My 94-year-old mother
lives in a nursing home. She hates it, but her multiple disabilities
make it necessary. She frets that there won't be anything left
for my brother and me to inherit, and she's probably right. Fortunately,
he and I aren't the fretting kind.
My friend Angela's
father has just moved in with her. Until a few weeks ago, he lived
in an apartment, determinedly alone. Through Senior Services,
he had a twice-a-week housekeeper, a visit from a home healthcare
nurse, and Meals On Wheels, about which he grumps: "Gourmet cooking,
it's not." After a series of falls from which he could not get
up, Angela convinced him to move into the room her son vacated
when he graduated from college and left the state.
Angela and I have a
long history of sharing tales of our elderly parents. We
have laughed together, cried together, shared information, and
worried together. We also help each other immeasurably, as each
of us tries to cope with the business of parenting a parent who
is not always a willing subject.
Her father's problems
with balance won't be getting any better, as they come from an
inherited neurological disease. She reports that he is angry over
the loss of his smooth gait, and complains: "I have to shuffle,
like some old guy with a load in his pants." She managed not to
point out that he is indeed an old guy, load or no load.
He is still driving,
and Angela is trying to figure out how to convince him to give
it up.
I'm the wrong person
to ask for advice. Mother simply ignored my hints, rationales,
and ultimately my demands that she give up her car. I once discovered
that she was driving a friend to an evening concert despite the
fact that her license had been restricted to driving during daylight
hours only. I remonstrated strongly. "Oh, it's all right," she
said blithely. "I only drive around town where I know the streets."
Ultimately the problem
was solved by the sad fact that Mother had a stroke that destroyed
most of her right visual field (both eyes), leaving her legally
blind and unable to read. But even now, from time to time she
says wistfully: "I bet I could still drive a car...."
Both our parents amaze
us by the creative intelligence that they turn to the problems
of being very old.
Angela's dad lives
in a blizzard of Post-It notes to cope with his short-term memory
loss. He has mastered the Internet in order to keep up with his
grandchildren, but must keep a list right next to his computer
to remind him of the steps necessary to turn it on or off.
Mother has developed
a number of adaptive measures to cope with her limitations, everything
from lying on her back, feet in the air, to put on her panty hose,
to a careful, one-two-three method of transferring from wheelchair
to the front seat of my car. Because she has trouble remembering
the current day of the week and the date, she rips off the upper
left corner of the newspaper, where there's a weather symbol and
the name of the day in big letters (that she can barely make out),
and puts it in her shirt pocket. The only problem with that is
that sometimes she wears a shirt two days in a row. The other
day, she fished up her newspaper corner, and said: "It's Monday.
No, wait, here's another one; it's Tuesday." And then, with an
imp's grin: "My, how time flies!"
Short-term memory loss
makes life incredibly difficult, both for the person who has it,
and for the caregiver. My mother, for instance, can never remember
where she has put something. Each time she "loses" an object,
we spend lots of time trying to figure out what possible new hiding
place she has created. "Let's see," she says, "where would I put
that if I were me?" and we both laugh.
She also can never
recall what time or day a future event is supposed to happen,
and her limited vision makes leaving notes or marks on the calendar
useless. I often arrange to take her some place and arrive to
find that she is not dressed for it, or is off at the beauty shop
or in exercise class. I drill her on what's coming next, each
day when I leave her, but most of the time she has lost the agenda
within an hour or two, and telephones to ask me what it is she's
supposed to know. The fact that she has trouble processing what
she can hear over the phone causes immense frustration for both
of us.
She has lived exactly
half her life in North Carolina, and the other half in her native
California. True to what the books on geriatrics tell us, her
long-term memory is excellent, and she vividly recalls friends,
places, and events from that first half. The last 47 years are
all but obliterated, and that's too bad, because they were very
happy ones. When we drive, she will see some place that reminds
her of an earlier time, and say: "That's where Father and I climbed
the rocks" even though her father never set foot in this part
of the country. Everything seems to relate to her California childhood.
Angela's father goes
two days a week to the Senior Center in our town, which gives
her a bit of worry-free time. What she'd really like, however,
is a weekend off, so that she could spend time alone with her
husband.
There are many things
you can't do for the truly elderly. You can't give them back their
lost physical capacities. You can't remove the ache of losing
their independence. You can't replace their lost beloveds. I remember
that when my stepfather died, my mother said sadly: "The salt
has gone out of the stew." That was nearly twenty years ago, and
she didn't stop living an active, involved life, but neither has
she enjoyed it as much.
There are, however,
a few important things you can do to make their lives more pleasant.
Chief among those is simply listening. That can be hard when you
hear the same stories over and over - but in large measure, when
we get old, we are our stories, and we need to share them with
those around us. Being a listener can also be difficult when you
become the much-needed vent for angry feelings that often take
the form of tall tales. Being sympathetic while remaining non-judgmental
is a difficult balancing act.
There are also many
little things you can do to boost spirits, simple things that
make a big difference. Helping the very elderly to feel useful
is one of them. Whenever possible, both Angela and I find things
that our parents can do to help us. When there's a family dinner,
my mother snaps the beans. During holiday times, she and I make
cookies to give to others in the nursing home. Although she can't
see very well, she can still use a cookie cutter, or a spatula
to take them off the sheet or spread frosting. Sometimes she helps
me polish silver, and although I have to sneak a piece or two
aside and go over the streaks she missed, it's a favored chore,
especially since many of the items came from her home.
Angela's father has
a thing about clean eyeglasses, and every morning he insists on
washing hers for her. She often asks him to read the paper to
her as she irons, and folding laundry is a chore he enjoys, especially
matching and rolling up the clean socks.
I do my mother's laundry,
because the nursing home has lost several items and washed a few
others in water so hot they ruined the clothes. Also, they don't
iron, and my mother likes a well-ironed shirt.
I provide plain yogurt
for her morning cereal because she prefers it to milk ("I don't
like soggy cereal!"), and the nursing home serves only flavored
and sweetened yogurt. It's a small thing, but it matters a lot
to her.
I take Mother out every
day for an hour or two. Sometimes we drive into the country or
up into the mountains. Sometimes we walk a wheelchair-friendly
trail that meanders in the woods near an historic park. Sometimes
we go to the mall, just to walk around and feel that we're in
the midst of life. Sometimes we come back to my house and sit
outside on the deck, or in the winter, by the fire. Sometimes
we stop by the coffee house for a pot of tea. Sometimes we walk
in a nearby formal garden. One of her favorite jaunts is a visit
to our local "Fresh Market," where I shop for spices and coffee.
Mother refers to that as "going on a snifnik."
When we exit the nursing
home, Mother greets my little car as if it were a person: "Hello,
baby! What's up for today?" she asks. She also says: "I'm a child
of the automotive age. When the wheels are going around under
me, I feel normal again." (Her father bought his first car, a
Reo, in 1907, the year she was born. The neighbors looked askance
when her parents took her riding: "You're not taking that baby
in that, that...machine!").
Angela drives her father
to the podiatrist. I cut my mother's fingernails. We both administer
small comforts like moisturizing eye drops twice a day, and lip
balm morning and evening. Thanks to her, I've found a really good
lotion to use on Mother's dry, dry skin.
From time to time,
I haul out Mother's old photo albums, and we look at them together.
She never bothered to write the names of the people in the pictures,
so I'm taking notes and labeling them as we go, and she's enjoying
the memories.
Angela and I shop for
clothes for our parents rather frequently, because they are shrinking
and changing shape at an alarming rate. I do a lot of sewing for
Mother. Simple shortening of skirts and pants is the least of
it: waists must be let out, and shoulders tucked and sleeves shortened.
I'd let the store do it, but she cannot stand long enough for
a true fitting. Much of what I do is guesswork, but it seems to
look all right. Her arthritis makes buttoning her shirts difficult,
so I remove the buttons, sew them back on top of the buttonhole,
and sew large snaps underneath.
Every six weeks, I
go to the nursing home for Mother's "Care Plan Meeting." The people
who work with her are dedicated, earnest, and caring, but they
have so many patients that they can't always understand individual
needs. They are concerned that she is "isolated" because she hasn't
made friends and often rejects the group activities. I try to
explain that inasmuch as she can't see, can't hear, can't walk,
can't read, and in fact can't communicate in any way except to
talk non-stop, it's no wonder that she has no friends. As for
the activities, Bingo or hymn singing or spelling bees don't hold
much appeal for a former English professor whose idea of a good
time is discussing Virginia Woolf and Edna St. Vincent Millay.
She's still an intellectual, even though her intellect has begun
to erode.
Angela is also worried
that her father is isolated from contact with people other than
family. He doesn't like shopping or eating out. He does see a
young neighbor who stops by to visit with him from time to time.
Back when he was in the apartment, he made a great show of shutting
the door on the Meals On Wheels lady as soon as she delivered
his food. "She's just doing what she's supposed to do, which is
to check on you and provide you with a little friendly conversation,"
Angela told him.
"Huh," he replied.
"She's just looking to catch herself a husband. Not interested,
thanks."
On rainy days Mother
and I play Scrabble. I have to read aloud to her the letters on
her tiles. I have to place them on the board for her. She still
beats me more than half the time, although in a way, I beat myself,
since I'm the one who must find a way to connect her inspired
words to the board.
Angela and I are both
embarrassed when people give us praise for taking care of our
parents. "I love him," she says simply. "And besides, it's just
there to do."
One of her fellow patients
said wistfully to me: "Your mother is so lucky to have you." I
smiled and said something light like "I guess we're pretty lucky
to have each other." What I felt like saying was that considering
the number of disabilities Mother suffers, she's certainly earned
a little luck.
Mother is one of the
ones who must climb down the last cliff of her journey inch by
cautious inch. There aren't many ways that I can help her as she
struggles down it, but I do what I can. She did it for her mother,
who did it for her mother. I hope that my children will never
be called upon to do it for me, but if they are, I will accept
their help without apology. My friend who is an anthropologist
calls this a transactional relationship: you took care of your
children when they were small; they take care of you when you
are old. It's not that my mother is lucky—it's that people
whose children don't understand this are unlucky.
It is, in the most
profound sense, what human life is all about.
Caring
for the very old, Part One
Other
articles by Julia Sneden on the subject of the elderly and caregiving::
Blue
Plate Special - 10/19/99
Age
Rage Revisited - 1/16/00
