Stay Away or Be Betrayed By A-As-In-Hole Insurance Company

When my mother had her April Fool's Day stroke her left side was affected. Her left leg and left arm would not work and she could not swallow food. On the twelfth day of April This City Hospital inserted a plug tube in through the stomach wall to allow feeding via of a nutritious if ugly brown liquid from a bottle.

On the thirteenth day of April the Hospital shipped her off to Sunset City supposedly for rehabilitation.

And rub-a-dub-dub she did get rehabilitation from three therapists at this hub, The Physical, The Occupational and the Speech.  Speech is a bit of a misnomer for my mother's talking wasn't at all affected by her stroke. She could speak as well as ever. But Speech Therapy apparently covers all things mouth and throat and this therapist was there to help her regain the ability to eat real food again.

These therapies were doing some good. My mother was regaining movement in her left leg, to the extent at least that she could move it back and forth and reposition it in bed. The left hand was the stubborn part. From the beginning she could raise that arm, but her hand stayed immovable with the fingers squished together. The best that had happened after 39 days of therapy was a slight wiggling of her fingertips.

However, her swallowing was quite another story and in some way the swallowing was the most important of the therapies. If my mother could regain her ability to eat real food it would increase her quality of life immensely even if she did remain handicapped in her extremities. If she could not walk again she would at best be able to enjoy the taste of her favorite foods. This would also allow her to be more mobile, albeit with the use of a wheelchair. It was difficult for her to be moved with the feeding tube. Without it she could be taken to have meals in the cafeteria with other residents, enjoy a meal and perhaps some conversation.

By the 39th day she was eating selected foods such as yogurt and pudding. However, on the 39th day there was a great leap forward. On that day Sunset City took her to a Distant Hospital for a video digital scan of her mouth and throat. Distant Hospital had a far greater reputation in this field than This City Hospital, although my mother complained about them taking her so far rather than across the street.

The next morning I had an email from one of her friends that they had visited that night and she was eating a peanut butter and jelly sandwich. Whoa, I thought. If she can swallow a PB&J then can't she swallow everything? I have difficulty sometimes swallowing peanut butter.

When I visited the next day it was lunch time and mom was sitting up in bed being fed normal food, the menu item of the day for the noon meal, macaroni & cheese and a fruit salad. (She said she passed on the chicken as it was a bit chewy.)  She was also eating this straight up, just as you and I would eat. Prior to this to sup on a cup of yogurt she had been forced to turn her head to the left and down with her chin practically on her shoulder. This was to help force the left muscles of the esophagus to push the food along.

What they saw on that video scan changed things. My mother has a pouch in her throat. It is a pre-existing condition. Her personal doctor has recommended surgery a couple years or so back, but she refused because she didn't want to leave dad home alone while she was in hospital. Somewhat ironic as things turned out.

It is my opinion this pouch was more the culprit with her swallowing situation than her stroke. Nonetheless, on the 40th day of her rehabilitation she had made great progress within the last 10 days. Her left leg had become mobile again. She still couldn't "stand and pivot," meaning she couldn't walk, but the Occupational Therapist told me the problem was her right leg was too week to support the left. It was certainly possible with continuing therapy this might be strengthen enough to allow her to stand. If it couldn't she would be limited to a wheelchair, but people can propel a wheel chair with their feet and at this point that seemed a possibility. And she was now able to eat normal meals portending a time when she might actually be rid of the feeding tube.

Everything was looking good.

Then on the 42nd day A-As-In-Hole Insurance Company cut the strings.

On the Friday afternoon of Memorial Day Weekend they sent notice that they would no longer provide coverage for her therapy because she had plateaued, as they called it, and no progress was being made.

The insurance coverage ended on May 28 and so did her therapy and so did her eating of any real food.

TO BE CONTINUED

Part Four: Follow the Golden Years Road of the Last

                       

nce upon a time, a not so young man was swept away by the sudden swirl of events into the Land of the Last.

There he was sent on a quest to find the Magical Nursing Home that would rescue his mother from the evil witches of Sunset City. It was to seem a daunting task, but he had a plan for following the Golden Years Road, although after a while it seemed more a maze of dead ends.

There were in this particular county 24 such places sometimes called Skilled Nursing Centers and sometimes called Long Term Residences. It would seem a lot of choices, but not so much for a poor boy.

Although it was not strictly a matter of cost, that certainly played some minor part. Throwing aside the Veteran's Administration Facilities, of which there were two, neither ranking well on the Medicare 5-Star Ranking System (1 Star for each or much below average), the average yearly cost for a home was $8,219 a month for a semi-private room (slightly more for a private room at $9,223 a month). These ranged from a high of $14,752 a month (a place that rated 4-Stars or Above Average) to a low of $5,627 a month (and a rating of 1-Star or Much below Average).  Cost did not always correlate with the ranking. A home that charged $9,794 a month, the sixth highest, only received 2-Stars or Below Average, while the second cheapest (not counting the VA Homes) at $7,300 a month got 4-Stars or Above Average.

The place where the not-so-young man's mother was imprisoned ranked eleventh in cost, about the middle of the pack, at $9,277 a month, but was one of only two in the county to receive but 1-Star, or Much below Average.

Do you see why he needed to rescue her?

If cost was not a real criteria, the fact his parents had no real resources was. They would have to go into a home under Medical Assistance or not at all, and not every home accepted Medicaid. He could eliminate eight immediately for this reason.

Of course, Sunset City was where his mother lay, so it was subtracted from the mix. So could one home because his mother had insisted from the beginning he must stay away from there, although he never understood why since several people recommended it and the home had a 4-Star rating. Also eliminated was one of the two VA facilities, because his dad said he never wanted to go there.

That left 14 facilities that would accept Medicaid.

The Not-so-young Man eliminated three as being tucked away in a bewitched far corner of the county. They would be places of last resort.

He then contacted the remaining 11 Skilled Nursing Facilities and it began to seem to no avail. He toured four and was placed on the waiting list at three (these included Mushmouth Manor). He did not apply at the fourth because it was the only one in the county to require an application fee. The fee was $250 and since he was now applying for both parents (explanation will be in following posts) that would have cost $500 just to risk being rejected, another last resort home.

He learned from another source that his parents would never get accepted by Mushmouth Manor with their lack of money, confirming his earlier impression of the place.

He was advised at the first home he contacted that he should put them on at least four waiting lists and if one offered a bed to snatch it up. "Demand is high," the lady said, "and everyone has long waiting lists." This was proving true as he searched on.

Two quickly let him know they would not take his parents, one or the other, and the remaining five were not returning his calls (including the one VA facility he had contacted) and as time passed it seemed they never would.

He had reached out even beyond that county, but it was going the same elsewhere. He even went back to PassingGo Home, begging them to reconsider since they did accept Medicaid and that was now what his folks were applying under.

And just when it seemed his plight could not get more desperate, it did. His mother's insurance company dropped her coverage.

Indeed, he wasn't in Kansas anymore.



(Photo on left is from the 1925 silent version of The Wizard of Oz, co-wrote and directed by Larry Semon, who also stared as the Scarecrow [he is on the left]. The Tin Man in the middle is Oliver Hardy, who gained much greater fame later when partnered with Stan Laurel. The actor on the right is O. Howe Black [you read it right], who not too surprisingly was cast as the Cowardly Lion.)

Part Three: Lost in the Land of the Last

I had exhausted the lineup of homes my mother and her friends had suggested. It was time to step away from the few to the many. But how?

I began by that new old fallback, Google. I thus stumbled upon a website that listed every Nursing Home known to man and then some. It gave general information, such as name and address and phone number, a few tidbits such as number of beds and affiliation and lastly the Medicare Rating.

Medicare has a Five Star Rating System for all Nursing Homes that accept Medicare. 5-Stars are the most a home can receive and I am told by professionals in the Medical Field this is very difficult to get. The lowest is 1-Star. There is no such animal as a Zero-Star nursing home. Everybody gets something, even if only a Certificate of Participation.

For Instance, Sunset City only had 1-Star; translation -- Well Below Average, while my mom's vaunted Mushmouth Manor managed 2-Stars, or below Average. Her latest ideal of PassingGo Home wasn't bad at all with an above average rating of 4-Stars.

But these were out of the running for a permanent solution at this point. I needed fresh storage space in the warehouse district of the elderly.

Since Medicare ranked every Nursing Home they came in cahoots with I had some pruning to do. The list did allow you to select by state, so I started with that, but it didn't go so far as allowing the selection of  county. (Later, after more hard-knock education in this field I did find the actual Medicare ranking site and it did allow selection by county, even by individual home. Here is the website to save you the trouble of Google fishing for it if you are ever interested or need it:)

http://www.medicare.gov/nhcompare/include/datasection/questions/proximitysearch.asp?bhcp=1

I then spent an eye-glazing, mind-numbing time scrolling through all the Pennsylvania Nursing Homes and copying all located in my parents' general area to an Excel worksheet. From that list, which in itself was fairly long, I selected those homes rated above average. There were very few near my parents stomping grounds. I then contacted around six homes by email or phone.

Email seemed the better way I found. You could say more and might get a quicker response back. Telephoning connected you to an automated voice allowing you to choose from a menu of buttons just to get to someone's voice mail where you could leave a message, which may or may not ever result in a return call.

From those I emailed, I received an email response, mostly acknowledging they had my email and would contact me in the near future. These places obviously calculate the near future in a different galaxy than mine for I still await that follow-up contact from them.

From the phone calls I received brochures from one, a "Don't call us, we'll call you if we ever decide to care," and a polite but firm turndown from another.

One home did call and invite me to take the tour. My wife and I went on the appointed day and promptly got lost. Once again a road with a hidden part, much like Mushmouth Manor. When we did arrive it was to the wrong building. We finally got to where we were supposed to be and the Admissions Director was very kind and gracious, although we quickly learned there was no hope of placing my parents there. They not only didn't accept her particular form of medical insurance, but they did not accept Medicaid.

Despite this she was extremely helpful and still gave us the tour. This was another lesson learned. Medicaid was not universal in the Land of the Last. I needed more than Medicare ratings, I needed to know who accepted what.

I received about this time a packet from the Department of Aging. Within was a list of the county homes and most importantly whether they accepted Medicaid as well as Medicare. I now changed my approach from less shotgun to more rifle.

TO BE CONTINUED

Part Two: In the Land of PassingGo

Ever since the subject of a Nursing Home reared its ugly roof, I was hearing Mushmouth Manor. It was becoming pretty apparent that wasn't going to happen.

But somehow around this time a new mantra appeared, PassingGo Home. I can't remember who said it first, I just remember I got asked about it and told it was nice. Mom's Speech Therapist also spoke about it to her.

Why an employee of one Nursing Home would bring up another I don't know for sure. My guess is it was an indirect comment and came about from some casual conversation. My mother one time years ago worked for the Valley Maid Potato Chip Company. They really made the best chips around, but eventually they were acquired by Bachman and after that the chips were so-so. One of mom's fellow workers who she had befriended was now a resident in PassingGo Home. Apparently, the Speech Therapist had some business at that Home and when mother mentioned this lady's name told her the woman was in PassingGo.

Now my mother was fixated on that place.

I decided to visit PassingGo next time I went to visit mom. I skipped dad that day and went early, going what I considered a more direct route. It was at least one that took you to PassingGo -- eventually. It twisted and turned about the fields above This City, where my mom was, and I was almost certain I was lost when it popped into vision ahead. A tall building with a curvaceous parking lot and long path up to the front doors.

I went to the receptionist and told her I wanted to get some information about the place.

"Do you have an appointment?" she asked.

"No."

"You should have called and made an appointment," she snapped.

She picked up the phone and called someone. She hung up and pointed me down a hallway.

"Go to the third door on the left and see Maude."

I did as I was told. I came to the third door, which was half open and I saw a couple women inside. One was a somewhat stocky lady with a stern face. Turned out this was Maude, the Admissions Director.

I began to tell my tale of woe when she abruptly stopped me. She took me to meet Madeline Mild, her assistant. Madeline was very sweet. An older lady with a gentle voice. She gave me the ten-dollar tour and then we sat while she showed me the admittance form to be filled out and returned. As we parted she asked me to send her a copy of my mother's insurance cards so they could see if it was acceptable. I said I would.

I then went back to This City and visited mother. At least I could tell her I was at PassingGo.

From that moment on I was to hear PassingGo every visit and then within emails from her friends. I had to get her into PassingGo. When would we hear from PassingGo? How much longer until she went to PassingGo?

But as usual these things took time. I emailed a copy of her insurance card to Madeline Mild the very night of my visit. I waited a week and heard nothing. I called her on the phone. It was her day off, she wasn't there. I called the next day. No, she never got the email. She had been out, she said, and perhaps someone else got it and didn't know what it was. Could I send it again?

I sent it again and then called her again. She was not there; she had left for the day. It was very difficult to establish when this lady actually worked. Finally I got ahold of her and yes she had received the email. She had forwarded the copy of the Insurance Card to the business office. We would have to wait until the business office found out if they accepted that insurance.

I waited a week and called Madeline Mild again.  Gloryoski, she was in, but she didn't have the answer. This time the Business Manager had been gone, all week on vacation. She had just returned and Madeline Mild didn't want to bother her until she got caught up. So I waited some more.

After another week I finally got my answer. Sorry, but PassingGo Home would not accept that insurance. Do not pass GO; do not collect your mother and try to bring her here. Go directly to jail in Sunset City.

I now began a search in earnest. I looked first at the sheet the This City Hospital Social Worker had originally given me and saw I could have saved myself a lot of time and trouble. PassingGo Home was one of those crossed out because it didn't take my mom's insurance.

But even so, my mom and her friends kept up the chants for PassingGo Home as if constantly repeating its name would overcome reality.

As it were, I wasn't quite completely done with the place, but the rest of that story will come later. I had a lot of other stops in-between this end and that end.

TO BE CONTINUED

In the Land of the Last Stand, Part One

My mother's directive: "Larry, get me out of here," sent me on a quest for an open door somewhere. A month and a half later I felt I had gone about things backward. I should have dug deeper into my mother's purse and discovered it full of moths and looked to the financial future first, but I've had professionals tell me I did things right.

Anyway, I began by looking for a better "Home".

I began with the obvious, another visit to Mushmouth Manor, the place my mother pined for, though only she and God know why.

This time I called and made a set appointment. I also now knew exactly how to get there, thus I arrived at its doorstep over a half-hour early. I almost hate showing up early as much as showing up late, and I really hate showing up late. Showing up late is rude and inconsiderate. It inconveniences other people and it says to them, "My time is more important than your time." When I worked in the corporate world there were managers who came late to every meeting for that very reason, just to show they were somehow the more important person.

So I went a bit out of the way, stopped at a drugstore and bought a soda. I then went on to Mushmouth Manor where I parked in the back lot and drank the drink. Around five until the hour I ambled in and presented myself at the reception desk. The receptionist told me Ms Fingerrub would be right with me and please have a seat.

Mushmouth Manor had a large lobby, like a medium hotel, unlike Sunset City's modest entry with a table and one sofa. Mushmouth Manor had many sofas and chairs and tables and vases of flowers.

In the back, where the people were stored, it was not distinguishable from Sunset City at all. Long hallways lined with ancient citizens in wheelchairs or shuffling along with the aid of walkers. Every home was equipped with poor souls sitting still along some wall, hands folded in lap, back bent like a question mark and head down. It was as if you could order these people off Amazon.com for the singular purpose of decorating your nursing home hall.

I had downloaded two copies of Mushmouth's application and filled one out for each of my parents. After the tour I presented these, and was told there was a waiting list. My father might get in quicker than mom, but there was a wee bitty problem. Because of my mom's current condition she would qualify for Medicaid, but my father would not. He would have to come in as Private Pay (which would run around $9,000 a month), unless he might be eligible for veteran's benefits.

She gave me a business card. "This is our Veteran's expert. Call him and he will help you with your dad's benefits."

We bid good day (which was in reality goodbye) and I left with the same feeling I had the first time, Mushmouth Manor primary interest was dough-re-me. Some weeks later, an Elder Lawyer told me my parent's would not get into Mushmouth Manor with their bank account, confirming my initial gut reaction.

Many weeks and much aggravation later I was told a tale by a close friend of my parents, one of the coterie that had been looking after dad since mom was struck down. One whose husband was one of the most vocal about the indiscretions of Sunset City.

"I went through this with my father," she began. "He fell and broke his him and went into to Mushmouth Manor. Oh, what a terrible place. I came to visit and it was meal time. I don't know what was on his plate. It was a mess, pardon me, but it looked like dog dirt. I said, 'He can't eat that,' and the person told me, 'He can have a hot dog instead if he doesn't want that'.

"And while we were there I heard his roommate say something from the bathroom. He had been in the bathroom when we arrived. I asked, 'Do you need help?'

"'Yes, he said. I've been waiting in here for over an hour for someone to help me, but no one's come.'

"So, I got the man back to his bed and I went out to the nurse's station and told them, 'Have my dad packed and prepared to leave at 1:00 tomorrow. We're taking him out of here.'

"They said he needed a Doctor's permission and this and that. 'No,' I said, 'we're taking him out of here tomorrow.' I came the next day at 1:00 and he was prepared to go and we left."

I thought, why didn't you tell that story to my mother. Maybe she would have stopped yammering at me about the Great and Wonderful Mushmouth Manor. By the lady told me this story it didn't matter anymore.

In the time between my second visit to Mushmouth Manor and this lady's tale of woe, my mother had picked up a new mantra, PassingGo Homes.

It was mainly my own fault.

TO BE CONTINUED

What Grandmother Said

My grandmother (pictured to the left in 1967 with my dog Cynthia) always use to say, "This family can't do anything once if they can do it twice." What she meant was nothing ever worked the first time and we always had to do it over again.

When I left This City Hospital to go visit Mushmouth Manor they were wheeling my mom out to have a feeding tube implanted in her belly.

When I called my dad Thursday morning to ask how the operation went, he said, "They didn't put the tube in."

"What?" I actually though he was confused about the days. "When I left her yesterday they were wheeling her to the operating room."

"She didn't get the tube," was all he could tell me.

"I'll be up tomorrow," I told him and left it at that.

Not long after I got a call from the Admissions Director of Garden Green at Deep Pond. Ms Bubbly must have contacted them about taking my mother. She was calling to explain why they couldn't. They were a small facility, she said. They only had 20-some beds and she didn't have the staffing to deal with my mother's needs.

Okay, so Garden Green at Deep Pond was out and I had never even got to see the place.

I went up that Friday afternoon, having had to tend to some other business that morning, and took my dad to the hospital. When we ambled into room 261 my mom was hooked up to more tubes. (We didn't actually amble in, of course. Dad rolled in upon a wheelchair and I plodded behind pushing it.) There was a new addition to the IVs and monitors, the feeding bottle.

She did indeed now have a feeding tube, but it hadn't been easy. My grandmother had been close to right. We didn't do it once. We didn't do it twice either, but three times. It didn't get done on Wednesday after all. They had some difficulty doing it. They rolled her down again on Thursday and again failed to complete the mission. Finally, on the third try they got the tube inserted.

Now she was getting nourishment equivalent to eating regular meals every day, just without the pleasure of chewing and swallowing and tasting and enjoying. Her meals came in a rectangle bottle hanging above her head on the IV stand. It was a brown unappetizing liquid.

We were no sooner in the room when a young woman came in and informed us they were going to get my mother ready to be moved to Sunset City. Whoa, Nelly, they plugged that tube in and were wasting no time getting rid of her.

I looked around. Where was Ms Bubbly? Didn't she say she'd be right by my side the whole way? Where were the hugs today?

Shortly after two paramedics appeared with a gurney. The lead medic did all the talking. He was very cordial, introduced himself and his partner, asked what else we wanted shipped off with mom and assured us they would be gentle.

One of each got on either side of the bed, grabbed the sheet beneath my mother and on the count of three whisked her through the air onto the gurney and were off. I handed dad a couple potted plants my mom wanted and wheeled him out and down to my car.

We drove around the block to where Sunset City was located not far from the hospital. The ambulance was already emptied. It was nearly 5:00 now. I got dad his walker and took him inside and grabbed a convenient wheelchair left along a wall. There was no one to greet us. There was a counter for a receptionist, but no receptionist behind it. There was certainly no Ms Bubbly. I did not know where they took my mother.

Presently two young aids came out through double doors to a corridor where patients resided on the first floor. I waylaid them and inquired about my mom. They knew nothing and were in fact leaving for the day, but one graciously went to find us help. After a bit of a wait, another woman well decorated with tattoos appeared. She told us my mom was in Room 313.

Was any of this a good omen. The day was April 13, Friday the Thirteenth, and she was in Room 313.

I took dad up in the lone elevator and down the long hall on the Third Floor and into her room. There were three beds in the room and mom was in the middle. No one was in the others at the moment. There was an oxygen pump by the head of her bed, sending the pure gas up a tube that fit into both nostrils. It was very loud, as if not all bolted down tight.

I left dad and went back down to move my car from in front of the entrance to the parking lot. The lobby was again empty. I pressed the bar on the front door and nothing happened. The door did not open. I tried its twin to the left. Same result, the front doors were locked. How do I get out?

Just then a delivery guy pulled up behind my car and he came to the door with a package. He reached over on the wall and pressed a code in a keypad fastened here. There was a click and he pulled the door open. I breezed out.

I parked my car, wondering how I would get back in. I saw the ambulance parked nearby, the one that brought my mom. The two paramedics were standing nearby. I walked over. As I approached the one, the talker, hid a cigarette behind his back.

"You didn't see that," he said.

"I couldn't care less," I told him and asked how I got back into the building. He told me there was a button near the door. Press it and someone should come and let me in.

I walked back up the long path to the door. I found the button and pressed it. Nothing happened. I stood and waited and waited and waited. No one came. I saw a little card attached to the glass on the door. It said if no one answered the button, to call a number, which was given.

I traipsed back to my car, retrieved my cell phone from the glove compartment and returned up the long path to the door. I dialed the number and waited. I though this was another dead end, but then someone did finally answer and that someone did finally come and let me in.

I headed to the elevator and I wondered, "How will we get out of here later?"

The convoluted world of Nursing Homes was just beginning.

And where the heck was Ms Bubbly?

A Grand and Glorious Entry

Sunset City sits centered in a city street. Mushmouth Manor is mounted upon a hill. It looked down upon me all the way up its drive and into the parking lot. I looked at the clock. It was exactly 1:00. I had just made it, although such timing was in my own head. I had made no such firm appointment here. My email had said I expected to arrive around one.

I walked up and entered into the lobby. It was quiet different from my morning visitation. Sunset City had an entry the size of my living room with a counter to the rear and a small sofa and table off to its right. Mushmouth Manor had a cavernous lobby worthy of a hotel. It was supported by columns and festooned with plants. There were a number of chairs and sofas facing in various directions and end and coffee tables. (The photo is not Mushmouth Manor's lobby, but of some grand hotel in Asia.)

I told the receptionist my name and that I had emailed, but she already had me on her schedule and said the Admissions Director would be with me shortly. She bid me have a seat. I choose a plush chair facing toward the counter. When I am waiting to meet with some personage I always prefer to be facing the direction from which I expect them to come.

The lady arrived shortly and led me back into the residence halls. I noticed when we passed into these corridors it wasn't so grand and glorious. The rooms where my mom would be housed were not noticeably different from those at Sunset City. As we walked and my guide chattered on about the benefits offered by Mushmouth I felt a vibe. I am not exactly certain why. It probably was something in the tone and attitude of the Admissions Director. I came away not particularly liking her, although she had given me no real reason for my feeling. Still, when I left I was negative toward the place with a distinct impression they were more interested in money than people.

But this was the place my mother preferred above all others at that time and I knew I couldn't change her desire because I had a gut feeling. It would be on my list.

I thought I would visit Garden Green at Deep Pond in the next few days and perhaps a couple of those homes further south, but when I arrived home I had a voice message on the phone from Ms Bubbly.

Ms Bubbly was the Social Worker for the hospital. She was the one who told me not to worry she had my back, she'd be by my side through the entire process and she would be my guide and guardian angel through this whole ordeal. She even gave me a hug. I was never to see Ms Bubbly again.

Her message was, "I need three names of Nursing Homes immediately," like now, like stat, like before you take another breath.

Go visit several homes before making a choice, she had said, and she now needs the names two days later? Who did she think I was, The Flash?

I left her a voice message in return, because of course she wasn't available to answer my phone call live. Nobody ever is anymore. I told her Mushmouth Manor and Garden Green at Deep Pond because they were my mom's two favorites. I threw in Sunset City because it was really the only one left in that area and the only one I had a chance to visit other then Mushmouth Manor. It seemed okay and besides it was last on this short list. I hoped she'd go for the number one choice and get mom to Mushmouth Manor.

I was pretty sure Ms Bubbly would do just that.

Express to Unhappy Valley

Why did I have meetings to attend on that particular Wednesday? I was retired from the business world. I don't have meetings anymore. I always hated those meetings anyway. I go to a poetry group once a month and that's as close as I get to a meeting.

The operative phrase in the paragraph above is "was retired". These meetings were the first of my new job; one that goes 24/7, is demanding, frustrating, constantly second-guessed and the pay is zilch.

When I was bopping about the shiny scrubbed floor of the hospital trying to find someone who really knew my mother's condition, I was met late in my searching by Ms Bubbly. Ms Bubbly was a Social Worker and the Case Worker for the floor. She introduced herself with a wide assuring smile. She told me she would be with me every step of the way. I had little to do, it was in her hands. She told me of a list and gave me a hug.

I'm not a hugger. I am uncomfortable with this touchy-feely approach to causal relationships. That was the second hug I got that day, which was two too many. The first had been at my dad's when a friend of his gave me one.

The magic list was laying on the tray table by my mother's bed. It was a list of 18 Nursing Homes. Ms Bubbly had told me my mother would be sent to a Rehab Center eventually, but she, Ms Bubbly, would handle all the details and the transition. All she needed from us were three preferred homes. She suggested I should go visit these homes and see which ones I liked.

Eighteen Homes sounded like a lot to visit, but it really was less than that. First of all several had been crossed off by Ms Bubbly because they wouldn't accept my mother's insurance. (My parent's had made a bad choice in the insurance they choose, but more of that later.)

Then I asked my Ma if she had any preference.

"Yes," she said, "either Mushmouth Manor or Garden Green at Deep Pond." She waved a finger on the hand that worked. "Stay away from here and here and here and here and over there."

So okay, with the one's my mother very insistently told me to stay away from and the one's crossed off because of the insurance issue, our list was down to eight and five of those were far down south in the county. I figured she would want to stay up in the region nearer her home so her friends could visit. My list of 18 was pared down to three: Mushmouth Manor, Garden Green at Deep Pond and Sunset City.

Okay, just in case somebody's a little asleep reading this, none of these names are the real ones. Believe me, no Old Age Ho...(sorry)...no Retirement Home, Frail-Care Center or Skilled Nursing Facility would ever use Sunset as a name; Sunrise yes, but never anything too smacking of the truth.

On Monday I contacted Sunset City and made an appointment to visit and take the tour. I also left a message (it is incredibly hard to ever contact an actual human being at any of these places, in fact, any where anymore) that I would be in the area on Wednesday and would like to stop by and see Mushmouth Manor. I didn't call Garden Green yet, it could wait until I saw the other two.

On Tuesday I got the call that Mom was getting a feeding tube plugged in on Wednesday.

Things were speeding up here.

Wednesday morning I made the trip north to This City for my appointment at Sunset City. When I drove about the building and parked I could see it was an older facility. It wasn't fancy, like some you see and certainly not opulent. The reception lobby was small, about the size of a large living room. The receptionist was friendly and the Admission Director was as well. She was very nice and she explained the place and took me on a tour.

Again, nothing lavish, but everything was clean. There was a clutter of broken down bodies in wheelchair here and about, a standard in such places I was to learn. She showed me the dining area and the large Rehab Center and a typical room. There were three beds in each of the Skilled Nursing rooms. Each bed faced a bureau and there were TVs on these bureaus for each bed.

It seemed a decent place, although you could see age on more than the residents.

My meeting was over by around 11:30 and since the hospital was nearby, I did stop up to see my mom. When I got to her floor I found her asleep, so I sat down on a chair and waited. After a few minutes a nurse came in to tend to mother in some way and woke her up.

After this person did her thing and moved from the bed into the bathroom, I said to my mother, "She did what I didn't want to do, wake you up."

"It's my job," said this nurse as she now departed the room.

I told mom where I had been and that it looked decent. The people were very nice. She then asked about Mushmouth Manor. "I'm going there next," I told her.

About then a nurse came in and said they were taking my mom down to surgery. I said I was told she was going at 1:00, but they said it was moved up. They preceded to get my mom on a gurney and wheel her away. I left and headed for Mushmouth Manor.

I thought they placed mom on a gurney. Actually it was to be on the express to Unhappy Valley. (And no, I haven't forgotten what I quoted Grandmother as always saying in my last post.)