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As my relationship with Mom improved, my dad and I had knock-down-and-drag-outs over her treatment. He and the doctor wanted her in a hospital. She wanted to die at home. Dad wouldn't, couldn't pay for round-the-clock nurses. Part-time aides came and went, unable to take the hours and the unrelenting attention Mom needed. After she had a tracheotomy and required a tube down her throat, I had to learn how to apply suction to the tube when she felt the saliva backing up--a procedure most of the aides were either unable or unwilling to do.
She died almost exactly a year later, on Labor Day weekend, 1996. During that year, I loathed my dad at times, and I'm sure he felt the same way about me. As some men do, he just withered away after she died. He wouldn't let anyone into the house to clean except me. He ran off anyone who tried to help, then complained about loneliness. He picked up women on the bus, talked about getting remarried (always to someone in her 30s or 40s, I noticed), confided details of his marital life that I really didn't want to know. It was as if his internal censor had gone to sleep. And he began to lose his mind. He was convinced that city workmen were partying at night in his bathroom, that preachers were stepping out of the TV to say prayers with him in person, that a child had fallen behind the bed and was crying.
The doctor was adamant: Dad couldn't live alone anymore.
Pipher says that moves cannot be avoided, that being near family is what's important for the elderly when they live alone in a distant city. But I still wonder whether my dad's move wasn't the worst thing I could have done to him. I ripped him away from his foundations: from the pub he went to three times a week, the bus route he knew even blind, the house he could navigate in the dark, the newspaper that chronicled men he knew in the Jaycees, the people he had built houses and warehouses for.
He came to California and stayed with me for a while. Then we began to search for assisted-living places where he could have an apartment--with communal meals and activities, but where he could still come and go on his own. The most helpful guide was New Lifestyles, a glossy pamphlet published in many cities that explains the levels of care at each facility in town, from assisted living to hospices and dementia care. Social-service agencies, churches, hospitals and rehabilitation centers have similar listings. Friends recommended other places.
Dad and I visited all of them together. I was cheered by the activity in some; at others the rows of zombie-like elderly folk in wheelchairs lined up at the front door depressed me. There is no formula for choosing one. You have to inspect them thoroughly, check into state-agency reports--and ask, ask, ask questions. What's the ratio between staff and residents? Is there a doctor? What's the food like? (Eat there!) What kind of entertainment is available? (Go sample it!) What happens if my parent develops dementia? Will he be kicked out or moved to another, escalated level of care?