The “Suddenly” Part

Dearest Rachel –

There’s a line in one of Hemingway’s novels where a character is asked how it came to be that he went bankrupt. His response is an interesting one, but one that makes perfect sense upon reflection: “Gradually… and then suddenly.” I haven’t read the novel in question – I don’t even know which novel it is, for that matter – but I can easily imagine the concept; a slow, steady series of misfortunes and bad decisions that, taken individually, wouldn’t cause much in the way of harm, but once the final straw landed, everything collapsed, and hard.

Strangely enough, this apparently can work in a positive direction as well – at least, for a certain value of the term “positive.” Yesterday morning at the rehab center started out much as any ‘routine’ day since Dad’s been there could be (it’s still not quite been long enough to fall into a set schedule, especially after a weekend like this past one), but with a twist; we were expected to there early (like, ten o’clock or so) in order to meet with a representative from a palliative care organization, to determine what Dad’s next steps are to be.

You see, the whole point of his stay at the rehabilitation center is to get him fit enough for him to return back to the house, where he would prefer to spend his remaining days. And while he’s actually been able to do more, in terms of walking and sitting up in his wheelchair without getting tired, than he was able to when he first came here, it’s been a herculean effort, as far as he’s concerned. He’s having difficulty actually accomplishing the exercises, and the results are, from his perspective, minimal. Not to put too fine a point on it, but he’s losing the motivation to continue with the actual ‘rehabilitation’ that’s part of why he’s at this place. He just wants to go home (well, he really wants to go Home, but I still think he’s too connected here for that just yet. There are those that disagree with me, but we’ll get to that).

Anyway, the morning meeting turned out to be a bit chaotic in its own way. Originally scheduled for ten in the morning, I’d gotten a call from Mom Sunday evening, claiming she had been that the individual who was to be meeting with the three of us wouldn’t be able to do so until well after eleven, and so I shouldn’t rush over to the place first thing in the morning. However, she hadn’t heard from the individual herself, but rather a member of her staff, which rendered the claim somewhat suspect. In any event, I still prefer to get in a little work at the ‘office,’ so I made a point of getting there a little after nine. That way, no matter what the schedule was, I’d still have time to get stuff done before anything was confirmed.

As it happened, when I got there, she was getting in touch with the person, and sorting out the actual meeting time; eventually, the difference was split and ten-thirty was settled upon. A bit of a hassle to do, but nothing that put either of us out, especially not at this point, when we were ready for anything – or so we thought.

Dad was already up and in his chair when I got there, a little bit behind Mom. And we didn’t have to wait for long before Stephanie arrived from the care organization (I’m not sure that’s really what they call themselves, but the phrase makes sense for me) to discuss our options.

As I said, while Dad seems to have been recovering and gaining strength and endurance to accomplish certain tasks that he might need or want to do upon getting home, his progress has been… glacial, especially as far as he’s been concerned. It’s not so much that he’s getting impatient to go home (although I think he’s that, too), but that he doesn’t feel like he’s getting the benefit out of the effort he’s putting in. To borrow an expression I’ve been hearing a lot more these days than I ever used to, the juice doesn’t seem to be worth the squeeze. At the rate he’s going, he’s never going to be “fit” for discharge.

But here was the thing that Stephanie informed us; at his stage in life, going home isn’t necessarily a matter of being “fit” at all; quite the opposite. Her organization specializes in “comfort” care; whatever feels most comfortable for Dad, that’s where he needs to be, that’s what he needs to do (or not do, in terms of exercise and what not). If he would rather be at home, and not putting himself through what feels like pointless exercises – indeed, by deciding against the latter, the former becomes something of a necessity, since rehabilitation is something of the point of his current situation – that can be arranged.

But here was the shocking part of this discussion. Even though his decisions, and her organization’s action would have to be processed through Medicare, this could be accomplished in a matter of days. Normally, in my mind, anything that requires government approval in going to take weeks, months or years, but somehow, this apparently could be done in a matter of 24-48 hours. This is the “suddenly” part of Dad’s situation; he’s going to be home, complete with all the supplies that he currently has at the rehab center all provided for, by tomorrow afternoon.

Once we agreed to getting this process in motion, we stayed with him for the remainder of the day (as we’d normally have done, anyway) until a second representative of the organization came to go over things with us. There was some paperwork to sign, and further questions to be answered – although given the situation, none of us really had had time to actually come up with much in the way of questions as such. This second individual, Jennifer (yeah, that might cause some confusion), did what she could to address what concerns we might have had before we could come up with them.

For the moment, what needed to be done was to clear space in the room in the house where Dad would be moved to, as he would be having his hospital bed brought in there. That will be arriving tomorrow, and, rather than going to the facility to be there with him, I’ve been assigned to be at the house then; first, to receive the bed, and then, to receive him. Essentially, I’m to be the welcoming committee for his return home.

There’s more to this story than all this – more even to the rest of the day, in fact – but I’ve written enough for the moment, and I’m not sure I’ve time to tell you the rest just yet. So I’m going to sign off for now, honey, and ask you to keep an eye on all of us, and wish us well. We’re going to need it.