Scheduled Neuropsych visit - 9/16/13

This was a crazy day.  My dad's business taxes were due for a business whose financial records were a mess.  I spent a lot of time trying to piece together what I could, trying to make sense of what little information he had by matching it up to his bank records.  I had to call in a favor to the woman from his bank who was in on this situation.  She would often call and warn us when X would come in with my dad to withdrawal money.  She was able to help piece together his check records and helped me discover that he continued to write himself paychecks every month.  Sometimes several times a month.  In his mind, that was how he got paid.  It didn't matter that he didn't have money in the bank to actually cash the check.  And did his business ever deposit the payroll taxes from these checks?  Of course not!  Which is where the countless tax notices from various organizations stemmed from.  Month after month after month...

 

So I needed to finish the tax return as best I could so my dad could sign it.  The other problem was my dad's doctor appointment was in the middle of the day.  He does much better with his morning appointments because he is always home when we come to get him (by surprise, never a warning so X doesn't find out about it and make him change his mind!).  From 11:00 on we never knew when we could catch him because he would start walking the neighborhood - his daily routine.  Sometimes X would pick him up (in his car she kept).  But we had no choice, we had to take the appointment we could get and hope we could get him there.  It was always very stressful, with a lot of worrying the night before about whether or not we would actually make it to the appointment with him.  This day, we decided to have my sister go get him early and bring him to my house so we would know where he would be.  We were worried about keeping him occupied for that many hours.  We figured he'd get antsy, would keep asking for beer, and just wouldn't be able to contain himself in my house.  But it was the best option we had. 

 

Well, this was our plan.  But here is an email from that day I wrote to my uncle that explains what actually happened...

 

Just wanted to let you know my dad's appointment did not happen today.  My sister took the day off work and picked him up this morning while I finished up his business taxes that were due today.  I also made an outline of what I wanted this therapist to know.  I decided to call the VA this morning to make sure we were going to the right location, which is when I found out the appointment had been cancelled, the doctor called in sick.  This was about 30 seconds before my sister pulled into my driveway with my dad.  Needless to say I'm beyond frustrated with this process and the pace things are moving.  So all we accomplished today was getting my dad out of the house (which seemed to be good to him), we got his taxes signed and filed, and I got a new mail forwarding address form from the post office signed by him so I can get his mail. 

We did discover some interesting pieces of information though.  He still has those "visitors" at his house.  They appear to be living there in his spare room. 2 young, young females, though we swear one looks like a young boy.  He insists they're two women.  "X set this" up he says.  He said that a couple weeks ago too - she set this up to happen once his utilities were back on.  So now we're thinking they are living there and paying rent to X!

He also said that cigarettes are so expensive and that for the last year or so X has been rolling cigarettes for him - or someone she knows has been doing it.  The last year is when his behavior has taken a turn for the worst, so I'd really love to see if these cigarettes are laced with anything.  He didn't have any left and had regular ones today, but we will keep an eye out for any chance to get ahold of one.

He still seems slow and spacey, and forgetful, and just backwards in public.  I really hope we can get a correct diagnosis soon.  I left a message to reschedule this appointment.  So far they said he's not available again until 10/23!!!, so I'm going to see what I can do to try to get him in sooner.  I'll keep you posted.

 

I can't even describe the planning and stress that goes into getting him to an appointment, and then the feeling of absolute disappointment when it doesn't work out.  The scheduling at the VA is completely absurd when it comes to emergency situations.  Six weeks is the standard wait for each and every appointment.  So we felt total defeat after this day.

9/3/13 First appointment towards finding the diagnosis

I've been doing a bad job at going back in time and putting some of the back story on here.  There is so much to this.  Not just the present situation, but how we came to the diagnosis, and some of the horrible incidents that happened long before we knew he was sick.  It tore the family apart and took many years to figure out why.  I always used to pray that we would some day find out that he felt bad for all that he did, and how he treated the family.  I just wanted to know that he recognized it and felt remorse, even if he couldn't ever admit it to us.  Never did I expect it to be a disease like this.  I should be relieved that it wasn't his fault.  But it just makes me more sad that this disease had to come in and ruin half his life.  And he has no idea.  With it being Veteran's Day, it made me think a lot about him.  Growing up, I never used to give much thought about his service in Vietnam.  It was something he never talked about.  But the older I get and I am able to understand and appreciate what these veterans have done for us, I am truly proud of him.  I also can't help but wonder if this disease stemmed from him being in Vietnam.  How unfair for a person to be drafted, go to war, and then end up with this horrible life-altering disease because of it?  We will never know.  Unless of course another family member gets it and we discover it is genetic.  Either way, it's unbearable.

So getting back to his very first appointment leading to his diagnosis.  It was with a social worker from the VA on September 3, 2013.  My Uncle took him to the appointment with my one page summary of his symptoms - recent and past  - in hand.  Here is an email I sent my family about it after I had spoken to the social worker after his appointment:

Dad signed a consent form so that she could speak with family members for his health issues, so she was able to call me and talk.  I think this stands for all his future medical care.  She said he wasn't very forthcoming, which isn't surprising.  And not new to her either, dealing with all personality types there.  She picked up on his hygiene/appearance.  He told her he showers daily, and she tried to put it tactfully that she didn't think he showered today.  He told her he drinks 2-3 beers/day.  I told her that isn't true, and she knows she can't go off what a patient says, she said they lie all the time.  She said she gave him a memory test.  It doesn't hold a lot of weight in diagnostic testing, but he did poorly on it.  She said it's obvious (X - insert name of woman who took advantage of him) is involved big time and she feels she is exploiting him.  She said she called twice while he was in the appointment, and it was clear she didn't want him there.  (Strange how he answers mid-session).  I think his issue is he shuts down when he's asked questions like this, but since he wasn't able to go out and smoke or dive into a crossword puzzle, this was tough for him.  I think he shut down by not having a lot to say.  She said she's going to write it all up to his doctor and see if she can get him in sooner, and get him in for blood work also - that should be done through some sort of geriatric testing, but he needs the papers from his doctor.  I asked if she could have the dr. call me if we can schedule him sooner, because calling dad won't do any good.  Especially if X has anything to say about it.  The social worker wants to give Adult Protective Services a call.  She thinks its warranted in his case - even if I said no, she would probably be obligated to call based on what she found today.  It may speed things along, and at the least help us get guardianship over his finances sooner.  My other thought, is would he just sign that over to us right now?  Not really sure what he needs to sign, or how that is done.  I guess that would be another call to the attorney's office.

And here was my uncle's perspective after the appointment:

I took your dad to his VA appointment today - he was a little puzzled about the reason for the interview but co-operated when I explained we were going to initiate the process toward additional VA benefits. He indicated that X had already told him that she felt there were opportunities for further benefits.

We met with the social worker and I explained to her in detail the circumstances of your dad's financial and behavioral problems. I described his relationship with X and the apparent level of control she has over him.  I tried to make clear the extent to which we feel she has taken control of his life.   Your dad was surprisingly unresponsive during my presentation and offered very little comment. Ironically, during the interview, X called your dad's cell and her tone and demeanor toward him during the call (the phone volume was high enough for all to hear) spoke volumes to support our description of X and her influence over your dad. Incredibly, she even called back minutes later with a "furthermore".  The social worker was taking notes throughout -- the episode was not lost on her.

She got your dad to agree to respond to a lengthy series of oral questions - a psychological and cognitive assessment I imagine. -- he was a little irritated by some of the questions but completed the test anyway.

She feels it is necessary to accelerate the time until his next doctor visit. She said she will arrange this with the doctor and call us to advise the new date for the examination. Your dad was agreeable to this and said he would co-operate.

She also got him to sign a consent form which allows the VA to share his medical records and evaluations with you, your sister and myself.

So, that is how today went.

Let me know if any questions.

 

Looking back at this, I still can't believe how "easy" it was.  He cooperated for every appointment along the way, but we worried the whole time he would not.  He hated doctors and never went.  I think it was a fear thing.  It was so strange to us that he kept going.  We started out being kind of sneaky about it trying to almost trick him into going.  But we soon realized that wasn't necessary and he almost looked forward to getting out of the house and going.  It was such a blessing in the end.  The next appointment on the agenda was with the neuropsych on 9/16...