Hello to those who read my essays and thank you for stopping by to take a look! This piece is one I’ve written in the last few days, and I hope to post more this month than last, which turned out to be one. Uno. I can’t get The Red Man to shut up, but my own work is more difficult. Go figure.
Humpty Dumpty sat on a wall.
Humpty Dumpty had a great fall,
And all the King’s horses and all the King’s men
Couldn’t put Humpty together again.
—— Old English Nursery Rhyme
I noticed the red dried blood and purple bruising on the top of her left hand as she sat with both hands folded in the large brown leather recliner that was her assigned seat in the den and wondered what in the world had happened. This semi-conscious frail woman with wispy uncombed snow white hair slouched down in a chair that swallowed her…with her feet up in their usual elevated position. Her green sweat suit pants and bright flowered cotton blouse she wore today didn’t belong to her, but they were clean and looked comfortable enough. She sat on a white pad to prevent accidents to the leather chair. She was dozing when I came through the door and didn’t stir when I bent to kiss her unwrinkled forehead. She looked up at me and smiled and then closed her eyes again. My mother wasn’t interested in talking today.
Her caregiver Kathy sat across from me on the well-worn sofa and noticed my glance at Mom’s hands. Kathy was a tall woman and big-boned as we used to say when describing a woman her size. She had just stepped out of the shower when I arrived for my visit and her hair was wet and pulled back from her not unattractive face. She had a great smile and genuineness I liked.
“Has your mother always been a scratcher or is this something new?” she asked. “Most of the time when we struggle to get her to take a shower she scratches Norma or me. I’ve got a new one right here.” She pointed to a fresh scratch on her hand. “Yesterday Selma thought she was scratching me but instead she scratched herself so hard on her own hand she made it bleed and then pulled off the band aid I put on it. It looks worse than it is, though.”
The idea of my mother being a “scratcher” was like a foreign movie without subtitles. Difficult to comprehend, yet I knew it was true. I’d heard a nurse say the same thing in her hospital room a few weeks ago to the young aide who was to give Mom a bath in her bed. “Be careful, she’s a scratcher,” the nurse said. I had almost fainted. My mother, the prim and proper little woman who taught second grade in a public school for twenty-five years and played the piano in Southern Baptist churches for more than fifty years, was a scratcher. It’s a world gone mad.
“No, it’s not new,” I said. “I’m not sure how long she’s been doing it, but I know it happened at least once during her hospital stay several weeks ago. I’m so sorry she does it to you, but I can tell you it’s completely out of character for her.”
“Oh, no, don’t worry. I totally understand. We’ve seen most everything with our Alzheimer folks,” Kathy said.
I had entrusted the care of my mother six weeks ago to the two sisters, Kathy and Norma, who lived in the country twenty-two miles from my home in Montgomery, Texas. Their brick house was an unassuming ranch style with a beautiful swimming pool screened and covered like the ones I had seen in Florida. This made sense when I found they grew up in the Melbourne area. The sisters came highly recommended to me by a friend whose father lived with them for seven years before he died last year. My friend said her family had chosen them from several options and never regretted the choice.
Mom lived in a Memory Care Unit for the past four years in a large assisted-living residential community in southwest Houston. The setting was relatively plush and her unit housed twenty patients. The cost rose every year she was there and was now almost $6,000 a month for her care for moderate to severe dementia and the related deterioration of her physical capacities. Incontinence and lack of ability to walk without a walker were major changes in her condition in recent years. Her world was sustained by her routine and the familiar surroundings of her private small apartment that defined it. Locked entrances and exits set her boundaries and she adjusted to this world with an acceptance bordering on relief from the necessity of trying to preserve an identity she had long forgotten. When I visited her in the Memory Care Unit, I typically found her in good spirits and checking her watch to see what she was supposed to do next. Was it time for a meal? Should she be in the dining room? Did she need to go to the living room for a movie or exercise class or Wheel of Fortune or Bingo? Were they going out for ice cream? Someone had a plan, and my mother loved a plan.
God bless long-term care insurance and the benefits it provided that covered the last four years of my mother’s stay in Houston. Unfortunately, her benefit period ended this fall and economic realities made change unavoidable. Her move to the house in the country was an answer for one problem but generated a host of others. On the day I drove her to her new home, the conversation was dramatic foreshadowing of the days to come.
“Mom, don’t you think it’s beautiful to be in the country like this?” I asked her as we rode along in my pickup truck.
“Yes, it’s beautiful all right, but I wouldn’t want to live out here,” she replied.
Indeed, she did not go gently into that good night, as the poet Dylan Thomas described. When we arrived at her new home, she had forgotten the hamburger and fries I’d bribed her with at lunch to improve her mood. She reluctantly sat down in the den with her two new compatriots, Anne and Virginia. Anne had mild to moderate dementia and was in her early eighties, I would learn later. She was an attractive frail woman with pulmonary issues and needed frequent breathing treatments. Virginia was eighty-nine and proud of it and was in a better mental and physical state than either Mom or Anne. She forgot words but generally followed conversation threads and understood contexts. She was the only one of the three women who didn’t need a walker. I liked the two women immediately and hoped Mom would, too.
“I don’t understand why I have to be here, and I don’t think it’s right for you to bring me without telling me we were coming to stay,” Mom said to me when we sat down on the sofa in the den. Anne and Virginia each sat in large recliners facing the sofa and listened to our conversation. Lack of privacy was a new challenge in the intimate den, I thought.
“Well, they did the same thing to me,” Anne said to Mom. “My daughter Beverly and her husband just brought me in here one day and left.”
“Me, too,” Virginia chimed in. “But I like it now and I’m glad you’re moving in. You can have the other big chair. I hope we don’t get anybody else because we only have three big chairs.”
And so began the next chapter in my mother’s battle with the devils of her own mind and body. Within ten days, as we began the process of changing to local doctors and pharmacies for her medications, she developed a severe urinary tract infection, which is not uncommon for women of her age and physical state. But she required treatment in the community hospital for a week and after I brought her home from that stay, she hasn’t been the same. She says little and doesn’t eat solid food. The sisters feed her a liquid diet through a contraption that looks like an oversized eye dropper to me. She’s had company in the hospital and in her new home – visits from nephews, cousins, other family members and even a visit from her former pastor. She greets everyone with a smile and says a practiced thank you for coming. The level of recognition appears to be distant with no connection to the present.
Her main question for me in the hospital as she lay attached to tubes of all sorts day after day was, “How long are you going to be in the hospital? I didn’t know you were sick.” I told her I didn’t know how long but I was glad she was there with me.
Did she have the uti before she moved? Probably. Would she have been so sick if she hadn’t moved? Maybe not. The mind and body work strangely in tandem, I’ve observed, and my mother is seemingly lost without her old planned life in the Memory Care Unit. Hopefully, time will allow her to find a new routine that will offer her the comfort of consistency. Her world is like the world of Humpty Dumpty, however. All the King’s horses and all the King’s men won’t be able to put Humpty together again as he once was. The fall has been too great.