I seethed and I fumed as I trimmed and I shaped the bushes and as I pruned the tree branches back from the house and as I ruminated on our home health debacle. My shoulders ached from raising the twenty-foot-long pole high into the canopy.  I had been so excited to observe Weston spend three hours patiently gathering Dad’s medical condition data, kindly listening to Dad describe his growing paralysis, and giving us tidbits of helpful advice (like elevating the recliners).  I had been so excited to have a physical therapist and an occupational therapist come to coach Dad how to live safely in his home, how to become stronger even.  Knowing Dad liked his yardwork, Weston said PT would show him how to work safely in the yard and how to keep his balance.  But PT came and pushed him too hard to ride the stationary bicycle and pushed him too hard to circle the house behind his walker and for days he was nearly too weak to move and never took him outside to train him in yardwork techniques and balance exercises.  PT’s second visit contained no therapy at all, only computer problems, and an abrupt announcement that she was no longer needed and would not be coming back.  Dad was too genteel to report her rudeness and abrasiveness to Weston, partly because he did not want her coming back to boss and belittle.  And OT came and reported that, indeed, a few grab bars would be helpful, which Dad had in the first place informed her.  Case manager Weston came a second time, today, spent no productive time with Dad, offered no suggestions or course of action, stated PT would not be returning, said he (the home health supervisor) had no idea who Dad might call to have grab bars installed, instructed Dad to do whatever exercise he felt was right for him and to devise his own treatment and strengthening plan, offered to get out of Dad’s hair, and announced that home health’s role was finished.  He would not be coming back.  That was it.  That was the beginning and the end of home health.  They had done nothing.  I elevated the recliners (giving them full credit for the idea).  Mom will find someone to install the grab bars.  Nothing at all.  Except I’m sure they billed Medicare for every visit.  Dad felt diminished, belittled, abandoned, and disheartened, as if the great Home Health had decided he were a lost cause, too decrepit and paralyzed, too close to knocking off for home health to do any good.  The great Home Health left Dad with the advice to figure out his own course of treatment and strengthening and balance and activity, as if the sum of their meager efforts was, We can’t help you.  Figure out how to help yourself, if you can.  Maybe Weston thinks Dad does not need home health care, that I, Roger Baker, am the de facto home health care provider.  In 295 installments, I have not used this forum to vent anger or sarcasm or skepticism, but to find strength and tenderness and hope in the details of a very challenging experience.  But today I am beside myself with frustration and discouragement at the utter lack of home health or home help or home care and feel abandoned to stumble along do our best by ourselves.  But we still watch in wonder the hummingbirds from our dinner table, see the sugar-water level dropping, refill the feeder, marvel at their tininess and beauty, and contemplate agog their brave twice-yearly over-ocean migrations to warmer lands during our winter, and to know that the world is a beautiful and good place to be, home health be damned.