[Critique Group 1] Leonards comments on Martia

[tuchyner5 at aol.com]

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Thisis a description  of a man’s loss of mostof who he is. Can he lose any more, in any category.    Does he still fit the description of whathe needs to have to be considered for Hospice help.  It is presented in a straight forward journalisticway,  Yet the description is highlyemotional. It’s a very powerfl piece. I can’t see what I would change  Will you b able to continue to show he hasdeclined when he has so little left 






 




\DocumentableDecline





MarciaJ. Wick, The Write Sisters





January2020





WordCount:  719





 





 





Medicarerequires that a doctor determine a body could die within six months, andtherefore is entitled to hospice care, also known as comfort care, at the endof life’s journey. My 95-year-old dad, a World War II B-24 navigator, has beenreceiving hospice care at home for 12 months, yet he is still alive.Considering that he has lived six months beyond the six months he was allotted,Medicare may withdraw hospice support unless there is “documentable decline”every 60 days moving forward.





 





“Documentabledecline?” 





 





Duringthe year Dad has been on hospice), he has declined from using a walker most ofthe time to relying on a wheelchair all of the time. His master bed has beendismantled and replaced by a hospital bed which can be raised and lowered tohelp him sit up and eat when he can’t get out of bed. It’s equipped with amotorized air mattress to help prevent bed sores, and guard rails to keep himfrom falling out. His trousers and belt, shoes and socks, and jacket for the outdoorshave been replaced by pajamas, slipper socks, and a fleece throw blanket. 





 





Heused to shower daily; now he only tolerates the ordeal once or twice a week,peri-baths or bed baths occur more frequently. He used to assemble his ownbreakfast of toasted waffles, O.J., and hot tea; now he’s fed breakfast afterwaking at lunchtime, soft foods prepared by a caregiver. He used to sit outsideon the deck or ride his stationary bicycle; now he stares at the screen saverwithout sound or the innocuous Hallmark channel on TV. News of the day hasfaded; confusion each day heightens. The vocabulary of the chemist, teacher,and author has been reduced to “How did I get here?” Dad’s world has narrowed.He worries that if he doesn’t know where he is himself, how will his wife knowwhere to find him. We assure Dad that we’ll tell Mom where he is, withoutreminding him that Mom died more than two years ago.





 





Dad’shands and feet swell from inactivity; we had to call the Fire Department beforeChristmas to cut off the wedding ring he has worn for more than 70 years.Arthritis in his knuckle prevented its removal any other way. We’ve replacedDad’s upholstered arm chair and ottoman with a remote control recliner to helpelevate his feet and adjust his position when gravity scrunches him into aball. The recliner also reverses to help Dad “stand,” now that he can’t do itunassisted. To help Dad transfer from the recliner to his wheelchair, one of usgets Dad into a bear hugs while one or two others hoist him by handles on agate belt and perform unique dance steps to pivot 150 pounds of “dead” weight90 degrees. Each day in this way, we transfer Dad from his bed to thewheelchair, the wheelchair to the toilet, the toilet to the wheelchair, and thewheelchair to the recliner where he drifts off to sleep.  If his eyesopen, however briefly, his children or caregivers offer beverages andnutritious snacks. Even though Dad is sedentary, he haven’t lost weight; withprompting, he picks up the sippy cup or spoon. Sometimes when finished, heplays with his food, pouring his juice into his soup, spooning his soup ontothe tray. He wears a cloth bib to make cleanup easier. 





 





“Documentabledecline?”





 





Dad’sheart is strong. His blood pressure is normal. His oxygen intake is stable at90 percent. Here’s the thing. If he no longer walks, he can’t walk less. Ifhe’s incontinent, he can’t become more so. If most of his words havedisappeared, he can’t lose many more. If he can’t (bears) his own weight, if hedoesn’t recognize his children, if he doesn’t know his home of 40 years, if hedoesn’t remember he was a mountain climber, what is there left to decline? Aslong as we feed him, he could linger this way for months or even years.





 





Hestill reads the name badges of caregivers. He still smiles and giggles when weapproach. We manage his home. His belongings remain untouched. We maintain thesemblance of living. We’ve haven’t compose his obituary as if the need for itwon’t come.





 





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