Monday, December 12, 2016

Nebraska

The care home in which Mom lives sits on property adjoined on two sides by corn fields.
Empty of tall green stalks now, light tan with only dry husks lying about, the fields rather disappear from thought.
But not from flocks of migrating geese.
Stepping out of the rental car, stiff from three hours of driving, I search the late afternoon overcast skies for sight of the geese I can hear.
It takes a moment to work out the mystery.
The geese are not flying.
They have broken their journey, certainly Vs and Vs of them by the sound, to forage for corn kernels left behind during autumn harvesting.    

Saturday, December 26, 2015

For Whom?

In the early nineteen nineties my phone calls to my parents increased from weekly to daily. Then twice daily: morning and early evening. Except when I was overseas. In England, China, India and Egypt, lengthy and descriptive emails with photographs took the place of my calls. Daddy and Mom printed the emails and photos, kept them in a thick binder to share with visitors.

From hotels, airports and theatres all over the continental United States, Canada, Hawaii and Alaska, I did the math and called. At first, to North Carolina. Then Arizona and lastly, Nebraska.

Those conversations bracketed my days and the days of my parents. Occasionally I would suggest that I cut back to once a day, thinking I was interrupting the retirement fun and relaxation and had little to report when speaking so often. Daddy adamantly refused to entertain the proposal. Mom would say, “if it’s too much trouble for you, of course.”

The calls continued. I needed them, too. Just like Mom’s lovely and cherished letters, which awaited me in hotels around the country for over twenty years, we all relied upon our connection.

Until Daddy became ill and I was waking him unnecessarily.

I stopped the early evening calls.

The last weeks of his life, Daddy sometimes didn’t want to speak to me on my morning calls. Mom would make his excuses or say “hello” for him.

Stupidly, through all the years of calls and letters, I never considered how bereft I might be when they ceased. Or (and which is worse?) became less important to my parents than to me.

After Daddy died, I spoke to Mom every morning.

I’ve always been able to rely upon Mom to carry the conversational ball. It was little effort and lots of pleasure to listen to tales of hers and Daddy’s retired life, answer her questions, let her marvel and comment on my exploits wherever I happened to be. Mom’s Southern upbringing, inborn interest in people and her curiosity about everything made her a joy to chat with. Daddy, on the extension, would chime in occasionally and laugh often but mostly he was simply there as he had been for nearly all of my life—a secure, comforting, trusted presence that I relied upon so much more than I ever realized.

In the six years since Daddy died, Mom has, of course, aged. Her world has become smaller, her conversations more repetitive, her interests fewer and her attention span shorter. More and more, it has become my responsibility to juggle the conversations, find a topic to engage her. But until recently, she was sitting there in her chair nearly every morning at 9:30 by her watch, waiting for me to call.

“Right on the dot,” she would say. Or, teasing me, “You’re late this morning!”

Seven months ago we had to move Mom into a Memory Unit in a different facility. The bits of familiarity that had held her fragile world in place for nearly six years suddenly and inexplicably disappeared. We knew that this move would be horrible for her. We delayed it long past when we should have, relying upon a part time caregiver and door alarms to keep Mom contented and safe in an Independent Living apartment which was far beyond her capabilities to manage.

What I didn’t anticipate was that Mom would be unable to reestablish a routine in this new place. Is it the brain power she has lost? Or the interest? For someone so rigidly routinized throughout her life, she can no longer find, build, fall into a schedule. She now spends much of her day in bed. Is it boredom, resignation, anger, preparation for dying? For someone always so interested in cooking, eating, dieting, feeding others, she now often misses meals and doesn’t care.

I continue to call her daily—when I’m not visiting her. 

In an attempt to make this easier on her, I’ve requested that the nurses call me from Mom's phone when she returns from breakfast. I hope to catch Mom when she’s already on her feet, before she lies down again instead of making her struggle to rise from her bed and walker herself to the phone across the room. 

Our conversations rarely last longer than a minute. Usually she tells me that they are important to her, these calls, that she doesn’t know what she would do if I didn’t call her every day. But that is a sentence she has spoken for years and years and years, something she still remembers somewhere in her fading memory. I don’t know if she’s still telling me the truth or whether she wishes I would stop. Once she said, seemingly with irritation (but I’m overly sensitive to tone, emotion and mood), that she’d only gotten out of bed to answer my call. Twice, recently, she said, “why are you calling me.” I then remind her that this is our routine. “I know that,” she will blurt.


For whom am I doing this now? If it’s only for me, at what point do I stop? My precious relationship with a stranger who became my beloved Mother when I was seven weeks old hasn’t been about me for many years. It’s all about her now. And I don’t know how to answer my question.

Saturday, November 21, 2015

Letters from the past.

The friend with whom I have been closest longest lives in Yorkshire, England. We met in 1985. When renovating the living room floor of her stone house in Otley where she has lived for over two decades, she uncovered a treasure trove of our shared history. Among the memorabilia were letters, actual posted letters written on paper, that I wrote to her before email existed. She packaged them up and sent them to me.

Unexpectedly, the first letter in the pile bore Mom’s handwriting. I gasped and felt tears forming.

Mom’s handwriting is so dear to me. It’s messy and slanted and cursive and it means home and love and connection. She has been unable to muster the concentration to write anything, now, for some time.

For years and years and years, her letters trekked to me at summer camp, in college, while touring with The Acting Company and living in New York, New Jersey and Nevada. Years and years, innumerable 8” x 6” pads of plain white paper yielding, sheet by sheet, two or three page letters detailing hers and Daddy’s lives, noting recipes I might enjoy, containing enclosures of coupons or photographs or newspaper articles, relating news of family and friends, simply saying little more than “We love you.” But they came week after week, year after year. And they tied me to my parents and my home as I moved into adulthood and gradual separation.

I stared at this first letter in the pile, written in 2004 and from Pine, Arizona, Daddy and Mom’s summer place. A few photographs slipped out as I unfolded it. They were paper photocopies of snapshots Daddy had made. He’d copied them on the printer/copier that I’d given him one Christmas. Thinner than photographs, thus easier to mail, Daddy used this technique to share the life he so loved and valued with friends back in North Carolina, down in Mesa, with me and now with my friend across the seas.

I could only glance at the letter Mom had written. I will find the strength at some point to read it but not now. Realizing that it was written only a year before her health and Daddy’s began to fade just broke me. Her words, in my hands, are lucid and engaged in life, so pleased to describe the flowers and mountains of Pine, how lovely the summer, how entertaining the grandchildren. Happy. Contented. With no thought for or clue about what was soon to happen to her mentally or to Daddy physically.


In the past few days, I’ve read through, and typed into my journals, several of the letters that I wrote. They’ve dated from the mid and late 80s. These are prompts to my memory. A precious history of my life shared with a remarkable and cherished friend so very far away.

Tuesday, January 20, 2015

From my journal thirty-nine years ago. And so, it begins...

January 20, 1976


Today Kathy Romano took me to the Costume Shop in Taylor Theatre. I was introduced to the designer, Zoe Brown, and given a costume to build for Twelfth Night. Worked for 3.5 hours tonight on it-love it.



January sunset, Las Vegas, from my roof.


Monday, January 19, 2015

TIA

Mom’s brain inexplicably shifted into overdrive on a Friday evening two weeks ago.

Did the argument with her caregiver upset her? The package sitting by the post boxes in the care home wasn’t from me for Mom, as she insisted, it was addressed to someone else.

After a few exchanges, Mom’s caregiver Cindy said, “okay,” and let Mom take the box. Placing it on her walker seat, Mom pushed the walker to her apartment, let herself be given her pills and put to bed as usual. Cindy returned the box and went home.

Seven hours later, at one in the morning, Cindy was waked by a call from the nurses at the care home: Mom, in her underwear (which meant she had taken off her nightgown), had walked to the nurses’ station in another wing intending to pay her bill.

Mom doesn’t pay bills. She hasn’t for years.

Cindy raced to the care home.

Mom had ransacked her apartment, torn her bed apart, unrolled toilet paper from room to room and thrown her many books from the coffee table to the floor.

It occurred to me as I’m writing this to wonder if Mom had remembered the box (unlikely, we would have thought) and was looking for it.


Eighteen months ago, on a Sunday morning in July 2013, Cindy arrived to find Mom sitting in her chair with her head back and unresponsive, catatonic. The ambulance arrived, took Mom to the nearby hospital where she was not hooked to a telemetry device but was monitored and a CT scan was done. We all thought she was dying. She slept, or was semi-unconscious, but picked at her hands and moved her feet in the bed like she was walking.

Due to fly to New York the following day, I changed my plans and left very early Monday morning for Nebraska. While connecting in Denver, I called my sister. Mom was sitting up in bed, as if nothing had happened, demanding breakfast and to go home. It was too late to try to get to New York so I continued to Nebraska. Mid afternoon, I arrived to find Mom sitting in her chair, as she would normally have been at that hour, reading a book.

Mom had no memory of her experience and was puzzled for two days as other residents in the care home expressed surprise at seeing her going about her normal routine. Everyone thought she had died.

Reeling from the emotional whiplash, my sister and I found ourselves Googling Transient Ischemic Attacks also known as TIAs.

Since that episode, Mom has lashed out in anger, argued with Cindy, done and said peculiar things we attribute to her dementia. But she’s not had another incident that required hospitalization.


Responding to the nurse’s call two weeks ago, Cindy arrived in Mom’s room about 1:30 AM and tried to get her back to bed. Mom was having none of it. As the night wore on and Cindy pieced the apartment back into order, Mom began methodically dipping her fingers into a glass of water and licking them. She was “taking her pills”, she said, and angry that she had so many to take.

This went on for hours.

She refused to eat, drank very little water and chose to poor her coffee on the cereal Cindy prepared for her. But, aside from her anger about the pills, Mom wasn’t upset. She knew who she was, where she was, knew Cindy. And she certainly wasn’t unresponsive as she had been the first time something unexplainable and unending happened.

Mom didn’t want to speak with me at our regular morning chat time but was encouraged to do so by Cindy. The conversation lasted only seconds and Mom, “furious about all the pills,” went back to the ordeal of taking them.

Mid morning, without warning, the pill taking ended.

Mom began obsessing about numbers, black cards and red cards, touching her fingers and hands as if pushing buttons. The verbal monologue about card colors and numbers didn’t seem related to pushing buttons.

Around ten, not knowing what else to do, Cindy and my sister took Mom to the emergency room. In her hospital gown, patterned with little squares and circles, Mom began pushing those “buttons” while chatting about black and red cards.

“You can have the black nines, Cindy.”

Still understanding perfectly who she was and where, Mom recognized her doctor and asked about his family. But the bizarre behavior continued.

Blood work and a CT scan showed nothing unusual. After four hours in the ER, my sister opted to take Mom back to her apartment and leave her in Cindy’s care. There was nothing the hospital could do but recommend we discontinue one of Mom’s drugs on the off chance this second episode wasn’t a TIA but something else.


In October, I visited at the beginning of the month and again at the end for Mom’s birthday. Sparing the details, after my second visit we added an incontinence drug to Mom’s limited medical cocktail. She received it once a day in the mornings and it proved extremely effective. One of the side effects we were cautioned to monitor was confusion.

We have been extremely careful with Mom’s medications. She is on very few. When adding one, we measure pros and cons and do our own research in case of contraindications. We had a few extremely distressing incidents with Daddy when we blindly accepted a doctor’s recommendation. We no longer do that. Skepticism is now our watchword.

Was it possible that after only two months this incontinence drug, which had made such a positive difference in Mom’s life, could cause this schizophrenic behavior? 


Leaving the hospital two weeks ago, my sister took Mom to McDonald’s to try to get her to eat. When offered food or drink, Mom very calmly refused saying, “I just have to get this done.” In her mind, she had some sort of project to accomplish but we never learned what it was. Our only clue was her obsession with cards and numbers and her constantly touching her hands and fingertips to themselves.

This went on all day. Mom did not sleep. Typically she sleeps, naps or lies in bed an average of fourteen hours a day. Towards evening, still without food, drink or sleep, Mom decided that she and Cindy were going to “wash walls” in the apartment. Mom stood for hours scrubbing the walls with her dry hands. Her stamina was unbelievable.

Finally about 5:30 Sunday morning, after what we can guess was about thirty hours, Mom, nearly falling over in her exhaustion said, “I can’t go any more” and Cindy was able to get her to bed.

Rest was what we’d all been waiting for to see if her brain would reset while she was asleep.

The episode eighteen months ago lasted less than twenty-four hours and Mom was nearly catatonic rather than manic. Since this second event was so vastly different from the first, we had no idea whether sleep would perform its miracle a second time.

But it did.

When Cindy woke Mom about 1:30 that afternoon, in the hopes of getting her back into her routine, Mom had returned to what now passes for normal. With Cindy’s help, she showered, dressed and ate a bit of stew and cornbread that Cindy’s daughter had prepared. Then had ice cream as a treat.

I spoke to Mom mid afternoon. Despite obviously fatigue, she was cheerful and alert. Our conversation touched the usual topics and went round and round familiar circles.

It took another day and a half for Mom to become fully rested and back to her routine, for Cindy to cease round-the-clock care that she’d organized with her brother and her daughter.

And for two weeks, Mom was chipper and sweet, loving and happy, alert and lucid.

Then, after a follow up appointment with her doctor, we chose to put Mom back on the incontinence drug. Within thirty-six hours she became extremely confused: “where am I, what do I do now, have I had breakfast, can I put the blanket over my legs?” Again she was wandering the halls overnight but this time arrived, showered and dressed, at the dining hall at five in the morning thinking it was time for supper.

Again, Cindy was called and, in turn, called me.

Hours later, by the time I spoke to Mom at our regular morning chat, she was perfectly normal again. She had eaten breakfast from a tray Cindy brought her and rested for a while.

Needless to say, we have removed the incontinence drug from her regimen once again.

What is this?

We know, we’ve been warned, that transient ischemic attacks, known as “aspirin failures” because prophylactic aspirin has failed, predict the possibility of a full on stroke sometime in the future.

Are these TIAs? Or are two of these mysteries reactions to a medication?

We don’t know.



Wednesday, January 14, 2015

Cats

Less than three days after the dogs died, the neighborhood cats left the dubious safety of the concrete block walls surrounding my house and began exploring the back yard.

Word had traveled quickly.

They were three. The tormenters. All large and entitled, insolent and agile. They taunted and dashed, driving the dogs mad. Samantha once attempted a broadside leap of the pool to beat feet to the corner where the ground was highest and she might stand, paws atop the wall, to watch a gray and white invader run away.

Sam didn’t make the far side of the pool. Bo’s’n, distracted by an enormous splash, skidded to a halt then loped back to stare cock-headed into the water. My dogs did not choose to swim.

Samantha, pride at an all time low, paddled to the pool side and let me lead her around to the stairs where she crawled out, shook herself violently and repaired to the shelter of the spiny Yucca where she could pretend we didn’t see her.

My dogs didn’t start this war. They merely responded to the threat. The ground squirrels living in the wood pile and inside the retaining wall were their property to antagonize but never catch, not meant as the mid day snack of a marauding cat.

Sam and Boats were vigilant. From inside the house, they would somehow know we were being invaded. They’d tumble over one another to race to their dog door and fly out to meet the challenge. They never barked, just bounded over low shrubs and stumbled on gravel as they headed in opposite directions to cover their territory.

Despite their infirmities both dogs were attentive to the end. It saddened me to see how quickly their protected world went to hell once they were gone.

Of the three cats, I dislike the large black and white male the most. He sprays the lounge chair covers, the large boulders scattered about the yard and choice areas of the retaining wall. The dirty white cat and a mottled gray one with a white-ish face, sexes unknown, saunter with impunity along the tops of the wall knocking potted plants to the ground and leaving scat. My property is the highway between their hunting grounds—vacant lots on either side of me—and they seem incensed to find pots of cacti blocking their way.

I know where they live, these magisterial cats. Once upon a time, my dogs and I passed their house on our westward walking route. We’d routinely see them feeding from open cans of cat food left amidst the weeds of their front yard. For a time, there was a plastic dome cat house amidst the overgrown shrubbery.

I might guess that these cats have never lived indoors.

In Las Vegas, most properties are surrounded by block walls some five feet tall. These walls are often the first things that go up during new construction. When the five-acre parcel to the west of me was developed, the county required it be raised six feet with fill dirt. To circumvent a flood plain, you see, in the desert.

Instead of our sharing my existing wall, as is customary, my backdoor neighbor and I each have our own since his is six feet taller than mine. Between the two is eight inches of airspace. The ground is a five feet drop from the top of my wall and cushioned, at the bottom, by years of leaves and dirt and debris. It smells musty and damp.

Early Monday morning, while brushing my teeth, I stepped outside for a moment to taste the air and temperature. The gray cat, posed atop my wall, looked at me then deliberately crawled down into the air space and out of view.

I thought that odd but went about starting my day.

About ninety minutes later, I went out to address an electrical problem with the decorative lights on the Palo Verde tree. Sometimes when it rains, the GFI shuts off, won’t reset and takes some coaxing and drying-out time before it will cooperate.

Lying on the rocks just behind the tree was a dead rat. I’ve never seen a rat here. But it was definitely a rat. I unplugged the tree from its extension cord, replaced a fuse in the multiple plug strip then went for a shovel and to reset the GFI.

I tossed the rat into the next door vacant lot thinking the cat would want to come back for it at some point then had a thought. Peering down between the walls I blurted, “what the heck are you doing down there?”

Wedged between the walls, at the bottom, was the gray cat. It stared up at me utterly unconcerned, calm, quiet and looking fairly comfortable and cozy.

“Uh, I put your rat on the other side of the wall,” I said, pointing.

The cat didn’t move or blink.

“Can you get out of there? Do you need help?”

No answer.

Pondering my options, I left the cat, returned the shovel to the shed, picked up tools and set about making my tree lighting work again.

“Maybe it’ll climb out if I give it something to climb up,” I muttered. “Like a knotted sheet. No, that’s stupid. It doesn’t need knots, it has claws, moron.”

I cleaned detritus, dried electrical plugs and reorganized all the wiring into the multi-strip. Another glance over the wall. The cat still quite content, staring up at me. A trip to reset the GFI breaker that, this time, didn’t kick off right away. Hurray.

“There might be enough irregularities in the concrete block for it to climb out on its own,” I thought. “It’s a cat, not a kitten. It knows stuff. It’s probably been down there before.”

After testing the lighting and setting the timer, I rigged a long towel to a bungie cord. Hooking it through a break in a concrete block, I left it hanging near the cat.

“You can use this to climb out, okay? I really don’t want you to be stuck down there.”

The cat looked up at me with an expression of disdain.

So I went to work.

About eight hours later, I glanced out the sliding door as I passed through the kitchen and there was the cat climbing casually out of the hole—nowhere near the rescue towel—and walking north along the wall towards its home.

I went to make sure that the space was empty. It was. Then I peered into the vacant lot. Was the rat where I’d tossed it? It was.

I felt guilty. Do I owe this cat a rat? Was that breakfast?

The top of the wall is the cat highway. Is the ground between the walls a rat footpath?

Ick.

If that’s the case, perhaps I should be kinder to the cats.





A very young Samantha watching a retreating cat from the corner behind the Palo Verde tree.