The Long and Winding Road

I always approached her door with caution.

I longed to see her and yet I was fearful; apprehensive.

And when I peeked into her room, there she was: the woman in the wheelchair.

She looked just like my Mother.

When I entered the room, she would throw her arms in the air, grinning ear to ear.

Hallie! You’re here! I had a feeling you were coming!

I want a hug!

Did you fly here? On a plane? All the way from New York on a plane…?

Oh my…!

For more than ten years, we replayed this scene — and every time, I was grateful;
because after that, anything could happen.

Her mood could change in a flash; her sweet, playful expression could morph into a scowl; the loving caress transform into a clenched fist– ready to strike.

During one visit, my Mother raised her hands in the air; her fingers poised like a cat’s claws. She hissed, ready to scratch. I laughed; I thought she was playing, until a nurse quickly pushed me out of the way.

She scratches, she warned.

She scratches?

She scratches.

Just for the record, my Mother did not scratch people. But the woman in the wheelchair did.

And the woman in the wheelchair was, of course, my Mother.

I was always overjoyed when I found her in a good mood; we could have an upbeat, interesting conversation. On a good day, we would sit in the garden and watch the birds; exclaim over the view of Los Angeles; share stories of past.

But even on a good day, without warning the conversation could veer wildly –like a driver who suddenly ran off the road. Her words would become harsh, outrageous, nonsensical; her demeanor strident, angry, defiant; her memories jumbled, dark, impenetrable.

It happened so many times; you’d think I’d get used to it.

I never got used to it.

Sometimes it helped if I remembered an image suggested by my sister:

Think of her brain, she said, as if it were a piece of Swiss cheese.

Swiss cheese; not exactly scientific, but I liked the analogy. When my Mom appeared calm and conversant, I pictured her gliding on the solid surface. But any moment she could plunge into the void where she could no longer

Control her thoughts;

Temper her words;

Constrain her actions;

Or even have the power to try.

But even with that image to guide me, I never fully grasped what she was up against. Only now do I realize that the smart, complex, complicated woman who had been my Mother never stood a chance.

Dementia had claimed her.

And for me to think that “she wasn’t herself” was actually part of the tragedy.

She was herself, and her self was unraveling.

Perhaps it was just too painful to contemplate, but now I realize that I had witnessed the total disintegration of her being. Her personality and psyche had literally come apart, like pieces of a jigsaw puzzle.

Looking back, I think of dementia as a masquerade. Looks are deceiving; and because the woman in the wheelchair still looked like my Mother, I wanted her to be my Mother.

I wanted her to pull herself together, literally. I wanted funny, kind, smart, wry, dignified, wise, loving.

I wanted my Mama.

This woman embarrassed me.

Even years after her diagnosis, I desperately wanted to deny the power of the disease.

I never stopped longing for her to be the way she once had been.

I never stopped wanting her to be the person she could no longer be.

And that is my deepest sorrow.

The long and winding road that leads to your door
Will never disappear
I’ve seen that road before, it always leads me here
Leads me to your door …

…Many times I’ve been alone and many times I’ve cried
Anyway you’ll never know the many ways I’ve tried
And still they lead me back to the long and winding road
You left me standing here a long, long time ago
Don’t leave me waiting here, lead me to your door …

                                                           ~Sir Paul McCartney

A Swift Current Long and Winding Road

The Long and Winding Road that leads me to your door will never disappear Photo by Hallie Swift

The Long and Winding Road, words and music credited to Lennon & McCartney, Sony/ATV Music Publishing, All Rights Reserved.

Look Look Look–It’s Tiger!

It was a glorious Sunday in June.

I was heading to the nursing home.

And on the radio, the announcers could not contain their glee as they described Tiger Woods in the final round of the 100th US Open:

He’s got the line…

He’s got the speed…

And yet another birdie!

Over the years, I had heard a lot about Tiger Woods — from my Mother. A golfer in her youth, my Mom was dazzled by Tiger’s soaring career, eagerly cheering him on week after week.

And on that glorious Sunday morning, her favorite son was making history:

…that is phenomenal!

…at his most transcendent!

…a clinic of perfection!

Oh GOOD, I thought as I heard the broadcast. We will have a happy day. We will watch the conquering Tiger, and she will be so pleased.

When I got to her room, she was lying on her back, eating potato chips.

What are you doing? Stop! You are going to choke!

I like this. It’s fun.

Why aren’t you watching golf?!

I wrestled away the chips and sat her in front of the TV.

Look Look Look— it’s your Tiger!

She was more interested in the potato chips.

As I danced around the room and pointed at the screen, she gazed in its direction. Where was the expected elation, the cheers, the adulation for her Tiger?

She did not respond — even when the roaring crowd and delirious announcers celebrated one of the most decisive wins in golf history.

I was crestfallen. What was going on? The ingredients had been perfect.

But I was not able to give my Mother a happy day.

When I arrived the next morning, she was reading The LA Times. Grinning broadly, she exclaimed,

Look Look Look at what Tiger did yesterday! Oh Hallie, I am so sorry I missed it!

But Mama, we watched it.

We did?

She quickly looked down. She stared at her hands.

And in a small, sorrowful voice, she murmured:

We did?

(Oh my God, what did I just do?)

Until that glorious June Sunday, I thought I was beginning to understand this disease — the memory loss, the fantastical stories, the flashes of anger — but no one had warned me about this latest phenomenon.

In fact, no one warned me about most of the things that unfolded over the next decade. As I look back, I shake my head in wonder. I can only conclude that because her caregivers were overwhelmed, her disease unpredictable, her prognosis dire, it was ultimately no one’s job to tell me what could happen.

On that glorious June Monday, I discovered that dementia meant more than memory; more than fantasy; more than temper.

It meant that my mother could look at the TV and not see it; look at her sport and not know it, look at her favorite son

And simply not care.

On that glorious June Monday, I realized that this disease would always surprise me. I would never fully understand it. And every time I entered the halls of the nursing home, I would find a different version of my Mother.

But no matter which version I encountered, this is what I know:

She was still my Mother.

And she still loved her Tiger.

And she still loved me.

Is this really happening?

Look at this, look at this…

It’s just not a fair fight…!

 
A Swift Current  "Eve"  Rodin

“Eve” at Musee Rodin, Paris Photo by Hallie Swift

(All the announcers’ quotes –in bold– are from the actual broadcast, available on You Tube)

The Illogical Song

Oh, Hallie, guess what? Natalie Cole visited the nursing home this week!

Oh, Mama, I don’t think so. I don’t think Natalie Cole would be at your nursing home…

Oh, but she was! She is so beautiful. I almost told her I knew her father, but I didn’t want to bother her.

Oh, Mama…

In the early days, I tried to counter every offbeat comment with a careful, measured explanation. On issues large and small, I would painstakingly try to steer my Mother’s thinking.

And when that failed, I tried to prompt her words. I thought if I spoke calmly–slowly–rationally, I could put her mind on the right track.

I thought I could talk her back to reality.

Do you remember?

Do you understand?

Listen to me!

In fact, I was the one who needed to listen. I was the one who needed to understand.

During my first visit to the nursing home, she excitedly told me that she had been to lunch that week at her alma mater, UCLA. As she described her adventure, I interrupted:

No, Mama, you didn’t go to UCLA this week. It’s too far. You were here all week; you live here.

Yes, I did.

No, you didn’t.

She became exasperated.

Hallie! How can you say I wasn’t there? I was with Kaye and Florence and Mary. We had a luncheon to talk about where we would live next…

No, Mama, you didn’t go there…you were here.

Yes, I did! I have a letter. My friends’ names are on the letterhead. They are very fine women. I will show you the letter!

She was angry; agitated; combative. And I was responsible.

I had transformed a happy conversation into a confused and volatile encounter. Even worse, I had ignored her most significant and revealing thought:

We talked about where we would live next.

If I had been listening, I would have realized that she had mentioned her college friends from the honors society Alpha Chi Delta. My Mother had invoked not only a stellar academic achievement of her youth, but also the blessing of her lifelong friends.

As with many of her fantastical revelations, there was a core element of truth in my Mother’s statements. I didn’t realize it then but it was now my job to parse her words; ponder her meaning; find her reality.

It was my job to listen.

Looking back, her words were clear. My Mother needed to decide where to live next.

She needed to be the one to make this decision.

And she had discussed her dilemma at a lunch…with her friends…at her alma mater.

Was it true?

What difference did it make? If that imaginary lunch led to this very real decision, who cares?

She cared.

Years later, she enthusiastically grabbed her nurse’s hand and proclaimed:

You know, before I came here, I did careful research, and this is the very best place in Los Angeles.

Not one word of that sentence was true. All of it was true.

I began to understand that every time I crossed the threshold of the nursing home, I was entering an alternative reality–her reality.

It was never easy. Sometimes I could not do it.

But over time I learned to acquiesce to her version of events and weave them into my own reality;

our own reality.

Hallie, Hallie, guess what? I am going to be honored by UCLA!

Really? What’s the occasion?

I am being honored for my contributions to the field of basketball! They must have read about me!

Oh, Mama, that’s wonderful! Have you decided what you’re going to wear?

And as for Natalie Cole, a few weeks after her purported visit, the nursing home newsletter included a profile for the “Resident of the Month.” That month’s featured senior was a songwriter. In fact, she had been inducted into the Songwriters Hall of Fame. She had written hit records for several artists, including…

(Oh, Mama…)

including

Natalie Cole.

The women of the UCLA honors economics sorority, 1937..."

The women of the UCLA honors economics sorority, 1937: “Only those women who are Economics majors and who have a very high scholastic average are eligible for membership…”

The New Scarlet Letter

Dementia? 

The head nurse was right.

Of course, she was right.

Direct and unflappable, her words were clear.

My Mother had dementia.

But the head nurse was the only one who used that word. Even a year later, her doctors hedged their evaluation:

“She has significant cognitive difficulties…” wrote the neurologist.

“The results…are consistent with early Alzheimer’s disease…” wrote the internist (emphasis mine).

I understood their delicate choice of words; I realized there couldn’t be a definitive diagnosis.

But it took me years to learn what those careful words meant. And even after our “decade of dementia,” I am not sure I understood it at all.

Dementia/Alzheimer’s is a myriad of conditions; a multitude of behaviors; each with an unpredictable path; all of it painful.

But more than just painful; dementia has the power to shame.

And that shame is compounded by the underlying sense that if she just tried hard enough, she could think of the word; tell the story; find the road;

Recognize her daughter.

I believe Dementia is the New Scarlet Letter.

I say this because a friend’s father is forgetful and confused. To her, the signs are unmistakable.

But her sister claims he is faking; he just wants attention.

I say this because a friend’s mother has Alzheimer’s; once vibrant and popular, no one comes to see her anymore.

Suzanne is alone. Is it just too painful to witness her decline?

I say this because when I first said dementia, people said I was disrespectful. Friends would visit my Mother for twenty minutes and declare: she is fine!

For years I heard the chorus: she is fine.

I say this because I had tremendous difficulty finding resources to guide me through the labyrinth of physical, legal, social, moral, and financial issues. I received a lot of flawed advice.

For years I doubted my every decision.

And I say this because up until the moment of my Mother’s death, I never completely grasped a simple truth:

I could not ease her pain.

For years I confronted my mother’s dementia as if it were one more challenge. I came from a world where if you studied hard; you did well in school. You worked hard; you got a promotion. You picked the right partner; you got love.

Nothing prepared me for this.

I share these experiences with no small amount of trepidation. I am not a doctor, nurse or social worker. I do not have encyclopedic knowledge or answers to profound dilemmas.

But I do have stories: what we witnessed; what helped; what I would do again; a lot I would do differently.

I hope through sharing these stories, A Swift Current can be the source of ideas and even refuge. I welcome you to share your stories with me.

And together we will say the word

And not be ashamed.

Dementia.

The Three Windows Will Barnet, 1992, oil on canvas, Smith College Art Museum

The Three Windows Will Barnet, 1992, oil on canvas, Smith College Art Museum

Say It Ain’t So

Her doctor’s words echoed in my brain:

Your Mother will never go home again.

I refused to believe him.

(Not go home? No way. You were right the first time; she will dance out of here.

You’ll see. She will show you!

We will show you.)

I was determined. I was defiant.

I sent an email to everyone I knew in LA; does anyone know anyone who knows anything about eldercare?

Someone did.

Through my all points bulletin, I found a team of geriatric social workers. They recommended a new doctor, and off she went to a new team of specialists.

Her original doctor wasn’t happy with me. I didn’t care.

The new doctors put her in special program to improve her cognitive skills. (Yes…a program… that’s what we need…)

My Mother gleefully shared reports about her commute across LA. The van driver sang her name. She looked forward to seeing him.

At the program’s conclusion, she got a certificate.

When I tried to enroll her in the next level, the hospital declined; we are sorry, but you see, we are funded by grant. Our participants have to show progress. If they don’t progress, we don’t get our funding. And well, we can’t have your Mother back. She didn’t show progress.

She didn’t show progress? But she has a certificate!

She can’t come back.

I found another program: a senior center with classes to improve memory skills. (Yes, a better program…that’s what we need…)

We are sorry; your mother doesn’t exhibit the cognitive ability…

NO. NO. NO.

You are wrong. You are all wrong.

I convinced the nursing home to move her to the “assisted living” section. The residents live in cute little rooms and occasionally need a helping hand. She would prove she could be on her own. She looks so much better than the other patients… certainly my Mother doesn’t need around-the-clock care…after all, she’s not really sick…is she?

And my Mother moved to assisted living…not once, not twice, but three times.

And each time, within a few hours, she fell. After the third attempt, the nursing home administrator referred to my Mother’s “staged falls.”

Excuse me?

Staged fallsshe “falls” gently; she’s not hurt and she knows we will find her. He explained that subconsciously she knows that she can’t be on her own, so she “stages” the fall, and back she goes to full-time care.

Do you think it was starting to sink in?

Do you think I was ready to admit defeat?

Do you think despite her plaintive pleas to go home and my willful determination to make it happen, my Mother actually knew she needed to be there…in a nursing home?

Help me, Hallie!

How do I help you, Mama?

The answer came from the nursing home’s new director/head nurse.

In fact, there was nothing new about her. She had retired from the same job–in the same facility–a few years earlier.

But retirement bored her.

She was back.

She was tough.

She looked me straight in the eyes.

Her words were direct, unequivocal, uncompromising.

Your Mother is the best of the worst, she said.

You are right. In comparison to the others you see around here, she looks good.

But your mother has dementia. She is not able to function on her own. Her falls are cries for help.

Dementia.

No one had used that word before.

OK. I am ready.

Tell me, please. Tell me what I need to know.

Your Mother is the best of the worst.

She will not get better.

And she will not go home.

A Swift Current || Reflections on Elderly Parents || Say It Ain't So

Photo by Hallie Swift

You Can’t Go Home Again

Her home was the culmination of her dreams.

And as my Mother encountered the increasing physical challenges of her later years, she clung fiercely to her independence and her refuge.

I remember one particular attempt to discuss her emerging limitations:

Maybe we should look into a retirement community…?

Maybe I should just die.

And so, from 3000 miles away, we cobbled together a ragtag but reliable network of friends and cousins, neighbors and home health aides, church volunteers and Meals on Wheels. It took a village, but our Mother would remain in the place she loved best.

And for more than a year, it seemed to work. But her knee started to hurt; then it started to buckle; then she started to fall.

Her doctor’s proposal: knee replacement surgery. But my Mother was apprehensive, fearful.

Should I do this, girls?

We set out to answer that question during our annual Christmas visit, weighing her options in a brief, upbeat examination with her doctor. He countered her doubts, and happily assured us that after the surgery “you will be dancing out of the hospital.”

It’s alarming how charming a doctor can be.

After the surgery, my Mother reported from her hospital bed that she was living in an opulent room, decorated with crystal chandeliers, gold damask drapes and a heavy red brocade bedspread. It was a castle, she giggled; her every wish was their command.

I thought it was bit unusual, but I didn’t worry; clearly she was still under the effects of the anesthesia.

But the fantastical descriptions continued. I didn’t know anesthesia could last so long. Her conversations made no sense.

She could not stay at the hospital. After multiple discussions with doctors and social workers, we moved her to a “convalescent” home. It was described as a temporary interlude; the best place to learn physical therapy for her new knee.

I called her. She burst into tears.

Oh Hallie, I am so glad it is you. Last night I slept on a park bench! Now I am trapped in a school!

A school…?

Call the police, Hallie. I am lost!

But Mama, I called the number for nursing home. They answered. And they put you on the line. You are where you’re supposed to be.

Hallie, please help me. Call the police! I am lost!

But…

Hallie, HELP!

(Time Out…is this still the anesthesia? OK…I can get her through this. If I keep telling her where she is– what is going on–my smart, stubborn Mother will come out of this. The anesthesia will wear off. She will wake up; learn the physical therapy; go home.)

Yes, Mama. I will help you.

I called again.

Oh Hallie, you are missing a fun party. I am at Aunt Mary’s house and there are lots of people. I can’t find Mary, but there are so many people here. I am sure I will find her.

Mama, you are at the nursing home.


Hallie, don’t be silly. I am at Mary’s house. It’s a party. Lots of Mary’s friends are here.

My Uncle called me a few days later. I spoke to your Mother. She thinks she is at Aunt Mary’s…at a party!

(That must be some party…)

But I still didn’t get it.

I thought her mental lapses were temporary. I thought it was the anesthesia. I thought she was going home.

Do your exercises, I implored; my sister implored; our cousins implored. Our village was unanimous: Do your physical therapy and you will go home!

The nursing home notified us; Medicare will not cover her care unless her doctor prescribes more days…(Yes, I thought, she needs more days to learn her exercises; more days so she can go home!)

I called the charming doctor. I would to convince him to prescribe more treatment; give her more days. I know she will get better…

I heard his hesitation, and then I heard his words.

Your Mother had me fooled; she was so bright and bubbly; funny and sweet.

My Mother had you fooled..?

I didn’t ask the right questions. I didn’t realize that her mind was gone.

What?

I would never have done this surgery if I had known her mind was gone.

WHAT? What are you saying to me?

I am saying your Mother will never go home.

A Swift Current || Reflections on Elderly Parents || You Can't Go Home Again

California Dream– Photo by Hallie Swift

I love you I love you I love you

As I write this post, the actress Jodie Foster is still receiving headlines about her recent awards show speech. Largely ignored in this latest opinions-r-us frenzy is Foster’s poignant tribute to her mother Evelyn, who is declining into dementia.

Mom, I know you are inside those blue eyes somewhere and there are so many things that you won’t understand tonight. But this is the only important one to take in: I love you, I love you, I love you. And I hope that if I say this three times, it will magically and perfectly enter into your soul, fill you with grace and the joy of knowing that you did good in this life. You’re a great mom. Please take that with you when you’re finally OK to go.

I was deeply moved and grateful as Jodie Foster tearfully articulated the love and pain and desperate hopes of one daughter witnessing the brutality of this disease.

As we embark on a new year, A Swift Current will broaden the discussion to encompass the last decade of my Mother’s life; her struggle with dementia.

Like grief, dementia is a topic that brings instantly averted eyes and swiftly changed conversations. Despite the concern of our family and friends, I often felt very alone in my largely futile efforts to assuage my Mother’s torment and ease her decline.

Even on a good day, “eldercare” is complicated and tough. How do you care for someone with 85 years worth of opinions?

But there you are, taking away the car keys.

The journey into dementia means new, uncomfortable roles; unrelenting stress; unimagined sorrows. But for me, amid the pain, there was unqualified joy. Amid the confusion, there were unexpected gifts. The decade-long struggle engendered a renewed love and even deeper dimension to our bond. For the first time as adult women, we were inextricably immersed in each other’s lives. And neither of us was truly independent, ever again.

It was “for better and for worse”—even though we never said those vows.

But Jodie Foster, in the most public of forums, spoke to this harrowing reality. And because of her words, many sons and daughters of dementia feel a little less alone in the world. Would that we all could openly and freely and publicly reiterate her prayer; share our sorrow; and embrace our heretofore unspoken vows.

Mom, I know you are inside those blue eyes somewhere

And there are so many things that you won’t understand tonight

But this is the only important one to take in

I love you I love you I love you

And I hope that if I say this three times

It will magically and perfectly enter into your soul

Fill you with grace

And the joy of knowing that you did good in this life

You’re a great mom

Please take that with you when you are finally OK to go

A Swift Current || Reflections on Jodie Foster's I Love You I Love You I Love You ||

I Remember You Every Day, a bench in Central Park…Photo by Hallie Swift