About 18 months ago my father died. I'm glad his last few days went quickly. My observation of his demise has opened conversations with my own kids. "Please, if I ever get so I need this kind of treatment, smother me with the pillow, or buy some kick ass heroin and let me OD. " I'd hate that my kids might have to take a rap for that but as a person in recovery I can live with people assuming it was a relapse.
So why rework an old post I wrote at that time?
You can blame Facebook Memories. Two years ago, on this day, I visited and took the last picture of him. Today on Facebook Memories it appeared and caused my mind to spiral a little.
He looked like this:
Let me introduce you briefly to Charley Gager
That's my dad.
My dad had a dry sense of humor, not with the best delivery, but the jokes and puns were delivered in a humorous way. He was an engineering egg-head, who worked on the Star Wars Defense system. He counted cards to win Hearts, Rummy, Bridge...had a high winning percentage at Scrabble and a high IQ. He was 15 when he started college.
He looked like this:
My dad moved from his home in Massachusetts, to an Assisted Living in Maryland, near my brother, then to a Memory Care Facility. In March 2022 when he broke his hip, his body and mental status became even worse, he was moved to a Rehabilitation Nursing Home. He could no longer feed himself or get out of bed. He needs help to be adjusted in the bed or in a chair where they move him to. He is in pain. He yells out when being touched, and does not know who, what, where, or why any of that is being done. He is only able to be fed pureed food, which in that form, I was unable to identify by color or smell, or anything, what was being served.
We systematically don't care about our elderly. The people who work as caretakers make minimum wage as the facility takes in the rest. Under paying makes staff people not want to stick around. On the weekend at the Rehab/Nursing Home there were thirty or so infirmed people needed care in phases of indignity and there was one nurse, and one aide. Minimal care which included feeding, which my father needs right now are not possible. So after the Nursing Home Care is paid for, for which you receive people hardly checking in you.
So, Pay More
Our family is spread out across the country, so it is best to pay an additional agency to make sure he gets nourishment. Care.com was looked at, but we had to vet the people ourselves. One, we liked, came back with an outstanding warrant, which was much less than outstanding. Next, up was an agency we used when my father was at Assisted Living. They still had him in their files but it was a different county. The contact was going to refer us to the part of the agency which covers that county, and we were told, if they can't do it, the further county would cover this. Then, days went by. Then more days went by. Then the in-county person ghosted us. Then the original contact person apologized and said they couldn't do it.
Total: 5 days, no care.
Another agency got involved and from intake to starting with an aide, it took 6 days (Total: 11 days, no care), which is pretty good. We needed 40 hours, and the hourly rate is $32.60. The aide probably makes minimum wage again, and even with 40 hours of staff, there's going to be turnover. Also, we don't know if they are going to do what we expect, like show up first, and feed him---and get help when needed. We wanted shift notes to be kept in the room so family/staff could read what happened. The extra agency of service said this wasn't possible because of HIPPA and possibly stepping on the toes of the Rehab Hospital or Nursing Home. All we, the family wanted was the ability to see if my father ate, or drank...how much and what. Again, they said giving us this information wasn't possible.
Insurance--yeah, good luck?
Medicare doesn't kick in to pay for Hospital Level Care until unprotected money is drained at the rate of $4,000 (low end) to $20,000 a month. My father had bought additional Long-Term Care Insurance which kicked in at 90 days at the Memory Care Facility. Well since he is no longer there, it is now uncovered, and to save that placement, we pay out of pocket starting immediately. Since the Rehab has not served him for 90 days, the policy doesn't kick in there either.
No One Wants to Go Out This Way
My father didn't want to leave this world in this state. He completed a DNR, and did the Five Wishes. His diagnosis is currently not terminal but, based on the care he is receiving, I don't think he'll live another two months. No one I've ever spoken to would like to end their lives in this manner. I've been very vocal about wanting loved ones to snuff me out by suffocating me via a pillow if I ever get to be in that state. My intelligent, humorous and kind father I knew has lost nearly all of his dignity. He never wanted this---being treated as a number, an unknown, a human widget in the quandary of the elderly care system. Even preparing for the end, could not prevent this. The system is broken, and so is my father's quality of life. It's angering, heart-breaking, and devastatingly sad.
You hear it all the time
"It sucks getting old," is a phrase you also hear all the time, often after someone pulls out
their back reaching for the bowl of potato chips or something. It's something we make about "us." There is something which happens as well and it's about loved ones, and us taking care of aging parents or family members---where it is observed just how much the care sucks. The pain of navigating through the system where it is take it or leave it---.people living their whole life to suffer in the end, and there is nothing you can do about it.
TIMOTHY GAGER has published 18 books of fiction and poetry, which includes his latest novel, Joe the Salamander. He hosted the successful Dire Literary Series in Cambridge, MA from 2001 to 2018, and started a weekly virtual series in 2020. He has had over 1000 works of fiction and poetry published, 17 nominated for the Pushcart Prize. His work also has been nominated for a Massachusetts Book Award, The Best of the Web, The Best Small Fictions Anthology and has been read on National Public Radio. In 2023, Big Table Publishing published an anthology of twenty years of his selected work, with 150 pages of new material: The Best of Timothy Gager. He was the Fiction Editor of The Wilderness House Literary Review, and the founding co-editor of The Heat City Literary Review. A graduate of the University of Delaware, Timothy lives in Dedham, Massachusetts.