One step forward, two steps back...

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Well, I've gotten some news about Dad's health, and his financial issues in the past week. First off, Dad has two more areas of skin cancer that will have to be dealt with separately. One will require plastic surgery according to his doctor. He's already had cancer three times in the past, and one of the surgery's was very difficult. He's very unhappy. I spoke with legal aid. The woman I spoke to was surprised the hospital didn't just accept what he had been paying. She suggested he file for financial assistance and ask that all the medical bills be forgiven because he has no assets, like a house, or insurance, etc. She also said that he is entitled to spend his income on food basically "as he sees fit" since he cannot cook. She said a $50- $60 daily allowance for meals would be in the range of the local per/ diem businesses allow. She also said that I am under no obligation to cook for him / try to get him the lowest priced meals if the savings are just going to go to creditors... kind of a moot point, because if he eats $50 a day at restaurants, he won't have money for *anything* else. Oh, and best of all, my younger brother the parasite wrote again. He wants to stop and see dad -"before he goes" - before he takes his in-laws to Hawaii for the holidays. I'm still thinking of responses that use words without four letters in them...


Erwin, how old is your dad and what type of skin cancer is it?

I wouldn't let Brother bother me much. I have two brothers who are getting great enjoyment out of their lives. Even though I see and talk with them amiably, they are still nearly invisible to me. There's not much that feeling bad about them will do. At least since your brother will be in Hawaii, he won't be bothering you. There's always a bright side to things.
Hi JessieBelle, Dad will be 90 in January. The doctor says it is not the extremely deadly sort that spreads, but he is "still concerned about it." That does not tell me that much.

As far as my brother goes, I have no problem ignoring him - he's forgotten around here - except for the fact that he keeps writing letters demanding that I invite him, and when I don't, he whines to everyone we know how much he misses "his family."

When we still on talking terms he came out with this same line of horse-hockey at a Christmas party and I burst out laughing right in front of everyone. I only put up with him for our mother's sake. Now that she's gone, as far as I'm concerned, so is he.

I just wish he'd STAY gone :)
Erwin, unless it is melanoma, i wouldn't do surgery for skin cancer. Basal cell or squamous cell are " concerning" in a younger person. Not so much in a 90 year old.

Useful questions for doctors--"what is the downside if we do not treat this?".

" what would you do if this was YOUR FATHER? ".
Thank you for your answers. I think they are pushing surgery down the road.
I agree with Barb if it is a basal cell carcinoma unless it is in a sensitive area, such as around the eye, or is spreading faster than normal. Some of them grow so slowly that they aren't really a consideration when someone is old and in poor health. Basal cell doesn't metastasize. It only spreads locally. This is why I asked what kind it was.

Of course, what your father wants to do is also important. Some people totally freak out that they have a cancer that is not being treated.
Erwin, a few thoughts....

1. Skin cancer. See if you can clarify the doctor's "concerns", by asking what stage the cancer is. Plastic surgery would raise a big red flag with me; that would be an ordeal for anyone, let alone a 90 year old.

2. Your father's "very unhappy". Beyond critical medical issues, it's been my experience that the mood of a parent affects so much - his/her outlook, determination, acceptance of assistance...and more. So focus on that and set aside the cancer issue for awhile. If you can keep his mood more positive, he hopefully would be in a more congenial mood to address this.

3. Is the doctor who diagnosed the cancer an oncologist? If not, consider seeing one when you feel your father's up to it. This is too much of a specialty to rely on a PCP or other general doctor.

4. Legal Aid advice. The recommendation sounds like that person was recommending filing for bankruptcy. If so, you might want to think about the effect that would have not only on his credit rating, but on the effect on future medical providers. If he shows he's trying to pay down the debt, that's different from reflecting that he's trying to get it completely wiped out.

5. Research to see if you can find a Hill-Burton hospital in your area (sorry, I don't recall whether you're in an urban or rural area). HB hospitals were built with funds from the Hill-Burton act, and are required to accept indigent patients. Google "Hill-Burton hospitals". The first hit is a list of HB hospitals. See if there's one near you. Sometimes Catholic hospitals are HB hospitals and accept indigent patients.

6. Meals. I don't recall if you've contacted MOW or if your father won't eat them. Schwann's is a home delivery service that my sister used when she was first diagnosed with cancer. As I recall, the costs were higher than grocery store bought food, but if memory serves me right, the food was very good, and diversified.

Your profile doesn't enable seeing your answers, so w/o searching, I don't specifically recall all the details of your earlier post or whether I suggested some frozen meals. There are a few lines that are fairly decent - not overly spicy or salty, although most frozen meals do have more sodium than freshly cooked foods chosen for less salt, sugar and preservatives.
Just some quick answers as I go through all the ideas I've been getting - THANK YOU TO ALL OF YOU. That can not be SAID ENOUGH!!!

1) I called the doctor, and surprisingly got a call back. He is concerned because the one cancer is "pretty large" and the other is on dad's face. He suggested a second opinion, but said they will "certainly agree with me." I'm going to ask dad what he wants to do - 2nd opinion, or ?

2) Dad's mood is not bad when he isn't interacting with doctors, billing departments, etc. If the manure hurricane ever slows down, I think he'll be fine. He was even joking when my brother wrote ("I guess he needs more money"), although my brother is a very sore subject with him. He told me last night how much he resents the way he treated our mom, and that he wants to demand that he changes his last name...
I told him not to get into a peeing contest with a skunk. My life is so much better when I don't have to deal with him, on top of all the other issues.

3) As far as the legal advice goes, her main issue was that she felt that dad had been making a "reasonable effort" to pay his bills with the hospital. She said that if they didn't want to agree to accept what he was paying without threats, then asking for financial assistance - or actually, in this case forgiveness of the remainder of the debt - is a reasonable step.

She pointed out two things - More than 80% of their billed charges have been paid already. She says these bills are all open to negotiation on final amounts billed to patients. She suggested they might agree to a much lower bill to settle the account, or simply forgive it outright once they see dad has no assets - "and it gets through to them that there is no more money." She thought that was the main issue.

4) As regards meals, regardless of what happens, I am still trying to get dad to realize that while restaurants are convenient, they aren't the best way to spend what money he does have. I think he - A) Is desperate to get out, and sees this as an excuse to do it B) Hates my cooking, which is not unreasonable since I can't cook worth spit C) Wants to feel "normal" and going out to eat lets him feel that way when he sees everyone else eating out with their families.

Going to the restaurant is one of the few things that really cheers dad up, I'm afraid. On days that I put my foot down, and refuse to take him, or let him take the d*mn taxi - the other bane of my existence - he often won't even get out of bed. I've been trying to get him interested in hobbies again, but aside from taking a few pictures, and buying him a digital watch to play with (don't even ask), he really just wants to go out.

Erwin, thanks for the update and responses.

As to meals, what about meals at a Senior Center? When I've gone to pick up meals for my father b/c we weren't available during delivery time, I see seniors sitting chatting well after the meal is over.

There's a piano in the dining room; I don't know if anyone plays it (I'm tempted every time I see it). There are also other activities. E.g., a Thanksgiving dinner, Veterans' Day luncheon and a Christmas luncheon will be held.

There's a holiday greens sale, a crafts sale (some items donated, some made by seniors), so there's more opportunity for socialization.

Another thought: one of the restaurants we go to has a Veteran's Corner, with logos of all the services. The owner told me a group of Veterans meets there on a regular basis. I don't know how you'd find a restaurant that does as this one does, but it's a consideration if your father is a Veteran.
GardenArtist, thanks for all your thoughts.

I have taken Dad to the senior center here once a few months back. He hated it. They do have meals which he says are worse than my cooking - which he says should be used to poison enemies...

He only liked one meal they ever had there - Swedish Meatballs - and they only have that every few months. He hates going there regardless. Dad does not really complain to strangers at all, and he says that is all anyone ever does there. It depresses him.

He will complain to me, because I'm family, and therefore privileged to hear all of his jeremiads. But around anyone else, he just gets grouchy. Unless they are polite, and respectful women. In that case, he usually will be the same.

But if they are loud, rude, pushy, or mean, look out. He has told more than person off, and he is really brusque.

I've never seen a veteran's meeting area at any local restaurant. Of course, * I * rarely go to any. I do care about my budget! I will ask, though. He is better around other vets.

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