I often find Mom dozing in her wheelchair. She responds when I kiss her and is always happy to see me. But once I start talking, I wonder if she understands what I tell her or if she’ll remember anything I’ve said after I leave. I sit beside her, massaging her hand. She looks up if I vary my tone of voice or cadence of speech as if she suspects I’ve changed the subject. I often think she enjoys the rhythm of my voice but pays no attention to the words.
When I’ve exhausted the family news, I talk about the birds fluttering at the feeders and splashing in the bird bath or comment on what’s happening around us. To be honest, how much can you say about a group of elderly women sleeping in their wheelchairs or talking with a staff member or with no one in particular? Once, a patient leaned forward to talk with a friend. When she saw me watching, she cupped her hand to hide her mouth. I wondered if she was talking about me.
I arrive at the nursing home at four on Saturday afternoon. As usual I look for Dad’s car as I circle the lot hunting for a place to park. I’m disappointed when I don’t see it. I don’t see my sister’s car either, but Leslie visits Mom on her way home from work so I don’t expect to see her on the weekends. Without Dad or Leslie there, the hour will stretch on forever. I consider putting off my visit until tomorrow but feel guilty even thinking it. Why don’t the three of us overlap our visits? If Dad or Leslie is there when I arrive, I notice their look of relief. They too struggle to entertain Mom. We forget that sitting beside Mom is what’s most important.
When I don’t find Mom in the recreation area, I check the room she shares with Mrs. Battersby who is often in bed. In the late afternoon, the sun shines through the trees, providing a soft glow in their room. The odor of pills and dry skin is never disguised by the air freshener hanging on the wall. Mom’s bed is hidden behind a screen. When I cross the room, her roommate blinks her eyes at me.
When I first met Mrs. Battersby, I thought she was flirting with me. Only later did I realize her eyes twitch uncontrollably. If Mom isn’t in the room, I stop a moment to say hello and ask about her grandchildren. Her daughter brings them to visit every weekend. She is animated when showing me the latest pictures drawn by the children. Their artwork covers the wall beside her bed. A family tree hangs above her bureau with a photo of each relative.
Behind the screen, I find Mom in bed asleep. I place a chair beside her bed. I’ll wait until she wakes up although I regret not bringing a book to read. I look around but there’s no newspaper or magazine on her bedside table. When I look back at Mom, her eyes are open! I smile and lean over to kiss her. Her eyes, usually shiny and watchful, are dull, and I wonder if she’s not feeling well.
“Hi, Mom. Did I wake you?”
She frowns and shakes her head.
“It’s beautiful out today.” In mild weather, I often wheel her out to the patio to sit under an umbrella. But finding her in bed, I don’t want to disturb her. Besides, one of the aides will be by shortly to get her ready for dinner.
“Are you sick?”
Again, she shakes her head. She often won’t tell us, so I’ll ask the nurse before I leave.
“Was Dad here this afternoon?” My conversation begins with several yes or no questions to prime the pump.
She looks up at the ceiling, frowning, trying to focus her mind. “Dad?” Her voice is barely audible, as if she’s conserving energy. “I can’t remember.” There’s wonder in her voice as if she doesn’t understand why she can’t remember. I’ll also call my father when I get home to make sure there’s nothing wrong with him or his car.
“Rachel got a promotion and a raise at work last week.” I countdown the family news: the five things you need to know to start your day as they say on the news. Mom no longer asks about her grandchildren – a continuing irritant for Rachel. This no longer bothers me. After four years, I’ve learned to add specific details about them to refresh her memory.
“Leslie’s daughter, Elaine is interning with a real estate company. She’s very excited. She hopes it leads to a job after graduation”
Mom doesn’t respond. I can’t tell if she’s smiling or not.
“And Jon changed jobs and is now working in New York. Rachel is happy he’s closer.”
Looking for something to do, I see her radio and check to ensure it is tuned correctly. When she was no longer interested in watching TV, Dad set up a radio beside her bed. Mom complained the station kept changing when she turned it on. Dad soon realized the tremor in her fingers inadvertently moved the dial. He covered the tuner with tape so she couldn’t knock it off her favorite station.
“Would you like me to turn on your radio?”
She twists her head as if checking to make sure the radio hasn’t wandered off when she wasn’t looking. She shrugs.
“I’ll leave it off. Almost time for dinner anyway.”
I see a pair of nylons hanging from a bureau drawer. One has a run starting from the toe, usually caused when the aide pulls it on, and it snags on a sharp toenail.
“When’s the podiatrist coming?” The nursing staff is not allowed to cut a resident’s nails, but why? Are they afraid a blood clot could be dislodged? A cynic might suspect the podiatrists’ association had a law passed to protect their nursing home boondoggle.
“Let me check your toenails.” When she doesn’t answer, I pull the sheet up at the end of the bed. She draws her feet back with only her toes showing. I remember opening a trunk in our basement to find four baby mice living in one of Jenn’s baby shoes. With their heads tucked into the foot of the shoe, they thought they were safely hidden. Except their tails stretched back to the heel.
When I reach down and hold her foot, her leg jerks from my touch.
“Sorry. I didn’t mean to tickle you. I only want to check your nails.”
She lets me draw her foot from under the sheet. Her nylon is torn and twisted around her little toe. How can she bear the discomfort? My own toes clench at the thought of it. My little toe is so sensitive, I’m frantic when its nail snags on a sock.
I take the nylons off. Her toenails have begun to curl over her toes. Dad has forgotten to schedule the podiatrist.
“Let me get the clippers.” I find them in her bedside table. In the bathroom, I dampen a washcloth with warm water and soap and gently wash her feet. The smell is the worst part of the job, but lavender soap takes care of that. I cautiously cut each nail. Some are thicker and require pressure. I steel myself for her cry of pain, but she doesn’t react. I brush the nails onto the floor and push them under the bed with my foot. “That’ll do you for a while.” I replace the clippers and rinse the cloth in the bathroom sink.
I can’t think of anything to talk about. I listen to the cars on the main street. There’s a pause for twenty seconds when the light turns red. On green, the cars accelerate once again.
Someone is mowing his lawn while listening to a Red Sox game. The roar of the crowd echoes off the sides of his neighbor’s house. Some people play their radios at a volume that’s impossible to escape.
“Rachel and I are off to the Cape next week for the long weekend. We’re housesitting for friends. It's a small cottage,” I add, as if being exact makes all the difference. “Nothing fancy.”
“South Yarmouth. On the bay. The owners are friends from college. I don’t think you met them.”
Now the sun is shining in my face. I cross the room and lower the venetian blinds. I close my eyes and the bars of light turn green and float across my lids. Returning to my chair, I find Mom’s eyes are closed as if she thinks I’ve left. I squeeze her hand.
Her eyes open and focus on my face. A flash of alarm in her eyes. She twists her hand away.
“I haven’t gone. I’m still here.”
She’s agitated and hides her hands under the blanket. If she had the strength, I believe she would pull the covers over her head.
Something is wrong. “I’ll be back in a moment.”
At the nurses’ station. Mrs. Webster, shift supervisor on weekends, updates the white board on the wall. “Yes.” She turns around. “Oh, how are you, Mr. Aherne?”
“It’s my mother. She’s been withdrawn since I arrived but now she’s extremely agitated. Did the doctor reevaluate her medications?” After Rachel reviewed Mom’s prescriptions, Leslie passed on her questions to the doctor.
“Let me check.” She pulls Mom’s records from the cart. Every time I see her medical file, it seems to have doubled in size. This is her third folder. At the annual patient evaluation with our family, the house doctor brings all her records. He piles them beside him on the table as if to demonstrate that the facility is doing all it can for her.
Mrs. Webster clicks her tongue as she scans the records. “The doctor increased her Aricept. That should improve her attention and clarity, but it takes a couple of weeks to have an effect. He lowered the Ativan.” She looks up. “We’re monitoring her to make sure this change doesn’t increase her agitation.”
“I think it has.”
She turns to the previous page. “Your sister talked with the doctor about this?”
“Would you come and check on her?”
Closing the folder, she smiles. “I’ll have one of the aides look in. I’ll be down in a moment.”
When I return to her room, Mom’s favorite aide is helping her into her wheelchair. He lifts her feet onto the footrests. Born in Martinique, he speaks with a soothing, light French accent. He smiles when he sees me, his teeth flashing white against his black skin. “For the dinner, I’m making her ready, but I’ll take her later if you are to visit.”
“Thanks. I won’t be staying much longer.”
He leaves the room.
“He’s my favorite.”
“I know. He takes good care of you.” To my relief, Mom is less anxious. Her eyes are brighter, and she smiles. “You look like you’ve had a scare.”
I can’t help laughing. “That’s the pot calling the kettle black. I was worried about you.” What will Nurse Webster think when she comes to the room? It’s like bringing my car to a mechanic with a loud rattle and finding it runs for him without a problem.
“I’m fine. I had a good nap, but,” and she lowers her voice, “I’m not looking forward to what they’re serving for dinner.”
We talk for a few minutes. She’s more animated and engaged, almost a different person.
The aide returns to take her to dinner.
“I have to leave now. Say hello to Nurse Webster for me.” I kiss her on the cheek.
“Thanks for coming. I'm sorry I was asleep most of the time.”
In the car, I rest my forehead on the steering wheel, relieved to be away, but also afraid that I’m failing my mother. I wish the three of us could afford to move her to a better facility, but now that she’s on Medicaid, finding space in a new place won’t be easy. I sympathize with elderly people who buy lottery tickets with money they can’t spare to experience a few days of hope. I decide to stop on my way home and splurge on a few myself.
I tell Rachel about the visit and Mom’s agitation. “The doc adjusted her medications. It’ll take a couple of weeks to see if it helps.
“I can’t interfere, you know that. You saw how the nursing home reacted when they learned I’m a nurse. I’m trouble, and they wish I’d stop asking questions and just disappear.”
I remember the scene, but at the time I was more worried about Dad. He left the family meeting wondering if he’d made the right decision to keep Mom there. He was losing confidence in the staff. I told Rachel in the future not to question Mom’s care when my father is present.
“We’d be lost without your advice.”
“I’ll visit her the next time you go and see how she’s doing.”
I’m relieved. “Thanks. I rely on your medical good sense.”
“I’ll keep under their radar,” she adds. “They don’t want to know me.”
Upstairs, I lie on our bed exhausted. Rachel’s last words “They don’t want to know me” run over and over in my head. I try to relax but the refrain is constant.
I jump out of bed. “Oh, my God.”
Rachel meets me at the bottom of the stairs, frightened by my shouting. “What happened?”
I sink down on the steps. “When I arrived today, I sensed something was wrong with Mom.”
“When I first came in, she was in bed. When she woke I don’t think she knew who I was!”
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