LifePundit

Physical Therapy and Immortality

If only he worked out more, my father would live forever. He believes this and he's about to prove it. He'll be 96 one month from today and he's passed his doctor's generous predictions for his longevity, given his aortic stenosis and congestive heart failure, by one year.

So my father's given up on working out in his room with his dumb bells and he's going back to physical therapy at the assisted living place where he lives. He says he can tell that it's helping him. He's stronger and feels better.

He's still on oxygen, still struggling to stay vertical, still hits the floor about once a week. I think the floor is starting to complain.

I told this story about my father's return to physical therapy and his improvement to my husband, Paul, who's been such a wonderful support during my father's brinkmanship with death over the last couple of years.

"That's great he's working out," said Paul, who's 51. "When I move up there to the nursing home, I'll join him."

I thought this was funny, so I told Saintly Brother. He said, "The difference is our father can run on fumes; Paul can't."

It's a wondrous thing what the human will can overcome.

I Miss My Mother

My mother has had Alzheimer's for ten years. For ten years, I haven't been able to call her and have a sensible conversation. For ten years, she's suffered the confusion of not knowing who she is, where she is or whether she is safe or not, and there's very little we can do for her other than tell her lies to comfort her, which she'll forget in an instant anyway. It's a far worse disease than merely forgetting. I had no idea.

Since she's been "gone" so long, you'd think I was used to it. But I still find myself thinking, "I'll call Mama and tell her what happened. That will make her laugh (or she'll come to my defense, depending on the situation)." Or, "I'll call Mama and ask her how to cook this (or handle that)."

But I can't call Mama. She's still among the breathing and sometimes among the laughing and talking, but those phone calls are gone, along with her memory. It's been ten years. You'd think I wouldn't still have the impulse to call her, and then have to remember that's not a possibility.

I have a friend whose mother died when my friend was a pre-teen. Her growing up was hard, but she says now that she's grateful that she's not having to deal with an aging mother. Though that sounds cold, there is some truth to it. And elderly parent can be a blessing and/or a burden. Since my friend had no choice about losing her mother when she needed her most, she may as well have reconciled that with something positive.

I'm beginning to realize that when my mother is really gone, and has been gone for decades, I'll still be seconds away from picking up the phone to call her. It's not quite as good as the real thing, but at those times I can summon up something from my memory about her and visit with that. When she could still answer the phone, I believe I called her up enough to almost be able to predict what she would say. No, that's not true. Sometimes the call wasn't about the question, but about the loving presence on the other end of the phone.

People who love a person with Alzheimer's are said to have "frozen grief." Mama is gone. But she's still here. So my grief is frozen somewhere, stuck between loss and not-yet-lost. It would be a mercy if she were released from this terrible disease, sent to heaven where her wits and her own mother wait. Could I, would I, miss her more if she was really gone? Would knowing that she's free but no longer here be worse than seeing her captive and confused but within my touch?

A counselor once told me that grief is a blessing because at least you have something to grieve -- something good that was lost.

That's my mother, one foot planted in the here and one in the hereafter, straddling the abyss of Alzheimer's. Still here, but surely lost.

Go Work Out While Working Out Still Works

When you're two months away from your 96th birthday, chances are that the people who sit with you at your table in assisted living will be younger than you. Chances are that the people everywhere you go are younger than you. Maybe not as full of life or determined to live, but younger.

Such is the case with my father. I think that is probably one of the rough edges of life in assisted living. You sit with the same people for every meal (the staff tries to put people of similar life experiences together) and they come.... then they go. They go to the hospital and don't return. They go to the Alzheimer's unit and don't return. They go to the nursing center and don't return, though my father sees them staring vacantly into space while parked in the dayroom in their wheelchairs when he goes to the nursing center to visit my mother.

He's enjoyed the company of a younger, more vigorous (though still old as dirt) man at his table for the past few months. All was well until the other night when my father was in the shower and this man walked in. The man asked, "Where do you get water for the dogs?"

My father said, "There aren't any dogs." And the man walked out.

The man is now missing -- he's been moved somewhere where he can't wander off. The staff doesn't talk much about what happens to people when they suddenly disappear, leaving their friends to wonder if they're dead or just elsewhere. Probably with the HIPA (if I used the right initials) regulations, the staff shouldn't talk at all. But these people are living together. They need to know what happened to their companions. My father misses his friend.

The list of his dinner companions has turned over many times. It's depressing. Not only does he miss his companions, but he has to wonder if he's next.

My father has developed some kind of lung infection within the last few days. Nobody has used the pneumonia word, or any word for that matter. He's on antibiotics and two other kinds of medications (in addition to the usual bowl of pills). He sounds terrible, says he feels terrible. But he tells me that if only he would take the time away from the garden to work out and get in better condition, then he would be all right. He says he's been too busy to work out and he's gotten in terrible shape. Working out would fix it all. (This is of course not true, as he has congestive heart failure and aortic stenosis. He's on oxygen and falls all the time.)

I got him to agree not to work out (he has free weights in his room) until after his lungs are clear.  I don't know how worried to be about this illness. If it can be shaken off, he will shake it. The will to live is a powerful thing.

In the meantime, those of us who are not 96 have no excuse. Go work out -- while working out still works.

Mama is 96 Today

Here's a photo of my parents before Mama got Alzheimer's and before my father turned into a skinny but determined old fellow. Today is Mama's 96th birthday. My father had it all planned out. I would drive up there, we would load her into my car and take her on a joy ride. Since she's bedridden, can't walk and they need to use an automatic lift of some sort to move her from bed to chair and back, this whole fantasy required a good bit of imagination.

He sort of sucked me into the whole idea. Poor Mama stuck in a nursing home. For her 96th birthday, we'll take her out for a drive. Never mind he can't stand upright without falling over and is a hazard to take places. Never mind that Mama doesn't know who we are or where she is most of the time. Never mind that when she was mobile and could go places, she so objected to having to go back to the Alzheimer's unit that we had to put lorazepam gel on her wrists to get her calmed down enough to return.

Saintly Brother pointed out the many ways I had lost my mind with this scheme. That's what Saintly Brothers are for. I am gracefully bowing out but not engaging my father in discussion about the why.

I may not even see her on her birthday, which makes me sad. Then again, I can see her on another day and we can declare THAT day her birthday, and pick any number we choose. We can celebrate her 50th birthday or whatever sounds good to her, since she doesn't know what year it is anyway. I doubt she'd believe me if I told her she was 96. I'm sure she wouldn't. I hardly believe it myself.

Here's a photo of us celebrating our birthdays in 2005. That's my non-teenage daughter, Lily, in the middle.

When Are We Going to Panama?

It's back. My father called me tonight to tell me to make arrangements for us to go to Panama. The Panama Canal, the thing I've heard of all my life. That's where he was stationed during WWII. Please note that it wasn't bombed or destroyed, so he obviously did a good job of protecting it.

He's always wanted to go back and renewed his passport when he hit 92, but didn't have time to go then. He says that if we schedule it around the things that are growing in his garden (such as the 150 tomato plants for a man who lives in assisted living, gets three meals a day and doesn't like tomatoes), he can go in the next few months. I'm to go with him, as is anyone else who wants to go.

What a happy fantasy! I would love to go with him. I'd love him to show me where he was stationed, ride through the locks with him and let him explain how they work -- and what's changed. I've even gotten him to agree to go on a cruise ship, not some little boat and go hiking through the jungle to find his old camp.

Now he can't walk from his room to my mother's without stopping three times to rest. He can't go anywhere without his oxygen. I called him the other night and he fell trying to answer the phone. He uses a cane, sometimes uses a walker and is always supposed to use a wheelchair. He can't button his own shirts, but he can strip the leaves off of baby tomato plants and hand them to Ike to be planted.

Except for grandiose expectations for what he can do, he's as sharp as ever. I'll go through the motions of planning the trip. I'll give him options. We'll talk about it. Maybe this fantasy will be good therapy for both of us.

Too bad we didn't do it decades ago. I doubt he can leave Mama for that long. And I doubt it would be responsible of me to take him (plus driving him to church and back is grueling -- not sure about a week on a ship).

Would an airline even take somebody way past worn out? I have a feeling that cruise ships would, because I've seen their rickety old passengers. And if it's too much for him, well, at least he was doing what he wanted to do. Or, what if it is too much and he is miserable and scared the whole time and it makes him worse without giving him a good experience?

He'll be 96 in August. He wasn't expected to live until July 2007 (he doesn't know this). He's squeezing every drop he can out of life. Maybe he'll make it to Panama. Maybe he'll even make it back. But then what?

A Visit from the Collard Claus

He comes in the middle of the afternoon when you're not at home. (Maybe you're napping in the carpool line. "He knows when you are sleeping, he knows when you're awake," etc.) He leaves a pile of collards and cabbages by your door. Or rather, around the corner from your door, so you don't see them at first, and when your eyes do take them in it takes a moment to process.

What's that stuff? Green leafy piles of.... what? Brain whirs and searches. Collards! Cabbages! Piles of them. I've been visited by the Collard Claus, AKA my father. Ninety-five years old and still delivering collards.

Hmmm. Might be a good idea to eat a lot of them. Collards must be the energizer bunny of nutrition. They're just so hard to wash. And wash. And wash. And then find a spot for them in the refrigerator because they're so big. I can't fit them all in. I can hardly fit some of them in.

Fortunately, my neighbors like collards and cabbages too. Which the Collard Claus told me was his plan.

Looking forward to the Tomato Claus.

Kindness Can Look Like a Tomato Plant

My father's room in assisted living has a window that looks out into an area with bird feeders and raised flower beds. The staff there knows of my father's love for gardening, and last week when they were planting summer flowers in their gazillion raised flower beds they did something different for the one my father can see from his room. They planted it with tomato plants.

One of the staff came to him and said, "Mr. C., do you see what they're doing?"

"What?"

"Look out of your window. Do you see what they're planting?"

He looked. "Tomatoes," he said. Then he went outside, dragging his oxygen with him. He watched for a minute, then asked the lady planting the tomatoes, "Where's your lime?" he said.

She looked at him strangely. "I don't have any. What do I need lime for?"

"Blossom end rot," he said.

I wish he had said things such as, "pretty plants," "good job," "thank you." But no. It was "Where's your lime?" You're doing it wrong. Oh well. He is who is he. The lady managed to change the subject to her divorce problems. From here on I'm pretty fuzzy about what happened. My parents have been married for 72 years and a stranger confessing things about her divorce was more surprising to him than planting the tomatoes without lime.

Honestly, I think it was hard for him to perceive the kindness behind this act of planting tomatoes where he could watch them from his room. Or maybe he did perceive the kindness, and was lost on how to respond. Plus, he just planted 150 tomato plants in his garden in the country (with much help and all the right ingredients). What does a man who get three meals a day in assisted living need with a giant garden? Gives him something to do. A place to go. Life bursting with life.

He planted 150 tomato plants and he doesn't even like tomatoes. Seriously. Won't eat them.

I am touched that the people who care for my parents are that insightful and kind. Lime or no lime, I think it is beautiful.

Palm Treo vs. Old People's Phone

After my father lost his last phone, he wanted a Palm Treo, which Saintly Brother got for him. My father never mastered it, though he dearly wanted to. He couldn't even hear it ring or check his voicemail. He was very excited that it could take and store photos. Now it has gone the way of all his cell phones. Lost in the garden. Or somewhere between assisted living and there.

So he needs another cell phone, maybe another Palm Treo. Or does he? I called Saintly Brother and offered my opinion, which is that he needs one of those Old People's Phones. Easy to use. Big display and big buttons. Saintly Brother agrees, but doesn't know how to gently suggest this option.

He's going to offer our father another Palm Treo or an Old People's phone. I would think that cost would be the deciding factor, but it wasn't last time. If I were in charge, I'd just get him the Old People's phone and show him how to use it. I'd distract him from the Palm Treo somehow until he realized how much easier the Old People's phone is to use. I guess that's why I'm not in charge.

How to Take An Old Person to Lunch

My father likes for me to "come get him out of there" and take him to lunch. The more limited he becomes, the more difficult this is. Here's a list of suggestions to myself for the next outing:

1. Bring a patient grandchild along. Bribery can inspire patience. Bribery cannot inspire cheerfulness but cheerfulness can be faked. Demand it.
2. Don't have anything scheduled for the rest of the day.
3. If you plan to pick your old person up at 11:00 a.m. for lunch, be aware that they will be sitting there waiting for you at 8:00 a.m. and will be mad when you show up on time that you weren't there earlier. Getting there earlier won't help, unless you get there at 7:59 a.m.
4. Make sure you have room in the car for the walker.
5. BRING AN EXTRA OXYGEN TANK NO MATTER WHAT THEY TELL YOU.
6. Ask often if they need to go to the bathroom. Those heart meds bring frequent and urgent needs and are  most likely to occur when there is no bathroom. Like a toddler, they will resist going to the bathroom when the needs isn't urgent (yet) because the effort to get to the bathroom and tend to their business requires so very much work that it's physically exhausting. However, so is cleaning the urine smell out of your car. My father wants to bring his portable urinal with him, but he's not a good aim. This is TMI for you -- and for me. Believe me. We are deeply into TMI in the elimination department. It must be just awful.
7. The average maitre d' will try to stick you into the back because elderly people with freshly spotted pants and oxygen tanks do not look good in the front of the restaurant. This is their problem. Insist that you be seated in a convenient, quiet table with padded seats that isn't far from the entrance or the bathroom.
8. Try to pick a place that isn't loud. Pick a place with incredible desserts because the sweet taste buds are the last to go.
9. Think in advance of subjects to talk about so you'll have topics other than elimination.
10. Bring a (waterproof) pillow in case the chairs are hard. When an old man has lost 50 lbs., he's got no butt or back padding. I may get a pillow just for this purpose. Maybe an outdoor cushion with a back and bottom in it. Just hope it doesn't slip and slide and throw him on the floor!
11. If the meal they choose comes with pasta, ask for bowties or other shapes that are easier to handle than long noodles that need twirling.
12. Order something extremely healthy for yourself. You might get old and you want to be healthy and in good condition. If you need reminding, look across the table.
13. Expect to hear that the food doesn't taste right. It probably doesn't because elderly taste buds are shot. Be sympathetic and not argumentative. Offer to get something else. Some foods do still taste good, though it seems to be a random thing and I can't tell you what they are. It's not a fun outing for somebody to find out that one more thing is wrong with them.
14. Bring Shout or some other brand of wipes to help clean up afterwards, if they don't mind. Nobody likes to wear their lunch but sometimes it's better not to acknowledge it.
15. Don't forget to stop at the bathroom before leaving.
16. Leave a good tip.
17. Ask if you can run errands on the way home.

Usually we get lousy service from people who want to stick us in the back and find us high maintenance. Yesterday Lily and I took my father to the Macaroni Grill. The maitre d' immediately found us a table where my father didn't have to walk far (without my requesting it) and brought extra napkins for my father to sit on so the chair would be softer. The waiter wanted to chat with my father about his life, since they'd both graduated from the same school. It was too loud, but my father was okay after taking his hearing aids out. The loaf of bread (loaves I should say) was a big hit. Great service from kind, thinking people. And not one word about elimination.

Women's Color Knowledge is the Last to Go

My father was visiting with my mother, who has Alzheimer's, and she was ignoring him, which is sometimes a good idea. Or perhaps it was one of her non-responsive days. Either way, he wasn't getting a thing out of her, so he was talking to her about things he hoped she would find interesting. He noticed a basket of silk flowers in the day room where they were sitting and, not expecting an answer, he said, "Aren't those pretty blue flowers?"

My mother quickly responded, "They're purple."

She didn't say another thing that day.