Dad feels trapped, is despondent and angry. Any suggestions?

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Dad is 85 with congestive heart failure and recently released from the hospital after a bout of pulmonary edema. He's been put on oxygen due to the fluid retention and has a condenser at home. He has visiting nurses out twice a week to check his coumadin levels as well as his permanent catheter.

The hospital sent him home with a script for portable oxygen and the nurses had them filled. Turns out he's allowed 4 tall tanks of oxygen (each lasts around 4 hours) and two small portable tanks (about 1.5 hrs) per month according to insurance. It's their stance that, since he's getting visiting nurse care, he's home bound and doesn't need more then "back up" oxygen.

Problem is, my father has a gambling habit, and insists on going to the casino at least twice a week. My sister in law is more then willing to take him (he's a different person when there..happy and more carefree thanks to the endorphins released when he gambles), but it's an hour drive to and from and once there they play about two hours. This would mean he'd use a full tank of oxygen on every trip. That's 2 tanks a week minimum when he's only allowed 4 a month, (and those are needed for backup should the power go out, which it does often in the country).

He's like a two year old on this issue. He insists that, oxygen or no, he's going to go even if he loses his in home health visits (which he hates anyway) and if he has to buy the oxygen himself. Problem is, sister in law really needs the nurses to come as they live quite a distance from any doctors or hospital and she relies on them and their advice.

We don't mind his gambling, as we feel he's earned his right to have whatever fun he can in his life, and he can afford it. We'd love to be able to see to it that he does get to the casino...we just don't see how to do it.

Anyone have any good suggestions on what to do, or what to say that will help dad better accept this situation?

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Vegaslady, I just reread your answer about getting the doctor to increasing the amount of Oxygen... In other words, if he's on 2 she could say he needs 4..that would give him twice as many canisters. I'll suggest this to sis in law to ask the Dr. if this would be possible. If the doc agrees that the gambling is like medicine to him, maybe she will do it... It's a possibility to explore anyway... Thanks!
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Vegaslady... we did try talking him into bingo, but he's very anti social at this point, not wanting to interact with anyone, which he doesn't have to do at the casino but would have to do at a senior center. Jessie and Jeanne...Dad can afford both the gambling and the oxygen twice a week. The question is how to get the script for the Oxygen and how to get additional oxygen for the trips without going through the visiting nurses. There's no doubt that his insurance would stop the nurses if they knew he was going gambling. But he needs those nurses, or at least my daughter in law does. She doesn't have the time nor the where with all to take him twice a week for care and testing as well as taking him twice a week to a casino.

He can not afford the nurses without the insurance. It's easy to say just tell him he can't have both the nurses and go to the casino. I have advised they talk to his Doctor, but sis in law doesn't think the doc will agree that he needs the gambling. She, on the other hand, think that without the gambling he's just going to give up on life, since it's the only thing he looks forward to doing these days. She says it makes him a different man when he goes and for a couple days after... it's like medicine to him and without it she thinks he'll become so depressed that will be very difficult for them to have to deal with.
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Can he buy his own oxygen for the trips, not going through insurance? How much is a tank? What is his weekly budget for gambling? Could he afford the oxygen if he only went to the casino once a week? Or does he have sufficient resources so that he can afford both the gambling and the oxygen twice a week?

The other issue, though, is the assumption that he is "home bound." If he can make a two-hour round trip twice a week to a casino, the reasoning goes, he could make trips to the clinic. The nurses are coming to him because it is a hardship to get to them. So even if he can afford it, going out that far that often may violate the terms of his home care. I remember that the conditions listed on my husband's orders were that he could only leave home for religious services or infrequent special family events, such as a graduation. (I sneaked him out once to see autumn leaves -- don't tell on us.)

Can he afford to pay for the extra oxygen, and the visiting nurses, and the casino? I guess if you have enough money lots of things are possible.

Maybe discussing this frankly with his doctor would help you come up with a solution.

I wish you well!
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I'm sorry, but I think your father is going to have to learn to live within his financial and oxygen means. Perhaps you guys can work out a budget how much extra he is able to pay for O2 each month. I know that gambling a lot means losing, so I can't see paying so much for O2 so he would have enough to lose money twice weekly. I understand gambling is something he enjoys, but everyone has to balance enjoyment with finances.
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Get his doctor to increase the rx amount for oxygen. Or let him pay for it himself, either from his gambling winnings or what he has saved from not gambling. Couldn't he go to Adult Day Care and play Bingo?
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