For the last five years my ex-husband has been living in an assisted living facility. While he’s driving around in his motorized wheelchair wearing a Frank Zappa t-shirt, there are gray-haired seniors all around him, in varied degrees of decline. I’ve watched them all age and worsen over these last five years; some have died and some have moved to who knows where. The Ex is among that small number, moving to a more hands-on, intensive nursing home.
The few weeks preceding this day had not been easy as the two of us began to deal with the adjustments we could only imagine would lie ahead. The decision to move him to a nursing home was one I made and one that he gracefully accepted. As I write this, the move has been made and he is now in the nursing home. I cried copious tears as I drove away . Tears of feeling I’d failed him, tears for his decline and tears of sheer frustration and stress for the burden I carry as well. He, on the other hand, was taking it with an almost saintly sense of the inevitable.
The moving from assisted living to a nursing home involved getting him enrolled in Medicaid. The process isn’t terribly complicated, but on the other hand, it would be challenging for individuals without stamina and a certain level of cognition. The process involved initial paperwork, an interview for me with the social worker, an interview for the patient with the social worker and a nurse, then more paperwork with the case manager. Along with that process came the onerous task of finding a suitable nursing home with an available Medicaid bed.
There were two nursing homes in the area I didn’t even call due to their reputation. Of the others, I received mostly negative response. In two cases, my ex-husband was too young. They were senior living residences and only served individuals 62 years of age and older. Several were short-term rehab facilities. Most of the places I called were private pay or assisted living facilities. In the community where we live, the average out of pocket cost for assisted living is $4000 a month and up and nursing homes are about $5000 a month and up. It is an amazingly expensive arrangement; I can’t imagine how most people can afford it.
The number of Medicaid beds are dictated by the state and communities can add beds only by participating in a state bidding process. Therefore, beds are few and the waiting lists are long. He is on the waiting list for a facility near my house. Seventeen individuals are ahead of us. And as the admissions director pointed out, there is no predicting how quickly the beds will become available. I want to wish for the list to get smaller, but that is tantamount to wanting people to die so I can get him closer to the top of the list. The next desirable one on the list has a waiting list of at least a year and it’s about 40 miles away from the town where we both live.
I was fortunate to find a nursing home with two open beds. To secure a bed I had to either start paying $161 a day while I waited for Medicaid approval or gamble on the bed staying empty. As I gambled, I got paperwork in order and anxiously prayed for things to work out. The paperwork involved charts from two doctors, the assisted living facility and the pharmacy. We had to schedule a chest x-ray and a physical no longer than 30 days before admission. And I had to give 30 days’ notice in his current residence. It was a house of cards. I couldn’t give notice until Medicaid came through and then I had to hope and pray the bed would still be vacant. As it is, I will have to pay for 9 or 10 days at the assisted living facility. Then I had to plan the transfer of his possessions and find someone with a truck to help with moving. The last few days were a series of “if this happens, I can do this…” Finally, the admissions director at my ex-husband’s new home called me to say yes that they would be ready to take him on Monday.
He’s adjusting slowly. I’m having my own adjustment issues as well. He thanked me last night for taking care of him and suggested I start taking care of myself now. Wise words, as this story is far from over.
Walker Thornton is a freelance writer and blogger based in Virginia.