By Ed Davis
Walking in the front door of your mom’s nursing home, you’re immediately confronted by men and women sitting on chairs and benches beside the door, looking like a reception line. They’re waiting to see a face they recognize. You say hi and smile, sorry to disappoint them. No response, but they’re not being rude. Age has drawn their mental curtain; they live more inside than outside their minds. You walk in wonder here, for you’re seeing yourself: not only in the future, but now, with thoughts about the elderly you’d rather not admit, but must, if you’re to grow your compassion for them as well as for yourself.
You sign the register. You want the powers-that-be to know you visit. You drive down from another state twice a year, not nearly often enough, and stay for a little while, though it seems like hours. You never get used to being here, never ready to face your own guilt and sadness. Can’t someone reduce the extreme neediness you perceive in these old people? Secretly you know that only you, and others like you, can assuage the hunger for meaningful contact with your visits, although they seem to bear such meager fruit.
You resist reaching out and patting someone’s shoulder. You fear a lack of response or, God forbid, a request you can’t possibly fulfill. Doubtless many of the patients have the same mental health issues your mother does, possibly worse. An outburst might leave you too rattled to continue, though you’ve never been seriously tempted to just turn around and leave. For a moment, you want a guide, a beneficent, smiling hostess to make things less awkward, more comfortable, to make these folks seem more like the senior citizens you occasionally taught in your college classes and less like aliens. But this is not the retirement community you’ve seen on TV or in colorful brochures highlighting the handsomely dressed and well-coiffed, posing with their beaming loved ones. These are the fast-fading elderly, and they’re poor, or at least not well-off. You can never forget economics here in the Land of Medicaid. If your mother’s care were up to you alone, you’d be bankrupt within a year. And that’s not all. Given the psychiatric diagnosis your mother received upon entering the home—schizophrenia with borderline mental retardation—meeting her needs would exhaust your mental and spiritual resources within a month. That’s why she’s lived here almost a third of her long life, entering when she was only 63.
You first started visiting 30 years ago, in your early 40s, accompanied by your mom’s older sister, who, upon entering, owned the place like a glad-handing politician at a county fair. Aunt Helen smiled at and spoke to every resident we passed. How can she be so comfortable? you asked yourself, graceless and amazed. But she’d always cared for others, strangers as well as you and your mother; sometimes you wouldn’t have eaten without her largesse—not to mention her calling you “precious” when no one else did. Her incredible generosity of spirit has never come as easily to you. It would be a few more years before you went through your own mid-life crises—divorce, addiction, recovery, remarriage—which taught you, by hard necessity, enough humility to meet these folks’ eyes, and to meet your own in a mirror with a certain measure of equanimity and hope.
You hardly glance any more at floors, walls, and people for cleanliness. Everything sparkles. And unless someone has had a very recent bathroom emergency, there’s no hint of bodily waste, in fact, no trace of alcohol or medicine, either. Yet there is an odor, an amalgamation of anti-microbial sanitizers and food, if it’s near mealtime. You proceed down pristine corridors, losing the light as you go.
Deeper into the labyrinth, past the cafeteria and the business office, the air thickens. You still occasionally take the wrong turn and get lost, have to retrace your steps. You walk slower now, not wanting to bang into either food/medical carts or wheel-chaired residents of long-term care, lining either side of the wall, narrowing the passage like a clogged artery. For a moment, you hear Dante’s “Abandon all hope ye who enter here,” then banish the allusion as over-the-top cruel. You’d rather believe, just by looking at their faces, that every man and woman has a history worth your respect, stories to dwarf your own woes, your adult life mostly full of comfort and privilege. You suspect, too, that many of these folks may be wiser and more knowledgeable than you about lots of things—or they were before losing their memories.
When you first started coming here, you were overwhelmed by a demanding teaching career and the unrealistic expectation that you’d be loved by your students just as you loved your own professors. By age 40, you were plagued by an assortment of vanities and character defects. But you faced and even made progress in mitigating the worst of these as you kept coming to visit through your 50s and into your 60s. Your baggage is slowly lightening, you hope, as you approach eligibility, for you believe you will be here, figuratively if not literally, assuming you stay alive. Whether in or outside your own home, you’ll be housed inside a body and mind that make you an immigrant in your own country as you’re relegated to the land-within-a-land of the truly old and elderly, the soon-to-die.
Putting all that baggage aside, you move on. It’s that or go back.
Passing the empty nurses’ station, you start down the long hallway, resisting the urge to glance past open doorways into patients’ rooms. You did that last time and regretted glimpses of folks in bed, mouths agape, staring at the ceiling. Eyes straight ahead, you pass parked wheelchairs, aides and nurses doing their jobs quietly, efficiently. You muster your courage as you close in on your destination at the heart of this former hospital.
You know you stand out in your visitor’s civvies, carrying your plastic bag containing a six pack of Coke; plain, not frosted, donuts; and York peppermint patties—her former favorites, which you hope that she still likes. Oddly, no one pays you any mind, for which you’re grateful and relieved. The closer you get, the more focused you become, wanting to get in and out without making a fuss. You regret the inconvenient, even heart-breaking, truth that this journey is almost too much to bear. Maybe it’s the grooved path itself—familiar and known—that keeps you walking it, year after year. It’s the least you can do, for your mother, for yourself.
But before such dark pondering becomes despair, you realize you’ve arrived. Now you’re glad you weren’t guided here, that there’s no intermediary to deal with, and that you’ve made it completely on your own. She’s two doors down on the left. Will she know who you are this time, or will it be like last fall when her roommate’s TV was too loud for you to hear yourself think, much less make yourself heard to a 93-year-old with dementia? Nerves shot, with no one to help you, you implored the tiny person on the other bed to turn it down, her frightened eyes mirroring your own fear.
But the roommate is gone, and your mother is alone, sleeping peacefully. After placing your ritual offering atop her mini-fridge, you step to her bedside and take her hand with its tissue-paper-thin skin, blue veins bulging in nearly fleshless fingers, knuckles bony as marbles. You lower your face and kiss her sweet-smelling forehead then her cheek as soft as a newborn’s. Her eyes flicker open for a moment without recognition. But you don’t need her to speak or smile. If you required signs of recognition and response, you wouldn’t be here.
You tell her you love her and thank her again for being the best mother in the world. And you mean it. Though her psychiatric diagnosis upon entering her new home distressed you, it was also a relief to finally understand why your mother lacked most life skills, just about ever since you can remember. Angry for so long, you’ve since forgiven her completely for her failures to meet your needs when you were young and cling to the memory that she always let you know you were loved, wanted, though life was beyond challenging for her as a single, severely mentally ill, mom.
That’s all in the past now as you lift and kiss her hand.
You wait till her eyes close and she’s softly snoring again, then you tiptoe out and back down the corridor, lighter than before, with release at hand. You even smile and say “good afternoon” to a dour-looking gentleman slumped in his wheelchair as you pass. With every step, you are returning to your life as a conscious amnesiac who thinks he has a lot more time than he does before he comes here to stay.
Is it paranoia, an unconscious fear of your own genetic history, making you believe you’ll wind up like her? You don’t think so, but it’s something to consider. You wonder if you’re being pessimistic, cynical, or just realistic—thoughts for later. Right now, you’re witnessing the indignity of people whose bodies have outlived their minds, spouses, friends and most relatives, observing the efficiency of those paid to care-take but not necessarily to care (though you fervently hope most of them do). For a moment you wonder whether keeping the elderly and obviously infirm alive merely provides employment in a thankless job characterized by low wages and high turnover. Or is your own mother, simply through her mute presence, teaching these younger people (and yourself) life lessons you can’t even imagine? You decided some time ago not to judge your mother’s quality of life. You now extend that decision to everyone gathered under this roof.
At last, you emerge into light and air, which you take deep into your lungs. Your sun-blinded eyes quickly adjust. In your car now, you wonder about a society that will never agree to pull the plug, to decide these lives aren’t worth preserving to the bitter end. There is, of course, a cost to those kept living this way, a cost to caretakers, taxpayers, and to you, who’ve endured it, visit after visit, year after year, at least a decade beyond what you’d anticipated. The cost of seeing her as a shell of her former feisty self, as a body in a bed, is one you willingly pay, but not without sorrow, grief, and, yes, guilt. Could you, should you, do more somehow? And what would that look like?
And there may even be another cost of which you’re only dimly aware—to yourself, personally. What beliefs, attitudes, even prejudices, will you have to abandon in order to face your own aging and eventual death?
Getting inside your car, you start the engine. You won’t think about these things until next time you make this journey.
Ed Davis is a cross-genre writer whose fiction, nonfiction, and poetry have appeared in many anthologies and literary journals including Main Street Rag, Slippery Elm, and Blue Mountain Review. His novel, The Psalms of Israel Jones, was published by West Virginia University Press in 2014.