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vsmini Asked July 2016

How I can deal with the fact that my father lives in another country, his health is failing and I can't be there?

How I can deal with the fact I can't be there? I was born and live in the United States. My father is from Argentina and moved down to Buenos Aires when he retired about 8 years ago. I'm an only child.

He is a lung cancer survivor that still smokes. He doesn't like to keep me updated about his health because he doesn't want me to worry. I found out about his lung cancer 2 months after he was diagnosed a few years ago. Just 2 months ago he was in the hospital for "confusion" and pneumonia. I only found out because the girl that was taking care of him (girlfriend? I have no clue) emailed me and told me to come down to Buenos Aires because he was dying and she couldn't make medical decisions for him. Well now I'm down here and he's not dying. He's getting better but needs to get into a nursing home/rehab facility because he can't walk (he's very weak from being hospitalized for 2 months straight with virtually no rehab in-house.) I don't have much money, he doesn't have much money - we can afford 1 month at a rehab facility but after that he needs to be out because we can't afford 8K a month.

This is my worst nightmare. I'm still relatively young and I have asked him when he was healthy and he moved down to Buenos Aires what his plan was in case his health failed - did he have a system in place, friends, contacts, DNR, will. He NEVER wanted to talk about it and totally shut me down. Now - here we are. Everything is so complicated because it's another country - their social/health system is not the same as the United States and because I don't speak the language it takes me 10 times as long to get something done.

I left my husband and my job to come down here - I am supposed to leave for the states this week but not everything is in place. He has virtually no friends and zero family down here. If he gets confused or is left on his own I don't know how he can take care of himself after the 1 month in rehab is up. He can't come back to the United States as he's not cleared to fly (and probably won't be for another month or so) AND he cannot apply for medicare in the states until January and then it won't kick in until June 2017 - so a year from now.

I'm also concerned because the girl that has been taking care of him (and wants out) also says he is an alcoholic. Which I never knew, but again, we've never been super close.

How can I possibly deal with the guilt of leaving this country without all of his loose ends tied up? It's eating me alive.

Eirie67 Aug 2016
I think others have addressed all the rest so I will answer this:

"How can I possibly deal with the guilt of leaving this country without all of his loose ends tied up? It's eating me alive."

You deal with it by making your rational mind and your logic take control of your emotions. You realize that guilt is a useless emotion when it is misplaced such as in your case and leads to often negative consequences, in the form of punishment, mental or emotional that serves no purpose and is administered under the dictates of the subconscious mind.

So you make the decision to get rid of the guilt and do what you have to do with whichever choice you decide to make. in other words, it is a deliberate and conscious decision you have to make so that your logical mind subjugates your emotions to its control and thereby negates all impact that the guilt would have on you.

it may not be easy but it is very simple and it starts again with simply making the decision. You do this by talking to yourself and every time the emotion of guilt tries to stir negative emotions, you talk to it and tell it you will not be a prisoner of guilt because you're doing the best you can and thereby, you free yourself from it.
hope this helps.

vsmini Jul 2016
CTTN - Probably best for you to keep a few things in mind.

-Great health insurance doesn't automatically mean no expenses or co-pays for 2 solid months in a hospital.
-Last minute plane tickets to another hemisphere cost a fortune and I had to get 2 of them.
-Nursing homes are not covered by insurance and the ones that aren't a death sentence are 8K a month and require 1 month's deposit - Hello $16K
-I don't have access to his pension plan bank account so his bills that he's been missing since being in the hospital and rent and all other monthly bills are coming out of my pocket

Igloo - Great idea about the boat - not sure if that will be an option for us but thank you for the suggestion. I know - I have so many ideas on what I can send back down here when I'm back in the states as thank you gifts to those that have helped him and me during this time. Argentina is really messed up with goods coming into their country. Whenever I send my dad something he has to go, pick it up and then pay taxes on the items. And they would too. I don't want them to have to pay to pick up their gifts as I have no idea what the taxes would be like. I'm going to get them some gift cards to some city spas so they can have a massage or facial. It's the best I can think of. I'd like to give them a lot more, because they deserve it...but as stated above - cash is crunched right now.

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staceyb Jul 2016
All great suggestions!
Mulatta, you are a wealth of information! Thank you!

staceyb Jul 2016
I would think that airfare, lodging, meals, and her Dad's medical expenses have eaten up a chunk of her monies, but how is that question relevant to this situation. This poor girl is in distress!

CTTN55 Jul 2016
If he has excellent insurance and a pension that is worth something in Argentina, then how have you spent $25K of your own money? I am confused about this.

igloo572 Jul 2016
If its the O2 that's the overriding complication to travel back to the US once he's out of rehab & more stable, look to put him on a boat. The cruise ships always have passengers in wheelchairs...with O2tanks...with walkers...special needs. Probably you or another would need to travel back with him but consider looking into this. There's lots of competive pricing on cruises.

Maybe bigger sailboat (100+ type) could also work IF he's comfortable on water as that type of charter will be faster direct back to a harbor in the US. I'd look for pacific (like San Diego) port of call for disemb if you do this during hurricane season (through Oct). There's a huge sailing community in BA & thoughout argentina plus across the water in Colonia to find a shared charter if need be.

Also please send some type of little giftees to his helper friends back in BA. Lots of US goods are so expensive in So America and will be so appreciated.

Mulata88 Jul 2016
Please vsmini, answer the message.

Maria Laura is on standby. She confirmed from Argentina just now!

Help is on the way! She said winter vacation is about to start over there.

Hugs,
M 8 8

Mulata88 Jul 2016
I know a person in Mar del Plata. She's a bilingual interpreter. She can do Medical interpretation on the phone, 3way calls with whomever you need.
Maria Laura Garcia, S.I.T = Solutions in Translation

Contact her, explain what you need. She can also get documents either translated for you, or written in Spanish so that you can give them to whom ever you need.

I am the translator FOR COOK.
She'll know what that means.

Hope this helps you! Hugs,

gladimhere Jul 2016
Vsmini, if he is alcoholic make sure it is in his medical records. A friend of mine, an alcoholic had a bone infection, osteomyelitis, alcoholics are more likely to develop all sorts of medical problems. This friend was treated for the osteomyelitis with intravenous antibiotics. Because of liver damage the antibiotics were not processed correctly. He became septic, went into septic shock, and died at the age of 54. He had not told medical staff he was alcoholic. So make sure this is in your dad's records so he is appropriately treated.

vsmini Jul 2016
Thank you, Caregiverto89 -

He has a very good pension plan from the United States as well as a retirement income here from Argentina - by US standards it is not a lot but for Argentine standards, his monthly income is very good.

He pays $300 a month for private health insurance (which is a fortune for health insurance to many people down here) so he is very lucky in that respect. He was just released from an amazing and beautiful hospital, literally the best in the country. So he has decent money he just needs a geriatric care manager to make sure his bills stayed paid! I don't want him losing that insurance.

Private nursing homes (the good ones) are expensive and only Argentina's super wealthy can afford them. We can give him a chance by putting him in a rehab/nursing facility for a few months but then he will have to get out and do home-care. Only problem is - it's difficult to find someone we trust. We just have to hire a few people and hope for the best.

It was difficult the first few weeks I was down here because nobody could believe that he just didn't have friends or family down here - it was like they have never ever seen a senior citizen have nobody to care for them. And every hospital demands that someone "be responsible" for him, which I understand completely, but it was almost as if they had no clue what to do if I wasn't here.

I leave the country this weekend - I will do the best I can, remotely, from the United States in coordinating things. Thankfully I have found a few old friends of his that have agreed to help out. Friends that he had cut off ages ago and he should be thankful they are willing to help his grumpy @ss out.

Caregiverto89 Jul 2016
Wow! I hadn't thought about foreign financial arrangements. How will your dad afford the nursing care in the future? Does he have income? Can he get into a government financed or charity program there for his health care? My grandparents lived in Columbia for a decade. They were Americans who ran a business there. My grandmother said that she often visited friends in the hospital because patients were expected to bring family or friends with them to help them with dressing, meals, blankets and sheets because the hospitals in Columbia in the 1950's were so poorly equipped and had few staff to do the daily tasks. Whatever you can do for him is important because there is little help for him otherwise apparently. Taking care of him at home, his home or yours, will certainly be cheaper than keeping him in that facility. Try to help him get well as soon as possible, and get out of there safely! The U.S. has many advantages! Praying that you will get the help you need...

vsmini Jul 2016
Sorry - I'm really on a roll now.

Another charming obstacle has been money. If you're not a citizen and don't have an Argentine bank account - everything has to be paid in cash. So 8K for a nursing home - cash. Argentina has a lot of restrictions on USD transactions so I can't wire money from my account or my dad's American bank accounts to any of these facilities to pay for things. I have to either withdraw it from an ATM or Western Union myself the money. Does anybody have any CLUE what $8000 USD looks like in terms of pesos? $118,400 pesos. NOT something you want to have to carry on you. Leaving the western union this afternoon with all that money on me was quite literally the most nerve-wracking thing I have ever experienced. BA is not the safest city and lots of people saw me get the money.

There has just been so many details and obstacles (most stemming from the fact that I'm not a citizen) that makes all of this so inefficient. Like I'm peddling through peanut butter.

blannie Jul 2016
Vsmini you're doing the best you can with what your dad has chosen for his life. I think you have to step back and accept that he's made his choices and they've wound him up where he is. Thank goodness he still has a couple of friends who will look out for him.

It is NOT your job to save him. You need to worry about your own future and emotional health. Obviously, you learned some lessons from your dad's selfishness and are a caring, loving person. So go back home and do what you can from the US, but don't bring him back to the US. He's made his choice and it's in Argentina, for better or worse.

vsmini Jul 2016
Churchmouse -

Cute name -

2 of his friends that I was able to connect with speak English and my Spanish is now ok enough that I can get by (usually when I come down here it takes me a couple weeks to warm back up)

I hear you about revolving doors - he gets pneumonia every winter down here and this has been going on for months because as soon as he is released, he picks back up with smoking and drinking and then he's back in the hospital. Sometimes I think my dad is trying to kill himself. He always said he'd rather be dead than have to live in hospital beds and diapers. It is a mess but there is a small light at the end of the tunnel - I get to leave soon. He will be cared for at this facility, if we need to keep him there for a few months we will but I have to go back to the States and I can't bring him with me. Truly a nightmare.

vsmini Jul 2016
Hi everyone -

2nd update:

He was born in Argentina but became a US citizen so he is a dual citizen and would have no issues with coming back to the US in that capacity. He waived his retirement medicare years ago when he moved to Buenos Aires permanently 8 years ago after he retired.

This is what complicates matters further - he has no Argentine bank account and has never set one up. His retirement $$$ comes through his American bank account and he relies on 2 debit cards so he can have money. So what happens if he loses the debit cards? He's SOL. He's a man that doesn't really do back-up plans or maps out his future. He's always been like this and ever since I was 18 I have been trying to get him to "come up with a plan" in case of an emergency - he always shut me down. Told me not to worry about it. Yet here I am - busting ass in this country calling the embassy twice a day (yes they are helpful but they only have so much power and can't do all that much) and making myself sick trying to fix everything. I've heard "He's made his choices" many times from friends, family as well as the people here - hearing it, though makes me sad, gives me some peace on the matter. He choose to move here, he choose to cut contacts with all of his good friends so he would be left alone about his smoking and drinking, came home from the hospital and immediately started smoking and drinking again. Refuses help. What more is there to say?

Financially impossible for him to come to the United States at this time due to insurance and his poor health. He would be in the hospital immediately.

Despite the fact that he's been terrible to all his friends and that I am his only living relative/daughter he has had some ex friends come out of the woodwork and offer to keep an eye on him while I go back to the United States. He will be in a rehab facility for 30 days and then we will try to coordinate at-home care after that for him. He has 3 guardian angels, old friends of his that have agreed to help.

But for the most part - I've had to come to the conclusion that he's on his own. I will come down when I can. This trip has already cost me every bit of savings and credit I have. $25K. There is no more money to give. And even after all of this I feel tremendous guilt for not being able to just make this ok and fix everything. I am so angry with him but when I see him, I feel so bad for him.

GardenArtist Jul 2016
I think there are 2 priorities here, which should be addressed above all others:

1. Spend time with him now, comforting him as much as you can, in the event that it's not financially feasible to bring him back to the US.

2. Research the suggestions made by other posters to determine before even considering bringing him here whether or not you can get medical care for him. Personally, I'm not sure the American medical system has a way of extending care to someone who's not an expatriate, ex-citizen, and apparently is quite ill.

You might have to face the uncomfortable fact that it's not financially feasible to bring him back to the States.

I'm unclear though on whether or not he worked in the US and then left when he retired. If he did work here, does he have any pension from his employer? Did he apply for and was granted American citizenship?

Glad also makes a good point; it was his choice to leave.

Caregiverto89 Jul 2016
It might be best to concentrate on one thing at a time. You say he must stay a month more before he is released by the doctor. What can you do for him in the nursing facility he is in? If he is weak, and needs help to walk, then ask the nurse to show you how to use a gait belt and put it on him and walk with him just for a moment or two, then slowly increase the time. Learn about his medications. Use a phone/computer translator Spanish to English so you can understand. In the month you have, get some answers about getting him a passport, and possible home-health care there. Ask at the nursing department of a University or University Hospital and see if you can find a bilingual nurse who might be willing to help you care for him at home. Maybe, when he is able to travel, the nurse could accompany you as you travel. There are many programs here for care for the poor, no matter where in the States you live. When he has recovered, then the next step will be clear. Do what you can do to help him recover there, while learning what might be possible with home care or learning how to bring him back to the States. The Embassy is a good source of advice in English. Praying for you to have the help you need....

Countrymouse Jul 2016
Ohmygod, you poor thing.

If he were not your father, but someone told you hypothetically about a man who had got himself into this position, what would you think ought to happen to him?

It is a mess, and I can quite see why you wouldn't be prepared to turn on your heel and leave him to it (you'd have to be pretty hard-nosed to do that), but for your own sanity do please grasp that You Did Not Make This Mess. So the consequences are not your fault.

Is this a really stupid question? - can you travel by train?

Assuming you can't get him back to the US - planes trains or automobiles - then you'll have to sort him out in situ.

You don't speak the language... can the embassy help with an interpreter?

Forget rehab. Get him set up to stay at home with support or be admitted to residential care. He may refuse both.

Look. This is hard to type. If he's so weak he can't walk, he'll have pneumonia again before you have time to turn round. It will be a revolving door of hospital admissions, IV antibiotics, weeks immobile, decreased lung function, increased muscle atrophy, discharge home, next lung infection, hospital admission...

Until it kills him, which may not take long.

How long have you been staying in Buenos Aires? And how long can you afford to stay without damaging your marriage and your employment?

Can you afford to go and come back again?

vsmini Jul 2016
Thank you guys -

He is unable to travel back to the US due to his poor health conditions and his need for oxygen - the doctor will not clear him to travel for at least another month. On top of all of that he has no insurance and he is very sick - it would financially destroy us. We have spoken to the Embassy many times as well as our state and he cannot qualify for insurance until at least January.

It's a really really tough situation.

Caregiverto89 Jul 2016
I would call the American Embassy in Argentina, and ask about getting him an emergency medical need passport so he can come back to the U.S. as soon as he is able to travel. You are an American, and maybe by birth or naturalization, he is also. You will be able to care for him better if he is with you and you can manage communications with his health care professionals. When he gets to the U.S., see if he can qualify for Medicaid in your state. Check with the local hospitals' social work departments and see what he might qualify for in terms of insurance or care programs until Medicare enrollment is possible. With no support system there for either of you, staying there is not a good choice. The language barrier is also a problem. Wishing you the best...

Eyerishlass Jul 2016
Can your dad afford $1,000/month each month? Or is that just for a month only? Because with 1k/month you can hire a caregiver for him but that would depend upon whether he can afford only 1 month's worth of care. But it might buy you some time.

I wish I could be more helpful but I'm not familiar with the healthcare system in Argentina. I can understand your frustration.

gladimhere Jul 2016
He left the US, he has made his choice. This sounds cold but you deserve your life. They must have something like geriatric care managers there. Find one that is bilingual so you can receive updates. The hospital may have a list of them. Good luck, oh my goodness!

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