29 October 2011

Can't Ask Alice

Alice sits with my mother at every meal. They live in a nursing home and only see one another at meal times in the dining room. My mother is non-ambulatory, using a wheelchair all day every day. Alice can still walk on her own and lives in a "secured" wing for people who have Alzheimer's and tend to wander if not kept under close guard. Each day Alice's daughter, Dorothy (names changed for confidentiality), visits for lunch and sits with the two elderly women, helping them order their meals, use utensils, and keep up a conversation.

My mother's been in the hospital for a week. The change in environment has caused her to be confused, even more so than the rampant infection that sent her to the hospital. Confusion, anger, and depression occur regularly with dementia. Nurses and family members learn to repeat directions and stories over and over and over before the point finally hits the mark. In my mother's case, her difficulties in hearing increase the number of times and volume one has to tell her even the simplest of things.

"I wonder where Alice and Doris are today," she asked me when I visited at lunchtime on her first day back from the hospital.

My first thought was to fudge the truth a little, tell her Alice had the flu or a cold. Like the old joke about telling the family their cat died, I'd start with "Alice is on the roof."

Knowing I'd have to tell her eventually, I said plainly, "Alice died last night."

Now, my mother, whose memory is not very keen on the best of days, hadn't seen Alice or Doris in a week. During that week, she's been in every state of mind except lucid. I wasn't even sure she really remembered Alice.

"She's where?" My mother asked.

"She died," pause, "last night," I said right up next to her ear, so the other residents dining at the table might not overhear. I wasn't sure the staff told residents when another resident passed away. Seems reasonable that they would tell them, but with HIPPA who knows what's private and what's not.

"He died?" was her response.

Momentarily confused myself, I changed the subject and asked her if she was going to drink her juice. Maybe she didn't remember Alice. Still I thought it was an odd response. The woman to her right was having difficulty with her wheelchair, and I offered to help her. Meanwhile, my mother was trying to fish out the details of the death from my husband who had to shout "Alice died. Not Dorothy's dad. It's Alice. She died." At which point my mother turned to me with a look of horror and said, "Alice died!!"

Now everyone knows, I thought. Like a punch line to the jokes we often tell her, I figured they would all forget within minutes and we'd play this scene over at every meal for weeks until their shorter than short term memory let go of Alice.

I suppose there's a certain grace in having dementia as we age. The people we've met along the pathways of our life's journey step off the path when their time comes, and all we see is the vista before our eyes at that moment. We can't mourn or even miss someone we don't remember. At the same time, dementia brings with it delusions and visions of people who passed away long ago making them ever present before us. Conjured up at will to keep us company.

Alice left her friends on the path and began another journey. She stepped off the path the way we would all likely prefer it--fall asleep, "To die, to sleep;
To sleep: perchance to dream: ay, there's the rub; For in that sleep of death what dreams may come. When we have shuffled off this mortal coil, Must give us pause: there's the respect, That makes calamity of so long life." Alice slipped off without pain, without an ambulance ride, without hospice help for family, without a chance to say goodbye.

My mother will continue to ask about her, probably remembering the answer as soon the question leaves her lips. I'd always thought of Alice as an angel. A gift of a friend to eat meals with, so that my mother always saw a familiar friendly face at the table. And I think it was the same for Alice. I won't see Alice anymore. But in my mother's dementia, I wonder if Alice will visit from time to time. I hope so.

***Photo taken today by an angel that visits my mother! (Matt 25:35-40)

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