Holding the Net

by Melanie P. Merriman

  “Mom told Valerie she did not need any help, but that it might be nice to have someone to visit with now and then,” Barbara told me. “I made it clear that we needed someone who could be there when she showered, and maybe even help with that.”

  Barbara was impressed with the way Valerie got all the necessary information in a conversational way, and made Mom feel good about how much she could do on her own. By the end of the meeting, Mom had agreed to scheduling a home health aide twice a week, beginning that same week.

  I heard almost nothing about the first two CNAs who visited Mom. I suppose they showed up and helped Mom shower and dress. Did they make the bed? Did they fix her a sandwich for lunch? I don’t remember anything about them, and neither does Barbara.

  And then came Dena.

  Dena was a hundred pounds of sunshine in a candy-colored smock. She had a thick Southern accent and plenty to say. She wanted to know all about Miz Pratt (Mom, that is). Dena asked Mom about her girls, what she liked to eat, how she came to live at McCarthy Court, and where she had lived before. Dena told Mom about her two children, and about her own mother.

  Mom got back into going to the recreation room for coffee and donuts.

  “Because Dena likes to go,” she told me.

  Twice a week, Dena arrived at around 9:00 a.m., while Mom was enjoying her morning coffee. She made sure Mom had a shower, dressed, and got out and walked a little bit. Before she left, Dena made sure Mom had something ready to eat for lunch. And the whole time, according to Mom, they carried on a delightful conversation.

  If Mom told Dena she didn’t feel like a shower, Dena would insist.

  “Miz Pratt, please don’t get me in trouble with Barbara. She’ll be mad at me if you don’t have your shower,” Dena told her.

  She called Barbara with a report on every visit with Mom. Sometimes, when I called Mom’s apartment, Dena would answer. And when we were on the phone, Dena did most of the talking.

  We all loved her.

  Meanwhile, Barbara became militant about trying to improve Mom’s strength and balance. She talked to Dr. S., who ordered more physical therapy. Either Barbara or Dena would drive Mom to the clinic once a week, and Dena would help her do her exercises at home. Holding the kitchen counter, Mom would rise to her toes and then lower back down. Sitting in her chair, she would straighten one knee to lift her lower leg, then do the same on the other side. Barbara told Dena to make Mom walk for fifteen minutes—up and down the hall, or if the weather was nice, around the parking lot. Mom didn’t like it.

  “I told you, I’m allergic to exercise,” she answered, when I asked why she had cancelled two physical therapy appointments.

  “It’s probably too little, too late,” Barbara said, “after a lifetime of being a couch potato.”

  “But she used to be active,” I replied. “Remember how she went on all the Girl Scout sleepovers, and set up tents and hiked with us?”

  “Sure, like a hundred years ago!” Barbara sounded fed up.

  Dena made Mom feel better and eased the burden on Barbara, but no one—not Dena, not even the physical therapist—could keep Mom from falling. I learned the hard way during my late October visit. I had gone up to the apartment to get Mom while Barbara and Phil waited in the car. We were headed out to dinner to celebrate Barbara’s birthday.

  Mom held the handrail as we walked down the hall. She took my arm, and we crossed to the elevator, where I pushed the “down” button. Suddenly, she sank to the floor, pulling on my arm as she went down. I couldn’t hold her up, but I did slow her fall. I felt my face flush and then go pale.

  “Are you alright?” I asked.

  “Yes, fine.”

  “Are you sure? Do you feel weak or dizzy?”

  “No, I’m fine. Just help me up.”

  I was shaking.

  Over dinner, I told the story, trying to make light of it.

  “Mom, you really should get a walker,” Barbara said.

  “I don’t need a walker. I can walk just fine. I just lose my balance sometimes.”

  “And when you do, you could hang on to the walker, if you had one.” I said. Mom accused us of spoiling the meal with all this negative talk.

  Shortly after my October visit, Barbara sent an email update.

  Took Mom out for lunch today. Before leaving the apartment, we went over the physical therapy bills because she was all confused about what to pay. When we got back from the restaurant, she started crying, saying how old and confused she feels. I decided I need to take over her bills, but I’m not going to tell her, I’m just going to go through the mail when I am there and take care of things.

  I called to offer moral support.

  “I feel so bad that there isn’t more I can do. Do you want me to take over the bills?” I asked her.

  “No, it would be too complicated to get them to you. I can handle it for now.”

  “Okay. Sorry it was such a tough day.”

  “Yeah. All of this bothers me, but not as much as it bothers her.”

  In November, four months after the fall in the recreation room, Mom fell again. She had gone into the kitchen to get a sandwich Dena had left for her. Somehow, both Mom and the sandwich ended up on the floor. With only three feet between the counters, there was no way she could avoid hitting something. She pushed her button and told the voice on the speaker she was hurt.

  “I need someone from the office,” Mom said.

  The McCarthy Court staffer who came to help decided to call an ambulance, and then called Barbara.

  Both Barbara and Phil met Mom at the emergency room.

  “I’m not sure why we’re at the hospital,” Barbara said to me on the phone. “She only has a little scratch on her arm and a bruise on her wrist. I’m guessing the McCarthy staff just didn’t want to take a chance. We’re going to take her to our house for dinner.”

  Barbara continued our discussion the next day.

  “How is she?” I was sitting at my desk in Miami. “She’s fine. She just takes these little falls in stride. When we got here last night, I put on a DVD of old Jack Benny shows. Mom watched from the leather lounge chair, and laughed and laughed.”

  “This is crazy,” I said. “Why is she falling so much? I’m afraid she’ll get hurt badly.”

  “I think it’s time to look into moving her to Homeplace. Then, if she falls, someone will be there to help her right away. They have staff on duty all night.”

  Homeplace was the assisted-living facility affiliated with McCarthy Court, located just across the parking lot from Mom’s building. At Homeplace, Mom would get three meals a day instead of one, and, for an additional fee, staff would help her shower and dress. She would have a lot more supervision—which appealed to me and Barbara, but I was pretty sure Mom wouldn’t like the idea.

  “Have you mentioned it to Mom?” I asked.

  “She’s adamant she doesn’t want to move. I think the other McCarthy residents, especially Sophie, talk about moving to Homeplace as the kiss of death. Mom says she would never see her friends if she moved over there.”

  “It’s across the parking lot, not across the state,” I said.

  “I know, but I guess it’s like there’s a Berlin wall between them.”

  “Well, why don’t you find out what’s available, or if there’s a waiting list. I want to know what’s possible before we bring it up with Mom.”

  After Barbara met with Kathy, the director at Homeplace, she became more convinced that Mom should move, because there was a rare two-room suite coming available in a couple of months. Mom would have a sitting room and a bedroom. Most Homeplace residents had just one room, in which they lived alone or with a roommate.

  “You really think it’s time?” I already knew the answer, but I hoped it wasn’t so.

  “I do. Anyway, better too soon than too late, right?”

  I trusted Barbara’s judgment. She saw Mom almost every day. I saw her only four times a year. And all the day-to-day care fell on Bar
bara, whether she was doing it or just managing it with the folks from Seniors Choosing to Live at Home.

  “How hard can I push her?” Barbara asked.

  “As hard as you want to,” I said, “I’ll support you a hundred percent.”

  I hung up the phone and wandered out to the Florida room. I found one of the cats lying in a wicker chair and sat down, pushing her to the side with my thigh. I reached down to scratch her ears and stared out at the bay. Mom had declined since July, but in many ways, she still seemed so capable. I didn’t like that she spent so much time alone, but knew how much she valued her independence. Maybe it was too soon for assisted living—or maybe it wasn’t. How could we know for sure?

  Convincing Mom to move to Homeplace took me back two years to the battle for McCarthy Court. Barbara and I used well-honed weapons of reason and logic. We told Mom this was likely her only chance to get a two-room suite at Homeplace. We touted the comfort of three meals a day and additional help for whatever she might need, both now and in the future. Mom parried with her arsenal of arguments—that she was comfortable in her apartment, and had friends. Then she tossed a grenade.

  “I just moved, and now you want me to move again?”

  I cowered, and let Barbara lead the charge.

  Barbara said, “It never hurts to look.”

  She and Mom toured the rooms in Homeplace, and had lunch there with Kathy. That afternoon, the three of us talked by phone.

  “You’re right. Homeplace is nice, but I have so much more room at McCarthy.” Mom was digging in.

  And you spend all your time in the living room or the bedroom, I thought.

  “I’ll move there one day, but not yet,” she said.

  The deadline to make a decision was a week away. Kathy had agreed to hold the suite for Mom, but we had to make the deposit by December 15th for a January 15th move-in date. Barbara threw her own grenade.

  “Mom, it will be so much easier on all of us if you move now. Melanie and I worry about you all the time.”

  Mom agreed to consider moving. I circled back to push from another direction.

  “If you know you’re going to Homeplace at some point, why not do it now, when you can have a suite instead just one room? You know that Barbara and I will handle all the moving and make it as easy as possible.”

  “What about my friends? What about Dena?”

  “Your friends will be right across the parking lot, less than a block away. And Dena can still come by to visit a couple days a week,” I said, not knowing whether this was possible or not.

  Barbara filled out all the forms, and after we gave each other a pep talk by phone, she went to visit Mom, who surprised us both by signing the papers. Barbara wrote the check and dropped everything off at Homeplace.

  I expected to feel relieved—even happy. Instead, I felt sad and nervous. I was sure this would be Mom’s last move. I took refuge in my lists—what should we move to make Mom feel at home? I wanted to help her adapt to Homeplace as quickly as she had to her McCarthy Court apartment.

  A week later, Barbara called me, crying.

  “She backed out.”

  “What happened?” I asked.

  “I brought her some groceries and mentioned the move. She yelled at me; said she’d never agreed to go to Homeplace. She said I tricked her.”

  “Barb, I’m so sorry. You know this isn’t your fault.”

  “I know, but she was so mean.”

  “She’s scared. And maybe a little addled. Her short-term memory has been getting worse. Is it possible she really doesn’t remember?”

  “I don’t know, but what do we do now?” Barbara sounded tired.

  “What did you tell her?”

  “I said I did not trick her, but I would see what I could do. Then I left, furious.”

  We decided we didn’t have it in us to force her, so we’d give it a day or two and see how she felt. Barbara called Kathy at Homeplace and Diane at McCarthy Court to let them know things were up in the air, and to find out how much leeway we had. They both understood, saying these things happened fairly often. They gave us a few days to sort it out. It was my job to talk to Mom. Barbara needed some distance.

  I waited two days—two long, short-tempered days. I thought Mom would call me. She didn’t, so I called her. We exchanged hellos and how’re you doings. She didn’t mention Homeplace, and she didn’t seem angry.

  “Barbara says you’ve changed your mind about moving to Homeplace.”

  “Yes. I want to stay here.” She didn’t mention being tricked. “I think Barbara is pretty upset.” It seemed pointless to remind her that she’d agreed, and signed the papers. Had she forgotten what happened?

  “I’m sorry. I don’t want to move, and I don’t think I should have to.”

  How much more can we take away from her? I thought. I wanted her to want what Barbara and I thought was best, but more than that, I wanted to let her decide on her own.

  “Okay,” I said.

  Maybe it just wasn’t time yet.

  Chapter 13

  MOM WON THE HOMEPLACE BATTLE, and stayed in her apartment at McCarthy Court. Barbara managed to get Mom’s entire deposit back, and someone else moved into the suite at Homeplace. It would not be our last struggle to keep Mom safe while also trying to preserve her independence. Every time, a win for either side felt like a loss all around.

  In early January of 2009, as I logged into the American Airlines website to buy my ticket to New Bern for Mom’s 93rd birthday, Barbara called from the emergency room. Mom was bleeding from a cut on her head. She told the doctor she had slipped while getting out of bed and hit the bedside table.

  “The doctor says Mom is entertaining. Personally, I am not amused.” Barbara was understandably annoyed about another trip to the ER. “He also says she seems pretty healthy, especially given her age. They’re going to do a CAT scan, and she probably needs a few stitches.”

  When we talked the next day, I asked about the results of the CAT scan.

  “Nothing remarkable, just the expected change from a moist, plump brain to a shrunken raisin-brain.”

  I laughed. Mom’s aged brain wasn’t funny, but Barbara’s delivery provided a much-needed spoonful of sugar for the bitter stew of Mom’s decline.

  I read the medical record for that visit to the ER after the fact. It described “an old lacunar infarct at the left basal ganglia”—evidence of a stroke. When had it happened? Could that have been the cause (or one cause) of Mom’s recent falls? If the doctor had mentioned this to Barbara when they had been in the ER, she would have told me. I can only conclude that it hadn’t come up.

  By the time I arrived in New Bern the following week, Mom’s stiches were out and her wound was nearly healed, but she had a bad cold. She was lethargic and cranky, barely interested in seeing me. I never got used to the way even minor illnesses affected her. When she got sick, or had an injury, she aged ten years. Then, after a prolonged recovery period, she’d “get younger” again, but never back to where she was before the episode.

  Barbara and I talked to Mom about her falls, and insisted she get a walker.

  “It’s not my fault. I tell myself not to fall, but then I fall anyway.”

  “That’s the point,” I said, “you just need a little help with balance, and the walker will be perfect.”

  Her refusal made no sense to me. If the issue was pride or dignity, wasn’t it more dignified to be standing than sprawled on the floor, waiting for a hand up? Pride goeth before a fall, I thought. Indeed!

  “There’s a medical supply store right around the corner,” Barbara added, “and Medicare will pay for it.” We knew we couldn’t make her use it, but we were determined to put a walker within her reach. “Come on,” Barbara said, “let’s go pick one out, and then we can stop at the bagel shop for lunch.”

  “I don’t feel like going out,” Mom grumbled as she turned on the TV.

  “Okay,” I said, “We’ll go get the walker and bring bagels ba
ck here.”

  I stood up from the couch and dug my heels into the carpet.

  “Bring me some coffee,” she snapped. “They have good coffee there.”

  Buying the walker was easy once we saw how the different models worked. Barbara and I agreed that Mom wouldn’t be able to manage the ones with brakes, and opted for the classic: aluminum frame, wheels on the front legs, rubber tips on the back legs. No seat, bells, or whistles. The clerk showed us how to adjust the height.

  “Medicare will pay for at least part of it, right?” I wasn’t sure about Medicare policies for medical equipment.

  “It will, if the walker is ordered by the doctor,” the clerk replied. We didn’t have an order from Dr. S., but Barbara said she could get one on Monday.

  “I’ll make a copy of your credit card and get all the Medicare insurance information. If you bring or fax the doctor’s order on Monday, we’ll bill Medicare directly. Otherwise, we’ll charge the credit card,” the clerk explained.

  I thanked her for making it so easy.

  “We do it all the time,” she said.

  Back at the apartment, we showed Mom how to use the walker, and made her take it down the hall to the bathroom and back.

  “I do feel a little more stable.” She walkered around the living room.

  “Is this mine?” she asked.

  “Yes,” I answered, feeling confused about why she was confused. “We just got it for you. It’s yours.”

  “Did I pay for it?”

  “No. Medicare will pay for it.” I left out the details. “Let’s put your name on it.” The other walkers in the McCarthy Court dining room were decorated with ID tags and colorful bows or scarves. Without these personal touches, they all looked alike. If I ever need one, I thought, I’m painting on some flames or a lightning bolt.

  “Here, use this.” Barbara handed me one of Mom’s return address labels. Mom used to put them on the bottoms of trays and dishes she brought to potluck parties back at the New Port Richey condo.

  I stuck the label on one of the bars of the walker, then guided Mom to the table for lunch. Barbara handed her the paper cup of coffee from the bagel shop.