When Parents Need to be Parented

---

For over 20 years, my dad has followed the same cycle:
Hospital → Rehab → Home → Decline → Repeat.

Every 18–34 months, like clockwork. The problem wasn’t just his health.
It was the system surrounding it.

In September 2025, dad was admitted to the ER for a suspected stroke.

Testing revealed a long-standing sinus infection that had eroded bone near his brainstem. Surgery was scheduled for December 17, 2025 - rhinoplasty for access, followed by a sinus flush. The surgeon removed two quarter-sized fungal masses. He was discharged the next day.

36 hours later, everything unraveled: fever, confusion, and a return to the ER at a different hospital network.

This wasn’t just a medical event, it exposed how fragile the care system becomes when information, timing, and coordination break down.

For the first time since 2004, I had the bandwidth to take point.

What became clear wasn’t just his condition—it was the system. Two hospital networks. Multiple specialists. No shared communication. What I stepped into wasn’t just care-taking—it was system integration in real time.

I became the bridge—connecting Infectious Disease, Internal Medicine, and ENT so decisions were made with the full picture.

After 21 days, he was discharged—stable, but severely deconditioned—and sent to rehab.

Rehab works because it provides structure. Home fails because that structure disappears. The gap isn’t effort -  it’s system design.

This time though, prior to him leaving we created a game plan: an outline of what his days would look like and small things that we could change to perhaps break the cycle. So we played with AI to determine activities he could do at home to stay engaged, exercise expectations to keep him active, and a more-natural replacement for ultra-processed Jimmy Dean's sandwiches. 

Before he left rehab, we built a plan - small changes designed to interrupt a 20-year cycle. We used AI to gather some ideas for small tweaks to his daily routines to help him stay healthier when he's at home. Then, I verified with his medical staff - his physical therapist and Primary Care (PCP) staff that the changes aligned. 

Experiment 1: Nutrition

The first big change we made was his first meal of the day. Instead of the ultra-processed Jimmy Dean's sandwiches, I started making homemade sausage sandwiches for him. It takes about 30 minutes once every 5–6 days, but it keeps him fuller longer, tastes better, and uses ingredients we can actually pronounce.

Experiment 2: Movement

Dad uses a walker to maneuver around, so I worked with his physical therapist to ensure exercises and expectations were aligned. Days I couldn't go visit, we would FaceTime as he did laps around the main living area (while I took him with me on Chicken Land tasks). Days I visited and the weather was nice, we would stroll around his neighborhood. It wasn't just about the exercise, it helped that we were chatting or joking around as we did stuff together to get him up and moving. It wasn’t just about the exercise - it was about doing it together.

Experiment 3: Cognitive Engagement

One unexpected lever was conversation. We didn’t agree on everything - especially politics, but the discussions required him to process, question, and engage. Over time, his critical thinking and presence improved.

Update 3/4/26 (1 month post-rehab):

• Weekly visits reduced from 3–4 to 1–2 
• Consistent walking routine established 
• Improved moderation in diet 
• 8 weeks of sustained breakfast prep system 

Update 3/31/26:

• PCP noted measurable improvements in mobility, energy, and overall health markers 

Most importantly:
For the first time in over 20 years, the cycle didn’t immediately repeat.

April marked a turning point in how we approached Dad’s care. After returning home from rehab and a hospital stay, we expected things to stabilize. In some ways, they did: his agility ad balance gradually improved. But at the same time, the frequency of falls increased. Between early February and early March, he fell multiple times. Thankfully, none resulted in head injury, but each required paramedic assistance to get him upright. At that point, it stopped feeling random and started looking like a pattern - so mom and I started tracking. 

Dad has long managed atrial fibrillation (AFib) with blood thinners to reduce stroke risk. But with the increase in falls, that same solution became part of the risk. Blood thinners don’t cause falls, but they significantly raise the stakes when one happens. In conversations with his cardiologist and primary care physician, we were introduced to the Watchman procedure as an alternative approach. Rather than continuing to manage stroke risk with long-term blood thinners, the procedure places a device in the heart’s left atrial appendage to prevent clot formation at the source.

For the first time in over 20 years, we weren’t just maintaining a system - we were redesigning it. Dad underwent the procedure on April 28. During surgery, doctors identified “smoky heart” (slow blood flow in the atrium), which requires extended short-term blood thinner use and additional follow-up imaging. A structural variation also required adjustment during device placement.

Next steps include a 45-day follow-up to confirm proper sealing, along with continued focus on recovery, nutrition, and consistent movement. Care-taking isn’t just about reacting in the moment. It’s about recognizing when the system needs to change - and having the tools and support in place to make that shift.

Estate Book

• Legal
• Asset & Property
• Medical Care
• Day-to-Day Care Operations

Modern care systems are too complex to navigate passively. Patient advocacy isn’t optional anymore—it’s required. This experience didn’t just change how I support my dad. It defined the role I’m stepping into next. 

If you’re navigating this with a parent, you’re not doing it wrong, the system is just hard to navigate.

More information on patient advocacy is available here: https://www.pacboard.org/#:~:text=The%20BCPA%20credential%20is%20awarded%20by%20the,(paid%20or%20volunteer)%20submitted%20as%20written%20documentation