Looking at Late July Discharge from Mission Terrace

I had a good call with Mission Terrace today, which included Dr. Omelid, the social worker, the physical therapist, and Bill.  The purpose of the call was to check in on Bill's progress and to discuss possible next steps leading to his discharge.

Dr. Omelid began by saying that he felt that the best (and safest) next step for Bill would be for him to move into an assisted living facility where he would have 'round the clock care available. When asked for my opinion about that, I shared that I had been going on the assumption that Bill would return home and would have IHSS (in-home support services, paid for by Medi-Cal) to assist him with daily living. These services would be in place for up to 4 hours per day. I stressed that Bill can't afford to move into an assisted living facility without selling his home first. It's not an ideal option for now, and, Bill wants to return home.

I referenced the book I had just finished, Being Mortal by Atul Gawande, and how it talks about the importance of older people living dignified and meaningful lives w/ some degree of autonomy and independence. Dr. Omelind concurred that this is important, and said that it would be a reasonable plan for Bill to move back home with a few hours per day of support in place. He added that there would be some risk involved, but he is generally supportive of trying this out and seeing how it works. He said that Bill could be released in 2-3 weeks, and between now and then, Mission Terrace would start allowing Bill more autonomy to get a better sense of how he would do living alone. Bill kept saying, "I've been living alone since 1999 and have only fallen once."

I also spoke about back-up plans I'm working on, such as our pending housing application for the Napa VA Home, and looking into assisted living places in Oakland for further down the road.

Bill called me after the group call had ended and said that he was pleased with the conversation and is on board with the discharge plan that we had discussed. He said that he is in no hurry to leave MT, as he has made some good friends there and feels that he is actually helping the guy with whom he's sharing a room; he considers this man a good friend now. Bill's morale seems quite high -- a big improvement over how it had been when he first got there.

I am going to let Mission Terrace know that I'm planning to come to SB July 25-28, and request that they plan for Bill's discharge to be around then. I'd like to be in town for Bill's transition, but my schedule is somewhat constrained by a major home construction project that will start on July 24th.

All in all, Bill seems happy and healthy, and the medical staff at MT are being reasonable and understanding.

Added: I left message with Giselle (social worker) saying that July 26-27, 2017 would be ideal discharge dates, as I will be in SB then.