“There he is,” Mom said, pointing to one of the men gathered in anticipation of the 4:45 p.m. opening of the dining hall. She whispered so that he wouldn't overhear, but I detected the school-girl excitement in her voice. He was white-haired and hunched into his own world, like most of the residents who waited on cushioned benches that lined the walls, on the drop-down seats of walkers, and on armless chairs. A few, like Mom, sat in wheelchairs. On our way to the dining room Mom had relayed her discovery: Eddie Albert, who had starred with Eva Gabor on the television show Green Acres, lived in her assisted living facility.
As though to confirm what she'd told me, Mom called out to the man she'd spotted, “Do you ever see Eva?”
Mom's bold overture, lacking salutation, surprised me. I knew her to be shy and socially unsure. Much of my life she'd been depressed and anxious, not always available even to those she loved.
When the man didn't respond, Mom repeated her question, this time a little louder: “Do you ever see Eva?”
Eddie Albert looked up, looked bored.
“Not in years,” he said, then bowed his head again, denying Mom any further conversation. Mom smiled at me and mouthed, Just like a movie star. Then the dining room doors opened, and an aide greeted each resident and guest by squirting antibacterial liquid into their hands and wiping down the handles of wheelchairs.
Mom had moved to the assisted living facility a few months earlier, and she'd told me it was hard for her to make friends. “Most of them are a little confused,” she said about the other residents. They couldn't remember that they had sat with Mom at another meal, much less what they talked about. They couldn't keep track of the important currency of conversation among the elderly—children, grandchildren, great-grandchildren. Like a version of the movie Groundhog Day, each encounter was an introduction. Stories couldn't build. Relationships couldn't form without stories. I could see that even if Mom weren't such an introvert, she would be challenged, so I'd accepted her invitation to dinner. That night, however, Mom was doing a good impersonation of an extrovert. I couldn't remember when I'd heard her chatter so much to people she barely knew.
When I got home, I Googled Eddie Albert. He had died three years earlier. I decided not to tell Mom.
On another visit, not long after that one, I'd barely stepped through the door of her apartment when Mom called out to me, “I want you to make copies of this!” She smiled broadly as she handed me a page ripped from the Sunday Parade magazine. What had caught Mom's eye? Large gold coins, a patriotic image embossed on them, that looked like they might contain discs of milk chocolate. The ad promised unbelievably low prices for these genuine gold coins, touting this as an unprecedented investment opportunity.
“I want you to give the copies to the aides,” she explained. “They make so little money, and this is such a good opportunity for them to get ahead.”
All my life I had known Mom as a quiet, no-nonsense person who examined the fine print on the inserts that came with her medications, looking for potential side effects and contraindications with other drugs. She scrutinized contracts before she signed them. When the credit card company sent a notice of a change in fees, she read every word printed in impossibly small type on pages as thin as tissue paper. She was smart. She didn't fall for scams.
“I've been calling this number all morning,” she told me, pointing to the toll-free number on the glossy page I held, “but I can't get through.”
I quickly read the ad and spotted the language indicating the coins were neither solid gold nor actual coins, but shiny medallions commemorating America's freedom. When I pointed this out to Mom her face fell with disappointment and shame, then guilt as she remembered that she'd already given some of the aides the toll-free number.
“They probably got a busy signal, too,” I told her.
A few days later, Mom's mail, ordinarily limited to catalogs and an assortment of solicitations for Catholic charities, included a small package. I handed it to her, and she immediately opened it with the unabashed enthusiasm of a child at Christmas, slitting through the packing tape on the box with the metal nail file that was always on the side table by her chair. Inside was a gold-colored ring with a large purple stone, which Mom immediately placed on the ring finger of her right hand, struggling to push it over a knuckle distorted and enlarged by arthritis. Once past the inflammation, the ring hung loosely, but Mom looked as thrilled as if it held a diamond that had been placed on her finger by her beloved.
“This was free,” she said, explaining that it was one of three rings she had picked out as gifts for joining the Jewelry-of-the-Month club. “One of them is cubic zirconia,” she said, in a way that let me know how thrilling the day would be when that ring arrived. She quickly added that she could return any of the monthly selections for a full refund.
I had never seen any rings on her fingers other than her simple platinum wedding band and an engagement ring with a small sapphire in an unadorned, classic setting. While the top drawer of mom's dresser contained boxes of costume jewelry bedded in cotton, they were all small, tasteful pieces made by Monet or Trifari.
Mom extended her arm to display the ring.
“You've never had anything like it,” I said.
“I know,” she replied, with deep contentment.
When Mom first moved near me, I imagined taking her to concerts, movies, plays. Often when I arrived to pick her up, tickets in hand, she'd become fearful that there might not be a readily accessible restroom or that the weather would turn foul, and she'd decide to stay in her apartment. In the weeks after the purple ring arrived, Mom expressed a desire to go shopping, to go out for lunch, to see a musical. She had resisted joining the bridge group, fearing her own mental skills might have dimmed and made her into the bridge player everyone tolerated but no one wanted as a partner. Now she arranged for an aide to take her to join bridge games whenever they needed a fourth.
Mom is coming out of her shell, I thought with relief. Settling in. Adjusting. This is good. I'd never seen her out of her shell.
“I want to have a party,” Mom said to me one day.
“What kind of party?” I said, glancing around the small apartment.
“Oh, I don't know.” She paused, thinking. I could tell she hadn't gotten very far in her plans. “I could have a shower for the kids,” she said, finally, referring to my son and his fiancée. Mom and I met with the staff at the facility, who showed us the different rooms available for private parties. The catering staff presented menu options, and Mom engaged them with stories about the days when she managed food service for a school district.
From deep inside of me and long ago, I recognized a longing for a mother I'd never known: this mother. This mother, who knew her own wants. This mother, who could express joy and enthusiasm instead of anxiety and judgment. A mother willing to take chances, explore the unknown, strike up conversations with celebrities, make bold fashion statements, throw parties that defied convention.
I remembered the last time my sisters and I had been together with Mom, a dinner to celebrate her eightieth birthday. Because of our differences in age and distance, it had been more than thirty years since we'd all been together. Looking around the table at the restaurant where we'd gathered, I thought about how I would feel if I were Mom. That year I had a daughter who had left home to go to college and a teenage son with a new driver's license and friends who were more interesting than his parents. My daughter had been home for Christmas, and my joy at having both my children around the dinner table was fresh. I tried not to imagine waiting thirty years to have my children together again and wondered how my mother had tolerated the way our family had splintered and dispersed to the farthest reaches of the country.
Mom wore a pale-blue chiffon dress that night. Her white hair, thinning on top, was freshly styled and sprayed into place. Her exceptionally fair skin, shielded throughout her life from the sun, was remarkably smooth and white. In the photos the waiter took of us, the four of us surrounding Mom, awkwardly leaning into one another, Mom is so pale she seems barely there. And that is how she has always seemed—a presence nearly invisible but impossible to ignore.
Mom said nothing to indicate that having the five of us gathered around the table was unusual or meaningful. She smiled and listened as we chatted about recent developments in our lives. I wanted her to tell the maître d' what a momentous occasion this was and order an extravagant bottle of champagne. I wanted her to throw her arms wide, as though to embrace us all at once, and say, “Oh, it's wonderful to have you all together with me!”
Finally I asked her how she felt having us all together. “I can't even say,” she said. It was all she said that night, and I knew she spoke the truth. I understood her silence then, her silences all the years I was growing up. It was not for lack of emotion, but lack of ability to express what she felt. She'd turned those feelings back on herself, holding them inside her, weighing herself down with the sadness and anger of life's losses, the fear of more. Perhaps she worried that if she let the joy out, the sadness and anger might start to seep out with it, and then, like a balloon let loose, it would all whoosh out, the momentum of release tossing the receptacle every which way until it landed with an empty flop on the floor.
The woman now planning my son's shower, this mother would have ordered the champagne that night.
I wondered if this was the woman my father fell in love with, before he returned from the war in a full-body cast not knowing how he would support his family, before multiple losses of unborn babies, before Mom learned that life could be so unpredictable, scary, and painful that all she could do to survive it was disappear into herself.
As much as I liked this new mother, the change seemed remarkable and sudden. I watched closely, as I'd learned to do as a child. But instead of being alert for early signs of irritability and withdrawal, I watched for impulsivity, impaired judgment.
One night Mom and I were watching It Happened One Night—the Clark Gable version—when an advertisement for senior living came on featuring attractive and energetic older men and women laughing while they played golf under cloudless skies.
“I always wanted to retire in Hawaii,” Mom said. “Not Arizona or Florida—I couldn't take the heat—but I loved the trip I took to Hawaii.”
“Let's go!” I said, assuming Mom was just engaged in the kind of wishful thinking that allows those of us who live in the Pacific Northwest to survive winters in which one gray mist follows another. But not long after, brochures began to arrive in the mail. Four-day cruises in the Bahamas. Assisted living in Maui. A time-share in Puerto Vallarta. I encouraged Mom to talk more about the tropics, hoping I could discern how serious she might be. “I don't know that I would ever move,” she said, “but it's fun to think about.” I relaxed. Mom shuffled through her pile of pamphlets before selecting one and handing it to me, saying, “I called their marketing person, and I can definitely afford this one.”
I had, of course, heard people talk about how the aging process returned adults to the physical state of a baby, incontinent and unable to walk or chew. I wondered if aging could involve a cognitive regression as well—not dementia, but a waning ability to think complexly. Mom seemed like an adolescent who wasn't tempering decisions with an understanding of the potential ramifications, not the mother who had taught me to make choices in terms of how they would appear to the neighbors.
If genetics was any predictor, Mom would live many more years, and her cognitive abilities would stay sharp until the end. However, her physical decline, including the arthritis that made it painful for her to walk, meant she would not be able to handle the consequences of poor decisions independently. She'd spent her life saving money, and she already needed it to pay for her apartment, for meal preparation, for someone to help her shower and roll elastic support hose onto her feet, up her calves, over her knees. She had every right to make her own decisions about how she wanted to spend her money, I reminded myself. But I couldn't help wondering what would happen if she spent that money unwisely.
When Mom named me to be her proxy for health care, I had not shied away from the delicate conversations about feeding tubes, resuscitation, vegetative states. But I didn't know how to talk to Mom about what I was seeing now. Mom, you seem to be happy, and I think that might indicate a problem. I didn't know where that conversation might lead.
I told myself I was worrying unnecessarily. Yes, she was being impetuous, but in general, the changes were positive. If, at eighty-eight, she had finally stopped preparing for a rainy day, who was I to remind her? Nonetheless, I wanted to make sense of what was happening. I wanted to know who my mother really was.
I thought back to when the behavioral changes began and realized they had coincided with the start of what I considered to be unnecessary treatment for nonexistent dementia.
I accompanied Mom to regular appointments with a geriatric psychiatrist. Each time, I offered to sit in the waiting room while Mom met with the psychiatrist, but she dismissed any need for privacy, wanting me to join her. The sessions were hardly personal or revealing, but were required so that the psychiatrist could get paid for refilling Mom's prescription for anti-anxiety and anti-depression medications. At each visit, the psychiatrist gathered data about Mom's mental status, asking her to draw a clock and position the hands with the current time, questioning her about the correct day of the week, the current president. “You should ask her to say the alphabet backwards,” I suggested once, remembering the pride Mom had in her only party trick. The psychiatrist only smiled at me.
Weeks before the Jewelry-of-the-Month began to arrive, Mom had told the psychiatrist of her fear that she might be developing Alzheimer's. She sometimes walked into her bedroom and forgot what she'd gone to fetch, she explained. Sometimes she looked for the key to her apartment and found it in the refrigerator. The psychiatrist explained that these experiences were common. I could imagine “Eddie Albert” with similar fears—not knowing who “Eva” was, but assuming he should know, pretending he did because he didn't know if he was forgetting important people in his life, forgetting when he'd seen them last. The psychiatrist reassured Mom that her mental status was excellent. And then he prescribed a medication that was thought, in some cases, to minimize the advancement of dementia. “I don't think you need this,” he said, “but it can't hurt you.”
I began reading the scientific literature about the drug she was taking as well as different kinds of dementia. Though there were no specific warnings, I saw reports that while the drug was effective with Alzheimer's patients, it wasn't suitable for dementia that involved the frontal lobe of the brain—the part that regulates emotions, impulsivity, social functions, and the ability to recognize long-term consequences. I began to suspect that the drug was acting like some kind of reverse lobotomy—Mom's flat affect and reserved personality were gone, replaced by spontaneity, joy, and reckless abandon.
I liked this Mom. I wanted to keep her. I wanted us to watch The View and exclaim over Whoopi Goldberg's clothes and Elisabeth Hasselbeck's opinions. I wanted to go shopping and giggle as Mom tried on outfits she would never buy. I wanted to help her plan parties. I wanted to believe that medication that changed Mom from a shy, anxious, socially awkward person to someone who could find happiness in life was no different than the drugs she was taking for anxiety and depression—except that it was effective. I wanted to believe that while this woman was making decisions the mother I knew never would have made, they were still coming from her, perhaps as manifestations of her genuine personality, a side of her that had been long-buried but finally had found expression. At the same time, I suspected that the drug responsible for the changes was being prescribed for a condition Mom probably didn't have. I didn't know how far her impulsivity would go, or what else the drug might be doing.
I wrestled with the question of my responsibility. Mom was still competent to make her own decisions. While that might change one day down the road, requiring me to step in and make decisions on her behalf, that was not yet my role; my role was to be a companion, to run errands, to take her to the doctor, to be her advocate. But as her daughter, I wondered what my responsibility was to her personhood, her uniqueness, to the choices she'd made to be the individual she was.
The French philosopher Emmanuel Levinas would have said that my very question indicated that I had received an appeal from the Other. A call had been made to me and I was hostage to it, to my mother, and through this call, to myself. Once touched by this appeal, I could not turn away. I had to do something, act for the good of the Other, my mother. But how does anyone know what is good for another? When does medication remove layers of temperament or qualities that don't “belong,” and when does it reveal a true nature or personality? How do those who care for and about someone know where the line is that separates eccentricity from illness, quirkiness from personality disorder?
I knew that artists with bipolar disorder sometimes reject medication that mediates the extremes of mania and depression, denying that the margins where they live constitute mental illness or embracing it as a price they willingly pay for creativity. I knew that some teachers see a child who is frequently out of his seat or speaks out of turn as having an attention deficit and believe he needs drugs to move him into the zone we call “normal,” meaning consistent with societal norms, receptive to society's structures of learning. Others see that child as bright and enthusiastic, and would consider medicating him a dampening of imagination, even genius.
I also knew that the loved ones of alcoholics—the very people who beg the addict to change—frequently sabotage recovery. Life with an alcoholic might be miserable, but it is predictably miserable.
Nel Noddings, an American feminist philosopher, says the individual caring for another cannot try to put herself in that person's shoes, but must invite the person into herself and allow herself to be invaded by the person in order to know how to act, to know what is good, to experience what is happening. But I didn't know whether to invite the mother I'd always known or the mother I'd always wanted.
Mom's apartment was dark and the door was locked when I arrived. I tiptoed to her bedroom door. Perhaps she'd fallen asleep and forgotten I was coming to take her to church. She wasn't in bed. Her wheelchair was gone. I walked to the area where the residents gathered to play games, then to the library where the donated paperbacks smelled like piles of dry autumn leaves. The calendar posted by the elevator did not reveal any musical groups or speakers that might have drawn her to the main floor. Trying not to jump to any conclusions—not even knowing what conclusion I might jump to—I went to the nurse's station. Mom had not signed out, a practice that I often forgot myself when I took her to church. But I didn't know if she'd left the building without telling anyone or if she was still there. I headed back to Mom's apartment, thinking, I should have listened to my instincts. This has gone too far.
I saw her as soon as I'd rounded the corner to her hallway. She was seated in her wheelchair, dressed in her favorite green Pendleton wool blazer. The cubic zirconia ring sparkled on the hand resting on the purse in her lap. She was laughing as Eddie Albert unlocked her door.
“Lois thinks you might be making decisions and spending money a bit differently than in the past,” the psychiatrist said to Mom on our next visit, after she'd positioned the hands of the clock at three and twelve and correctly identified the current occupant of the White House. I had called the psychiatrist before the visit to discuss my concerns.
“Oh, I don't think so,” Mom said. “I ordered some jewelry that I saw on TV. Well, maybe I am buying a few more things, but it's my money, why not?” She rattled on, moving quickly from one idea to the next, interrupting herself, saying more than she'd said to the psychiatrist in all previous visits combined. When her fifty minutes were nearly up, he scribbled an order on a prescription pad and handed it to me to take to the nurses at the facility.
“We're going to take you off this medicine and see how you do,” he said to her.
A week later, when I stopped by Mom's apartment, the dirty dishes from the lunch she'd eaten alone sat on a tray next to her chair, ready for an aide to take them to the kitchen. She was still wearing a cotton housecoat over her nightgown. She was paging through the Sears insert devoted to spring lawn and garden supplies. Without looking up, she said, “I think I'll send the kids money for a lawn mower instead of having a shower.”
4 comments have been posted.
Who is the wonderful artist of the graphic?
Anne Oneill | December 2014 | 1500 SW 11th Avenue, Portland
Thrilled to read this. Medications that affect moods leave us so curious about the identity of those we think we know. With my mother I finally caught an occasional glimpse of the stress and fear of a woman alone. Although her medication dulled her, her complaints dissipated. It was as if stress made her mind return to the same old loops of worry, which current circumstances should have mitigated. Her medication didn't brighten her but her critical edge softened.
Anne Oneill | December 2014 | 1500 SW 11th Avenue, Portland
Lois has beautifully captured the essence and complexity of the mother daughter dilemma . We come from a generation of mothers who with held emotion and affection. Our mothers were more concerned with "appearances " rather than real emotion. The strong, silent reserved Jackie Kennedy role model was to be emulated. I cheered for the mother who had become out spoken and spontaneous . I wish my own mother could enjoy the same liberation. Lois's dilemma is a struggle to set aside her own joy at having the mother she had longed for and making the moral decision that would once again make her mother unattainable. I applaud her character and weep for her loss.
Mary Marini- Svigelj | December 2014 | Ashtabula Ohio
Beautifully written. I am sure others will find it helpful in evaluating situations in their own lives.
Martha Ruskai | December 2014 |