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My dad chose a nice assisted-care facility with a spacious one-room apartment overlooking a courtyard in the Los Angeles suburb of Tarzana. But after just a month there, Round Two of elder-care hell began. While taking a walk around the block, he fell. I was out of town on assignment. By the time I got back to the city, 12 hours later, the local emergency-room doctors had doped him to keep him calm. He had gone crazy, they said, when they strapped him to the hospital bed. (I'd fight too!) He'd had three beers, they said, and was uncontrollable--a man who weighed only 130 lbs. In just three days my father went from being self-sufficient to an invalid. His injuries? A two-stitch cut on his head.
I took him home and detoxed him. Getting him in and out of the tub alone was a nightmare. He got up for the bathroom every hour all night long for two nights. By Day Three I was a sobbing mess. I hired a 24-hour "helper" to get him back on his feet and let me return to work. My dad was atrophying, physically and mentally, before my eyes. I put him in a rehabilitation facility. They did their best but were short staffed. His doctors wanted to put him on the harshest psychotropic drugs available. When several nurses warned me against the drugs, I fought for and got a milder drug regimen. But again, fearful that he'd get up and break a hip, they strapped him to his bed. He began to wither away, uninterested for the first time in food, because he was no longer allowed salt. He couldn't see to ring the bell for the toilet, so he would sometimes lie for hours in wet diapers or sheets until I or his 74-year-old sister would arrive for a visit. Half the time he didn't recognize me.
When Medicare and his supplemental insurance coverage ran out after a month, I was desperate. He clearly couldn't go back to his apartment. Luckily I didn't have to embark on a long search: the social-services lady at the rehab center recommended a nearby facility, actually two houses with six residents each, built around a garden, with a locked gate and round-the-clock nursing aides. It's what California calls a "residence for the elderly," far cozier than most of the corporate- or church-run rest homes and assisted-living facilities I had seen. The food is home cooked; there's a Friday-night Jewish service my Catholic dad loves; and no one straps him to the bed. But it's expensive: nearly $3,500 a month for room, board, doctors and medicine. How many people on a retiree's income can afford that?
Physically he's doing great, but he's dying bit by bit mentally. Now 84, he thinks he's been fired from his job; sometimes he's so lonely he imagines Mom is still alive. Over and over, he makes lists of family and friends so he'll remember them; each time the list is shorter as he forgets more names. He thinks that he's been abandoned in a house of strangers, that he sleeps in a vault, that everyone in the world now wears diapers. I'd laugh if it weren't so awful. Even with two aides on duty during the day and one at night--an astoundingly good ratio for a home with six residents--they can't watch him every minute. It took the new doctors forever, in my view, to diagnose an underactive thyroid, which caused some of his confusion. He is in what doctors tell me is the early stages of Alzheimer's. Yet both his father and his aunt lived to 96. Will he have another 12 years of living in this netherworld?