I’m in Indiana this week for my second stint at tending to my 92 year old father in law. In late August, I flew here on an urgent basis because he had been admitted to the hospital in heart failure and was not doing well either mentally or physically. He went downhill in the hospital. Imagine four nurses and an orderly trying to restrain a 92 year old man who thinks he’s being kidnapped, and you’ve got the picture. When things calmed down, he was transferred to a specialty heart center in Indianapolis and had a remarkable non-invasive and HIGH TECH procedure called a TAVR (transcatheter aortic valve replacement – watch the amazing video). Since then he has made a good physical recovery but continues to have some heart failure as well as confusion and forgetfulness, and we are unsure how much of this cognitive problem is new vs. pre-existing, and whether it might be temporary (due to lingering effects of anesthesia).
After that first week, my husband flew out to relieve me and I flew home. He presided over Dad’s discharge to a rehab facility, and helped Dad get used to that new environment. After a few days, we traded places again because David has some work that MUST be done at home, and I can take my work just about anywhere. (We arranged our flights so we could have a 2 hour “date” at the airport.) So here I am back in Indiana. The issue on the table now is: can this 92 year old guy continue to live alone, cook and clean for himself, and drive himself 20 minutes each way to the doctor’s office and the grocery store in his car? My father in law insists the answer is yes. We (his two sons and their wives – a physician and a nurse) are trying to figure out how to make it work. What is the RIGHT level of supportive services and is there a way to provide them in his teeny tiny hamlet community – so small there is not a single store of any kind.
Reality has intruded: I’ve gotten almost no work done this week, nor the week when he was in the hospital. Dealing with his medically-, administratively-, and emotionally-complex situation is VERY time-consuming and energy draining. I am keeping him company, reassuring him, entertaining him, making him comfortable, and ensuring that services are delivered when needed. Then in hallways with the doctors and nurses, and in off hours with the family, I am acting as his medical advocate while anticipating and planning for the future. For example, I have so far spent about 5 hours figuring out whether we can get him a cell phone that will work better with his hearing aids and his severe hand tremors, and then arranging for it – so he can more reliably RECEIVE and MAKE calls with his “support network” when he’s back at home.
In the meanwhile, it has become obvious that I am simply incapable of radically switching gears and lives in the same day. I have to FORCE myself to slow down and get into the glacial rhythm of life in a nursing home with a tremulous deaf 92 year old and his compatriots who deserve respect and compassion. I am not mentally / emotionally flexible enough to INSTANTLY reconstitute myself as an impatient, driven professional and resume my usual pressured work pace in the few hours I have in between events. (This predicament feels familiar – a reminder why my masters’ thesis remained incomplete for such a long time while my kids were little and underfoot. I just COULDN’T snap into and back forth between the “way of being” for Attentive-Mommy-Household-Manager vs. Graduate-Student-Writer during nap times. My hat is off to those who can!)
This experience is also a reminder of how important the Family Medical Leave Act (FMLA) is. It protects the jobs of working people while allowing them to take leave to care for illness in close family members. However, this experience is also a reminder that FMLA is not the WHOLE answer. For example, it doesn’t protect ME in this situation. First, I am the daughter-in-law, not the daughter – and the FMLA explicitly excludes in-laws. Also, I work for myself so I can’t be fired. But I can lose my livelihood by not being able to do my work – since as a consultant I generally get paid by the hour or by the deliverable, assuming it is produced on time! No work, no pay. Luckily, my financial situation is such that I CAN forego the income for now so I CAN be here and support him in an hour of need. If forced to choose, I will put my time and expertise to use in helping my husband fulfill his duty to this vulnerable and incredibly kind old man who deserves to be treated kindly after a lifetime spent in humble service to his family, friends, neighbors, and parishioners as a Methodist pastor. There are limits, of course, and I know I can’t sustain this pace forever.
The limits of the FMLA also became apparent last week when I talked to Kristina Phillips, a young woman in New York City whose life was turned upside down by a work-related injury about 18 months ago. Kristina had recently moved to the city. She’s a sales person and was assaulted on a subway while riding between accounts. Her longest-lasting injuries were to her neck and shoulder, and still interfere with her ability to lift and carry. The treatments the doctor recommended for the first 6 months were inadequate, did not reveal the correct diagnoses, and did not get her better. The insurance company initially denied more extensive care. She sought help from a lawyer who wanted to expand her claim and have her see more doctors to talk about her PTSD – but what Kristina wanted was to focus on the future, get the right treatment, and get well. All the state ombudsman did when she called to ask for assistance was tell her to request a hearing. Hearings take MONTHS.
Her employer was very solicitous and helpful, but after Kristina couldn’t perform the essential duties of her job for more than 6 months, she did lose her job. (FMLA only protects jobs for 12 weeks.) Kristina couldn’t afford COBRA payments on her workers’ comp checks, so she lost her health insurance, too. Her family couldn’t come to her aid. She is an only child of parents with very constrained financial circumstances living in a very remote area of the Pacific Northwest. Kristina started worrying about becoming homeless. A new friend saw her distress and brought her some food. He had taken Landmark Education courses and made it possible for Kristina to take the 3 day Landmark Forum workshop in which she realized she had to figure out how to get better and back to work by herself, while she continues in therapy. She applied for and got some jobs that turned out to be beyond her capabilities. Kristina has now invented a new consulting business for herself which is starting to take off.
And in her spare time, she wants to DO SOMETHING so that others will not have to struggle the way she did. Kristina wants to create resources to guide people who have been injured on how to get back on their feet – because “the system” doesn’t do that. Needless to say, we are now talking about how I can support her in that endeavor!