17 May 2025
On Wednesday Joyce wrote a check from her long-dormant Bank of America account to pay for her share-of-cost for February, March and April. I told Michelle in the business office she would pay for May when her Social Security payment is received at the end of the month. And she was fine with that.
The way it works, I've been told before, is that Medi-Cal doesn't pay it's share until the patient has paid theirs. So the facility fronts the costs. But the transition to Medi-Cal is so laborious that Medi-Cal covers costs from three months before acceptance.
Anyway, we're no longer delinquent.
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YESTERDAY (no coincidence), as Joyce was dressing, there was a knock on the always-open door and the administrator comes in.
"Mr. Abbott?" he looks at me.
I shake my head. He realizes his mistake and suggests I'm Joyce's "significant other." OK.
"We haven't met," he says, forgetting he was about to tow my car until he gave me a "pass" to put on the dashboard. "I'm Mike the Administrator."
He says Joyce has been receiving physical therapy and I confirm that. And he asks me how the therapists have been.
I look at Joyce, passing the question to her. "Have Kevin and Cassie been helpful?"
"Oh yes," she says. "They've been very good."
He's satisfied with her answer and about to leave when I point to her feet with the long shoe horn. "We do have a problem, though."
I tell him I've been asking about podiatry to trim her toenails since February. And he can see she needs the service. I mention I just asked the nurse and Cassie about it yesterday and they said they'd make sure she was on the list.
But I'm not sure there even is a list.
He says he'll look into it. He knows, he adds, that their podiatrist hasn't been coming as often as he used to. I hope it isn't Osteroff, who used to cut my mother's nails at home and made a mess of it, cutting her toes, too.
He stops me in the hall later to tell me he talked to the social worker about it and if there's a list they will give her priority. I thank him.
But the thought occurs to me that since she can get in the car, I can take her to her own podiatrist in Stonestown. The building has a garage so I can probably manage the wheelchair transport without leaving her alone.
Medi-Cal will cover it at the facility or she'll have to pay for it at Stonestown. So I decide to wait to see what Golden Heights will do. But I won't wait long.
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I WAS ALSO SURPRISED yesterday by Joyce's fear of falling when she walks. I'm aware she has always said she is afraid of falling when she walks (she hasn't since September and never at Golden Heights). But yesterday she was really worried about it.
It's the reason Dr. Khanna increased the Lexapro dosage to a three-quarters dose of 30mg. Although it hasn't been long enough to affect her.
Joyce was more concerned about it yesterday.
"Do I have to walk?" Every day. "How far do I have to go?" Just to the chair in the hall by the gym, as always. "Will you stay with me?" I always do.
She did fine. As we turned the corner, we saw Cassie moving her chair further away. "Oh, Joyce caught me!" Cassie laughs and leaves the chair where it was.
And later: "Do I have to walk any more?" Not today.
It's a persistent fear but nothing seems to allay it. Not the medication, not the walking itself. I suppose it's a symptom of the dementia.
But not wanting to stand up is a big problem.