Traumatic Brain Injury Rehabilitation – Stage 5: The Discharge Process Is Finalized.

At the beginning of July, reality began to sink in, as we approached our goal of getting David out of the facility. We had to be organized with our ‘Discharge Plan’ in order to bring David home permanently. It was also abundantly clear that David wanted to get out of the facility, and expressed it in the best way he could every time we saw or talked with him. But my greatest fear was that he might ‘go over the edge’ before we could get him home.

David’s dad was not ready to retire and move to Florida with me, so he rented a small apartment while we hunted for a rental home in Florida.

The calendar seemed to help David with the time he had left at the facility once we established a ‘date of departure’. He could cross off the days and see progress being made. This helped (along with powerful anti-psychotic drugs, an anti-depressant, and a ‘spasticity’ drug) to keep David calm as he was less agitated during his therapies and I grew more confident that he would be okay in my care.

When we could not communicate with David because the phone was busy, when he was in therapy sessions, or when the phone went missing – it was eerily disturbing to me and I could only imagine how he felt when we knew he expected that call every night. One day, I got the urge to call the main switchboard to ask if someone could take a message to David. Then I composed one to Occupational Therapy – to call me during his sessions so he knew we were thinking of him. My husband thought we should get him a cell phone – but we already knew how things went missing so we nixed it and put it on a back burner to revisit down the road.

While preparing to take care of David in Florida, we worked feverishly to resolve the financial issues created by his accident. After consulting with a lawyer, it made sense to file both personal and business bankruptcy. Her advice was to let his house go into foreclosure. Purchased during the height of the market and caught by the housing bubble, they were victims of the predatory loan scandal, maxing out both their mortgage and home equity loans…a poor choice at the time even though my husband tried unsuccessfully to deter their decision to purchase the home, they went ahead anyway.

Working through the liquidation of the business assets and bankruptcy filing was both a rewarding and depressing challenge for me. It was surprising that many of his creditors understood the circumstances and were willing to right off the debt. It renewed my hope in people helping others, while others held fast and even threated legal action. What the vendors didn’t forgive would need to go into this filing. After all, we were coming to terms with the reality that David would not return to work any time soon, if ever. Fortunately, his wife was able to keep her car by continuing to make payments so she could work, but every bill went into this as well.

I took charge of coordinating and documenting everything coming into or out of the special fund we set up to take care of the medical bills that now flowed into our new house. During this time, David’s wife continued to become more distant and at one point was more interested in transferring him to other facilities within the country as far away as Massachusetts or Chicago. Although we never discussed it, I believe she thought we would not be able to take care of him at home and was probably less than thrilled with the prospect of helping me.

But I saw hope. There was a twinkle in David’s eye and the old David lurked just under the surface. I empathized with the frustration of being held captive by the casts that made movement almost impossible and the daily dose of mind numbing drugs. I could not wait to get him home because I knew it was only a matter of time before his legs would get stronger and he would walk again.

Just before David’s “release”, my husband left a disturbing message on my cell phone one night. He said that when he talked with David, he was upset, and he wanted to come home – he told his dad – “Get me outta here.” And he assured him that we were doing everything within our power to do that…but he had to be patient just a little longer.

On July 25, my sister, brother-in-law, and I went to Ohio for a fundraiser, given by our family and friends. Going back to Ohio to participate in it was emotional and I will forever be grateful for those who contributed and made us feel so loved. We are blessed to have great friends – they organized the raffle at a local winery just to help David, with all proceeds going to his fund. It was a wonderful event and the out-pouring of concern and love was truly overwhelming. In fact, the winner refused to accept their ‘prize’! This made it possible to continue David’s rehabilitation beyond the 20 days his insurance would pay. When we talked with David that night, we told him – only 7 more days to go!

My sister and brother-in-law flew home and I stayed to pack up my house. I had three days to get this done! Although it was good to be home, it was for the last time. We divided the furniture, some would come down to Florida, some would go to the new apartment, and the rest went to the Salvation Army.

We knew going in that my husband would stay in Ohio for the next two years until he retired. We would sell our northern house, and eventually look at the possibility of purchasing a house in Florida sometime down the road. We had imposed upon my sister and brother-in-law far too long. By mid-July, we settled on a house to rent that had three bedrooms that was half-way between my sister’s and the hospital. This was large enough for me to handle and could accommodate David’s wife and baby – although they would have to share a bedroom.

When we discussed this living arrangement with his wife, she informed us that she wanted to stay in the house they had purchased, at least as long as she could, then move to a condominium closer to her work. This is when we realized she planned to move on with her own life and move out of David’s.

My husband and I mourned the loss of the son we knew but started to embrace our ‘new David’. We also felt a profound sense of loss for our daughter-in-law. Even though her leaving angered me and it will be a long time before I forgive and forget what she did, it still left a ‘void’. The saddest part was watching the clear pattern that took shape as she checked herself out of David’s life to move on with own.

We continued to resolve medical insurance issues as new ones popped up. We had to deal with home health care, getting our home ‘wheelchair ready’, ramps built, sessions in physical, occupational, and speech therapy in place prior to discharge. We needed preauthorization by David’s medical insurance case manager in order to proceed with their ‘discharge’ process.

During this time, an inspirational saying came across my desk. “Happiness is when you think what you say, and what you do are in harmony.” Mahatma Gandhi

The family continued to call David each evening and to our delight, he began to talk more and more, and although most times it was just a whisper, he often asked when we were coming and what time we would be there. He still thought that every time he saw us we were bringing him home – and we imagined that his anger stemmed from the fact he was still there. We tried to reassure him that we were putting things in place and we were getting close to our new date of departure – August 1. Because of his loss of short-term memory – he asked repeatedly.

There was so much red tape it made me want to scream! But we struggled through the final paperwork for David’s release from both the facility and the medical insurance company. The biggest irritation was the fact that the G-tube (which was no longer used) had not been removed. This was another example of how the system was not conducive to addressing issues. They continued to assure me that it would be removed and I became frustrated by the facilities’ double-talk.

As the days ticked by, we told David how many days were left before we would come to get him. We already knew that it would be a challenge but we also thought of it as an adventure. As depressing as that seemed, we began to look forward to rising David again. “We’ll do it right this time…,” my husband said.

Back in Florida on July 31, I called to tell David he had one more day to go!