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Things became impossible. Dad was going blind too, but he refused to give up his driver's license. I had to call the police to have it taken away, but he continued to drive anyway. At one point, his urologist called to tell me that Dad had driven into his parking lot and knocked down a sign: "Do you really think he should be driving?" After that, I had the Kazakhs hide the car keys. Dad followed Mom's precise path downward: his macular degeneration grew worse, he developed neuropathy, and dementia set in. He gave orders to his bookkeeper--who was now trying to keep track of the money owed six Kazakh caregivers--and his investment adviser, forgot them and then screamed. He fired the bookkeeper; the investment adviser quit. He caused a public ruckus by claiming that the manager of Brookline Village was cheating the homeowners, which made it impossible, initially, to move Rose and Madeline into either the assisted-living or nursing-home facilities there. He became credulously obsessed with his junk mail, sending thousands of dollars in donations to "charitable" lotteries run by phony patriotic and veterans groups. I'd tell him he was wasting his money, and he'd say, "But look at the printing. It's a beautiful four-color job." He screamed at the Kazakhs, who were patient beyond imagining. He screamed at Mom when the angels and murderers hovered about; he was a bit daunted by her phantom lover though.
Rose passed away in December 2010, and Mom began to decline thereafter. The emergency runs to the hospital became more frequent. She broke her elbow, her hip. And then, finally, came the pneumonia, and the feeding tube in October 2011. By this time, I'd had private conversations with several of my parents' doctors, who agreed--informally--to allow me to exercise my medical power of attorney. (My son, a lawyer, held the financial power of attorney.) We couldn't do this formally because Dad would have taken me to court. He was infuriated with me for stopping him from driving and forcing him to have full-time home health care. The hazy legality of the situation was exacerbated by the nature of the Medicare system. There was no coordination among the flotilla of physicians taking care of my parents. There was no real supervision of their daily drug taking: Dad was in charge, and sometimes he'd screw up; it was hard for me to communicate on the phone with the Kazakhs, whose English was spotty. On several occasions, Mom was rushed to the hospital because the drugs prescribed by her various doctors had interacted poorly or Dad had given her the wrong dosage. Their internist was a sweet man, but he refused to confront my father. My brother, who was living in Asia by then, figured that only a disaster would change the situation. Instead of a disaster, though, we lucked into Geisinger.