but it is as close as we can get, at this point.

Pa Bell

Out of the blue, I got a call from Dad this morning, on the phone in his room. He's had a room phone in all of his facilities since the stroke, but this is the first time he's used one. We talked for 20-25 minutes. It was a slow conversation, but a long one, and notable that he did it on his own, without assistance.

I asked Dad about being able to answer the room phone; I think he said that he could, but I'm going to test that (and his cell phone), before announcing that he'd like to receive a lot of calls.

This morning a friend sent me some questions about Dad that you might also have. And as he might be calling you next, I thought I'd share some answers.

Q: How aware is your dad of what has happened; what his condition is?

A: Pretty aware. He certainly knows that he's had a stroke and how it's affected him. One disconnect is that he wants to "go home". If someone talks with him about specific tasks that he finds challenging (eg, getting around a room), he will acknowledge the challenges and that they would be obstacles to going home. But when they try to put it all together, he still wants to and thinks that he can go home. According to his last speech therapist, a reasoning breakdown like this is more likely to be a consequence of the damage to his right frontal lobe than inherent stubbornness. He also seems to forget that he is in Dallas. (Admittedly, there aren't a lot of visual cues - no life-sized JR Ewing cut-outs - inside his room.)

Q: How aware is he of the pandemic?
A: Not sure. I've mentioned it on the phone and in writing. I've not wanted to dwell on it, but a) I want him why no one has come to see him in almost two months, and b) it's kinda hard to talk about our lives without mentioning it. He has expressed no curiosity about it and has never brought it up on his own.

Q: Is he able to read/comprehend a lengthier note (a typed letter...and should it be in larger print if he is?)
A: Yes, he can understand longer letters. My notes to him have typically been 1 to 1-1/2 pages, and by all accounts he's read and understood them. Typed is probably better than hand-written, unless your handwriting is much better than mine. But I'm just using 12-point font, nothing wildly big. And way back in March, when he started reading The Hobbit, that was an old edition with little print, so I don't think the visual part of reading is a challenge.

Moving (again, and not for the last time)

Dad transferred today from skilled nursing to an in-patient rehab hospital. The plan of keeping him in skilled nursing until he started to "plateau" ended up lasting about a week. As the therapy team only meets weekly, that's about as short as it could have run. At in-patient therapy, as in Oklahoma, he'll receive physical, occupational, and speech therapy, at least an hour of each per day. I'm glad for him to continue to receive intensive therapy.

I've heard initial estimates of one to three weeks at this hospital, at which time he'll discharge to a long-term care facility or residential care home. This next move should be his last for quite some time. We're assembling a short list of candidates nearby and will do our best to get a sense of them by phone interview and video tour.

The plans they are a' changin'

Yesterday, Dad's therapy team decided, based on the progress he's been making in his current setting, to extend his stay until May 11 (one week). I was a little surprised by the extension, as they've been angling towards in-patient rehab starting May 4 for a couple of weeks now, but I'm comfortable with the decision. He does seem to have made noticeable progress in the last 7-10 days; extending in that environment makes sense to me. Apparently they'll take stock at their weekly meeting each Tuesday, and as long as he's still progressing, they'll probably keep extending.

Something sounds different

The title of this post is somewhat misleading. When I spoke with Dad this morning, he sounded different from what we've been hearing since the beginning of March, but much more like himself pre-stroke. His voice was less croaky, and he was able to get out a lot more words. He said that it was still hard work talking, but it seems like LS's suspicion (mentioned back on 7 April) was correct: his vocal cords were spasming shut. It's clearly taking some deliberate effort for Dad to relax the cords, as the croaky, halting speech went and came while we talked, and he allowed as he needed a break after 15 minutes, but still, it was a wonderful conversation. The whole family here got to hear a lot from him.