April25_2016

Hi all, this is the one I thought I sent on Tuesday night  from Martinellis, obviously did not get published, so that just tracks the first two days. 

It has been full on and this is the first time I have been in a wifi zone, so here goes. I have no time to edit so sending as is.

I arrived in San Francisco right on time at 9.30. NOni and Linda came to pick me up and it was straight up to the hospital where spent the rest of the day till around 4. Krista was there for a while too. 

Across the afternoon we met a range of people across doctors, nurses and Social service people. Everyone is very nice to Gramps and Noni especially Dads young Phillipino Nurse, David, who is just wonderful with Gramps. 

Gramps is pretty down, knows he is not going to ever get back to any decent level of health and just kept saying things like "what is going to happen now, how will it all work?" 

They have definitely decided that he is too unwell to do the assisted living option, I guess because of the extra care he would need it would start to get too expensive and Mom does not need that level of care.  so it is about find a stay-at-home option and the Veterans Hospital has a range of options depending on "what your goal" is. They keep asking Dad what is his goal,  They have asked him this a few times, Gramps has not handled the question too well, so we have had to have lots of follow up conversations once various hospital were gone. 

They asked him in a few different ways does he want to to get better and build up his strength to get back to some level of independence or just to go home and "be as comfortable as they can make him". In real terms this means go home and be comfortable for as many days weeks months as you have left, but no one is saying the word dying. So it is all a bit awkward and a lot of the conversations just kind of skirt around the real question, is this the beginning of the end. 

Noni definitely thinks it is has said a few times " I did not think he would go like this, I thought he would just have a heart attack." Other things she is saying just in passing, it is clear that she thinks he is going but of course who can say if it will be fast or slow. She just hopes he does not stay like this too long, either gets stronger or goes fast.

Yesterday I just kind of listened to everyone and said a few things but just did not want to dive in too soon and say too much and certainly not want to look like I was dropping in and taking over. But by this morning I had had some conversations with Noni and separate conversations with Linda and said up front that I thought that the best thing to do was to try something new. And if the VA was offering a range of services we should go for the most comprehensive thing they had to offer, which is the Hospice Palliative care option. fOr Gramps every time they mentioned Hospice he had pulled because in their experience once someone goes into hospice the next thing was the funeral.  But they talk about it as a stay at home option for someone who is failing, using a non hospital approach, a health professional approach rather than just doctors who are trying to solve a problem, a different approach to medication, different response to crisis situations and a whole stack of education to support self management. So a whole new ball game. in general they are all exhausted from the merry go round of incidents and hospital stays, coming home and then finding themselves back in the same spot a few weeks later.  

we had an apt at 11 in Dads room with all of the doctors and social services people who have been looking after him, about 6 people. It just happened that I found myself in the room with just gramps about 5 minutes before everyone came in. Linda was parking the car, Non took foo to the toilets, so I took the opportunity to talk to Dad and see how what he was thinking. Of course he asked me first what "What is the decision, what is going to happen?" So I dived in and said I thought he should just focus on getting home with as much support as was on offer to make being home possible and get off the hospital merry go round. since the Hospice palliative care offered the most in house support, that was the way to go. It would represent trying something that was totally different and the fact that the services are available AT NO COST for veterans makes it a no brainer. 

sO by the time all of the specialists were in the room and Aunty Lindy and Noni were there and they asked gramps and the rest of us to talk to them about understanding of the options for what to do next, everyone looked at me and just sat there. Dad says, my daughter knows what I want and she will explain it.  So took a deep breath and talked it through and making it clear Dad was happy to go with the Hispice program.  It was clear to all of us that this is the option the doctors would have recommended themselves. Part way through we could all see that Dad was having a little snooze, which continued until everyone had left at which point he opened his eyes and looked at us and said Is it all organised?

Honestly it is like a weight has been lifted because a decision has been made and they're as a set of things to do now. once we have made that choice it is all systems go. Tomorrow morning a hospital bed will be delivered along with a range of other items Mike Linda and I took gramps bed down this afternoon. Once he is home someone from the palliative care people will arrive and walk us through the new world order. Will try to write another post tonight in prep for sending tomorrow.  

Personally I think getting him home will have a positive impact straight away. That's all for now, we are at Martinellis and the Chinese food has just arrived along with Santino and Krista.