




"There's my sister," Mom says, as I come into her room. She's sitting with her ST, Lisa, and Lisa says--"Now, Dorin, she really isn't your sister, is she?" Mom smiles a little complicit grin, and lets a second or two go by before saying--"True...true...she's not."
I feel suddenly relieved, as Mom's confusion over family members is something that distresses me--her constant references to her grandsons as her "sons" and to my sister-in-law as her "mother." This last one truly bothers me, nothing against my sister-in-law, it's just that I know how much my mom loved her mother and I know how much she mourned her (still mourns her) dying when Mom was twenty-one. Mom's sister, on the other hand, was not whisper close to Mom. Last week, when I asked her about Marguerite, I said--"Were you close like best friends?" She waited just a bit to answer, and then said--"No...we weren't....but I loved her nonetheless."
I keep trying to figure out Mom's complicated network of family relationships--why is Terry "mother" and why am I the "sister"? I'm the one here every day living her therapy, her meals, her boredom with her. While I know such transpositions are common with Alzheimer's patients, experiencing these missteps is another thing altogether.
"Oh...I love my sons," I can just hear Mom saying to Lisa--her voice is clear, confident, almost loud, takes me out of my musings and back into this room, Mom's room here at the Mirabella. "They are so delicious." While I'm trying to "not be present," to not interfere with the therapy session, I can't help but turn my attention to Mom just now. I can't wait to hear what she loves about her sons. Last I heard, one of them, Peter, was living defiantly somewhere in Arizona, though I have not been able to track him down through phone books and the Internet--it's been twenty-nine years since he left. The other son, Eric, Mom of course loves--but I wouldn't call him "delicious." He's more bristly and sometimes irreverently funny. As it turns out, Mom is really talking about her grandsons, Alex and Nick, but slips easily back and forth between these two generations as if thirty years is a matter of little concern. While Mom is time traveling, I am anxiously sitting on the side of Lorna's bed, wondering if Mom is going to pull this one off--wondering if today is the day Lisa is going to figure out just how confused Mom really is. I know I shouldn't be thinking this, but I feel afraid, not wanting Lisa or any of Mom's other therapists to decide that Mom is "too far gone" mentally or physically to rehabilitate.
I've never had a sister--two older brothers, yes, brothers so distant in age that I have always felt deprived of a blood-closeness, what I imagine it must be to have siblings you might depend on, confide in. My brothers and I have never been this way. But I do have sisters of another kind, better than blood because we associate by choice, by need, rather than by paternity. Lora and Laura, Cindy and Sara, Bonnie and Jilly. When we need each other, the bond is there. I feel fortunate about this. They are my family, along with my tabby cats.
Today is a difficult day--not just the first day of classes but also the date of Mom's first Care Conference at Mirabella. I am here, along with Lisa (Mom's private pay care manager), Jennifer (Mom's private pay OT), Marla (the social worker for Mirabella), Andrew (RN), Lisa (ST), Johna (OT) and Beverly (PT). We all at here around an oval table and ready to converse about Mom. Johna wants Mom here at the conference, but I just can't do it, can't expose Mom to the kind of frank dialogue I am imagining we will have. Does Mom really need to hear the long term projections her therapist make about her inability to regain use of her legs? Maybe she does, after she's done what she can, maybe then she needs to know. But for now, there are already enough tears getting in the way of her ability to focus on her rehabilitation.
I appreciate the honesty here in this room--how the collective wisdom of Mom's therapists is that we need to focus on Mom enjoying the next few months, years rather than spending it on therapy that is not likely to go anywhere. The idea seems to be that some gains will be made but significant progress is unlikely. In other words, we--the family--need to get our priorities straight.
Mom's PT, Beverly, reports that Mom has made strides in regaining some control of her torso--now she can sit for a minute-and-a-half on the edge of the therapy bench without falling over to the front or the back. This seems amazing to me--just three days ago all she could do was sit for two seconds before tumbling to her side. Mom's right leg is very "spastic" and will require a brace to keep the muscles from tightening to a point where Mom would no longer be able to move her leg. Mom is still very much a full transfer, full assist, an issue that requires two caregivers at present to handle.
Mom's OT, Johna, reports that she is still working on pre-steps with Mom--those preparatory movements we use to do such things as dressing, bathing, grooming. She
is able to pick up twelve ounce bottle of water (with gravity), however, and pass it off (a short distance) to Johna. This is amazing--I saw it for myself several days ago. However, Mom continues to have what Johna refers to as the "windswept look," meaning that Mom's body remains contorted in a twist of neck, back and hip stiffness and "tone," resembling a tortured "s." Mom's body mechanics are poor for this reason; she has a long ways to go to get her body back to "mid-line." Johna spends most of her time working with Mom on simply gross motor functions like sitting up straight, leaning forward and back, etc.
Lisa. Mom's ST, reports that Mom has significant word finding issues and concentration issues--neither of these is new to me or to Mom, as she was this way before the stroke. Despite the temporary decrease in Mom's swallowing and chewing capabilities last week, Lisa plans to observe Mom for several more meals and then, if all goes well. bump her up from soft mechanical back to a regular diet.
Andrew, the RN, reports that Mom's affect seems "smiley"--a big improvement over how she was last week and the week before. As he puts it, there are no longer "thunder clouds everywhere." Mom's Remeron (for depression and poor appetite) has been increased from 22.5 to 30 mg. Mom's other anti-depressant, Celexa, has been increased to 40 mg. Mom is still crying quite a bit, so much so that her sleep is interrupted during the night. Mom still has available to her oxycodone for pain, Risperdal and Lorazepam for anxiety. Other drugs she is taking are Fosomax (70 mg) for bone density (Mom has significant osteoporosis), Namenda (for her Alzheimer's, though it's doubtful this drug is doing any good as Mom's too far along in the downward curve of the disease) and Docusate Sodium (for her recurrent constipation maybe due to a neurogenic bladder). Should I be worried about so many drugs in her system?
Finally, Marla, the social worker for Mirabella, reports that we, the family, need to be thinking about "what to do with Mom," as Marla puts it, as Mom will be released most likely in about five weeks. Her total stay here will be about two months. "What to do with Mom" is a difficult issue, as no one option at present seems ideal. Returning home has always been the goal, but Mom requires two caregivers now--turning her in bed for a change, cleaning her bottom, transferring her in and out of bed, in and out of her wheelchair, all prove more than what Lorna or Mulu can do by themselves. Unless Mom should vastly exceed the expectations of her therapists, this is not likely to change in the next five weeks. On the other hand, Mom can't qualify for assisted living, even with a caregiver, as Mom is a two person assist; assisted living situations are "standby assistance" facilities only, meaning they are at the ready in case something happens but cannot help in ordinary daily event like transfers, feedings, etc. An adult family home is an option, but I just have a difficult time seeing here there--she is such a private person, a recluse almost. Mom has few friends--its always been this way. For having lived 85 years, she has acquired little continuity of connection, aside from her family. And even here her track record is not great: one son who shuns her; another who has disengaged, choosing to live a long ways away in voluntary isolation; and a daughter who Mom has had a push-pull relationship with for years. Is this how all families end up?
The atmosphere around this conference table feels tense, especially at the beginning. Do these people not get along? At the same time, everyone seem to genuinely like Mom and want to continue working with her. I am relieved to find this out--I have been worrying she's likely to be "evicted" soon. But all the while, as I am listening to Mom's therapists talk, I'm worrying a pointless thought--this can't be my mom, this woman who will never regain use of her legs, who will be lucky of she can re-learn how to put on her own shirt, much less feed herself. She must be someone else's mother. It will be difficult to find dignity in this.
Later, after class, when we go to the market, Mom is subdued. It's a beautiful blue autumn day, not quite as warm as last week, but nice all the same. Mom's dressed in her black coat, because my sister-in-law has Mom's red shawl, the one Mom wore the last time we went. When we get outside of the building I notice the elm trees lined up on Fairview, in front of the Mirabella. "Look Mom," I say, "the trees are turning gold." Mom is tilting or rather sagging to her right in her chair, so it's a struggle for her to see the trees, but she does. She's the one, in fact, who tells me they are "elms"--something that surprises me: both that she knows and that she can recall the botanical name. And it's also a struggle for her to smile once we get to the market. She's watching her feet or maybe other people's feet, because of the way her body is leaning. I wonder what she's hearing, what she's thinking--maybe this excursion is just too much for her this day. When I ask to take a picture of her with her $10.00 bouquet of flowers ($5.00 more than last week), Mom complies, but her smile is half-hearted. There's none of that spontaneous joy that occasionally marked her days this past week. When we learn this will be the last week for the market this year, she hardly seems to notice.
Back in the room, she refuses to taste her booty--the apple strudel we got from "Little Prague," the pumpkin ice cream from Whideby Island Ice Cream Company, the rainbow grape tomatoes from the Vietnamese grocer. They stay intact in her bags. I miss my "little piggy Mom" and the gusto in which we attacked last week's treasures.
Where has my mother gone?
I give up trying to interest her in a spoonful of pumpkin ice cream or a nose-full of Dahlia and marigolds (even though they may not smell, they do give off a clean, end-of-summer sort of perfume). Instead, we just sit, soaking in the absence of hustle-and-bustle, soaking in the place we have arrived, the two of us together.
Maybe she's just tired, I reassure myself.
Maybe I'm tired too.
Am I my mother's sister? I ask this of myself as I kiss Mom goodbye on the forehead and cheeks, her skin feels cool, papery to my touch...not quite living. I leave her to her newly arrived company, her nephew, Paul--Marguerite's son; she's not got much left to give him. I think of Mom there, prone, her striped boat shirt tucked beneath her sheets for sleep when really it's a long time before lights out. She's got her jet beads wrapped twice around her neck, a small vestige to beauty, to the woman who use to design and sew all of her own clothes from fashion photos in Vogue and never arrive anywhere without her hair coiffed and her fingers and neck bejeweled. Now, her hands and neck are devoid of treasure. Instead, the fingers of her right hand claw the top edge of her blanket, bent together at an angle not likely to be of functional use. This image of Mom is gripping, sticky in my head.
Other sleeping images of pain come to my mind--my grandfather Gus, Dad's Dad, right before he died in 1980, curled up into a fetal ball, disconnected from the world. My uncle, Court (Marguerite's husband), quivering with pain in a sleepless sleep, wishing for death. My aunt, Marguerite, in her pink and baby blue velor sweat suits, "sleeping" through her days in an Alzheimer's stupor, my mom nearby, tears running her cheeks.
By now Mom's tired and tearful--what happens most days by the end of the day. I wonder how she'd be if she'd been told the real story--that she's never going to regain use of most of her body. Maybe the tears would never stop? But then again, maybe she already knows--isn't this a good enough reason to weep?
As I wait for the elevator, I am imagining her eyes shut, her brain slowed to a point just shy of sleep--just the way I saw her when I left. Nothing that happens in her room will reach her now. She's traveling somewhere else, somewhere not even a sister or a mother or a daughter can go. Are we "friends for life" like sisters are "suppose to be"? Are we sisters in a common struggle--equal partners in a venture called Mom's health? What kind of sisterhood are we?
In the end, I will take whatever Mom has to give--sister or daughter or nothing at all. Whatever we are, this will have to be enough. Living in our present, making no claims for a common future. What other option do we have?
Deeply, a mother's daughter
--this is alifewithmom--