It’s been a transformative year for me. I feel like a different person in many ways. There were a lot of challenges and I hope to share some of the things that helped me get through them.
It was my last year with my father Daniel, much different from any other. At the end of May I went to Phoenix where we packed up a rental trailer and moved Dad to a room in Park Place, an assisted living home near me in Reno. With over a dozen medications to manage, the mobility limitations of advanced Parkinson’s disease, and unpredictable bathroom needs, we were ready for a challenge. Over the Memorial Day weekend we made our way between busy restaurants and restrooms, keeping the meds on schedule and avoiding any serious mishaps. My appreciation for the work Jan, his caregiver in Phoenix, had been doing full time for six months grew with my own experience. Dad was understandably anxious about such a big change but always managed it with grace when it counted. We arrived on time in Reno where Ann had managed to make his small, mostly empty room feel welcoming with a cozily made bed and flowers on the window sill.
The months that followed were some of the closest I’ve had with my dad, in a relationship reversed in many aspects from the one we’d developed as mostly independent adults. As he came to depend on me for more things my role became parental in some ways, something neither of us were accustomed to. Our deep trust in each other was tested regularly, but it held.
One thing I recognize clearly looking back is that my dad had some resources in place that made his care possible. Without these, many of the challenges would have been impossible instead of just difficult. Reflecting the state of our health care system, the big ones involved insurance. As a former United States Postal Service employee his primary health insurance was Medicare (Hospital/Part A and Medical/Part B). That was the first line of defense and the easiest to manage because providers all have it dialed in. It also paid for hospice care, which Dad started in December of 2021. Next he had supplemental health insurance from BlueCross BlueShield’s federal employee program. It often took some back and forth with providers to get them to submit to that plan correctly, but it usually worked. In addition to those he had an independent long-term care policy (Ameriprise Riversource). This was the most time intensive policy to manage with lots of phone calls and various submissions required, but it greatly expanded my dad’s options for in-home care and assisted living. I learned more about managing these policies than I ever cared to know. In cases where all the insurance fell short, my dad’s income from his retirement annuity and rental properties was more than sufficient to fill in the gaps. It haunts me to think of all the families facing situations like my dad’s without these resources. There are so many, and the number grows.
The number of problems to be solved and decisions to be made was staggering. It makes choosing what to share, what was most helpful, a little difficult. An over-arching theme was that there was almost never a clear, correct choice discoverable through diligent research. An example is finding in-home care. The most qualified providers can also be the most rigid and inflexible, not to mention expensive. Smaller or independent providers can be a crap shoot. Provider personality fit is also a giant factor that is nearly impossible to research. We ended up getting lucky with a provider from Seniors Helping Seniors who became a close family friend. Ideally you’d like to find and hire the right person directly, but the process of finding candidates is daunting. You look for a compromise that usually means everyone involved gives a little.
Having friends and family with similar experience to consult has been invaluable. Our friend Sally in Reno had been through some similar trials with her husband Tom, who suffered from early-onset Alzheimer’s disease. Her choices for hospice and assisted living turned out to work for my dad as well. I still did some additional research, but her experience gave me a better idea of what to expect than anything else could have.
I’m grateful that the signs of dementia my dad exhibited didn’t obliterate his sense of self or his ability to express his preferences. He did get confused, had some short-term memory loss, and toward the end had hallucinations he couldn’t always distinguish from reality, but he always knew me and was pretty clear about what he wanted. I made sure to discuss with him early on that if I ever had to make decisions for him I would rely on his written wishes in his living will, our prior conversations, and my best efforts at empathy beyond that. We reviewed that plan periodically, but I’ll admit my relief at not having to fully enact it. His expressed preferences about his care were often repetitive or anxious, but they were consistent and not alarmingly erratic or delusional. When the pain of his deteriorating body passed his own tolerance, he requested the morphine that eased his final days. My heart aches for anyone who must make this decision for a loved one. The strength required to do it must take a terrible toll.
One decision my dad struggled with was his desire to contribute to science by donating his body after his death. When we reviewed the local medical body donation program through the University of Nevada Reno he hesitated at the condition that no remains would be given to the family, and we never completed an application to that or any other program. When he died his body was too emaciated to be useful for research, and his wife Sarah took great comfort in the time she was able to spend with his body. At that point I was thankful his body was not whisked away by a program that couldn’t make use of it, though I still admire his desire to contribute to research.
I didn’t organize a memorial service for my dad, apologies if you were looking for one. I am more than willing to remember him with you, but his friends and family are so scattered over the earth that I couldn’t envision how to do it all together. What I did instead was create a website in memory of Daniel where I will share memories and accept submissions. Perhaps we’ll record some in-person remembrances there.
Obviously this was a big part of my year and there were many more aspects of it that I’m willing to share, but there are some other topics I have something to offer on.
Ann and I reconnected with Vanessa Belz, a friend who enhanced our year in many ways. An early and significant one was introducing us to the nearby Fort Sage Off-Highway Vehicle area, which turns out to be fantastic for camping, bouldering, hiking, and running. It’s only an hour away, our cat Maddy loves it, and we’ve gone back there repeatedly all year long.
Around my 50th birthday this year Ann introduced me to the Wim Hof Method, though she may now wish she hadn’t. I credit it with helping me get through a tough year. For me it boils down to lots of conscious breathing and a daily dip in the Truckee river. After that I feel replenished and able to face the day, sometimes even with some love and openness to spare. For those around me it can be weird and annoying, and I’m eternally grateful to Ann for her tolerance of my new rituals. She even encouraged to me to take a class that finished with a 3-minute ice bath.
Ann and I continue to volunteer with the Adventure Scientists Wild and Scenic River project. This year we did the first survey of the West Little Owyhee river in southeastern Oregon, and Ann did a solo trip to get the first grab samples from Cottonwood creek in the White mountains of California. These trips are great outdoor experiences that also provide data to researches and land managers grappling with climate change and other environmental issues.
In my reading life I continued my Octavia Butler kick and have now read many of her books. The Parable of the Sower and its sequel The Parable of the Talents especially made an impression, feeling like a history of a parallel universe. On the non-fiction front Ann’s recommendation of The Long Trek Home by Erin McKittrick was both a great read and a marker of how wilderness treks are changing. I continue to write book reviews on bookwyrm.social.
I’m uncertain what this coming year will bring. Ann has some family visits planned. We’d like to do some camping in the north Cascades. I hope to see my mom and visit some places that were special to me and my father. I want to continue our work with Adventure Scientists or other worthy causes. And I want to wish you a hopeful and fulfilling new year. Thanks for keeping in touch.