Assisted Loving

I always thought my parents were invincible until my dad fell and my mom was helpless to rescue him. It was then I discovered that the toughest thing anyone will ever have to do is to love their parents enough to move them from their home.

My father, Augustus Currie Monroe, has always had an extraordinary capacity to endure pain. When I was a child, we were loading the dishwasher together one evening and I heard a low moan. I looked over and saw that his thumb was impaled on a dishwasher prong, which had gone beneath the nail all the way up to the cuticle. He was stuck there. He slowly pulled his thumb off the prong, ran some water over it to wash off the blood, wrapped it up and kept loading the dishwasher. He didn’t say a word.

A couple of years ago, he had a huge red sack of fluid dangling from his elbow. He said the swelling was from a spider bite. My sister was so horrified when she saw it that she started to cry, begging him to go to a doctor.

“Daddy, please let somebody look at it,” she pleaded. But he refused to go. He said it would clear up and wouldn’t discuss it further. And whatever it was, it eventually did go away.

So it should have come as no surprise to my sister or me that Daddy refused to go to a doctor when his spine began to collapse.

Illustration by Jeffrey Smith

We knew something was wrong for a couple of years. As a younger man, Daddy stood six-foot-three and took outlandishly long strides when he walked. My mother, Winifred Black Monroe, was more than a foot shorter. When my sister and I were small, we all had to scramble to keep up with Daddy’s long legs, like chickens running after a rooster. His gait changed dramatically as he entered his 80s. He began to take tiny, splayfooted steps, almost shuffling, and he listed from side to side like Charlie Chaplin. I asked what was wrong. Sometimes he blamed his knee, sometimes his back. When I asked if he had seen a doctor, he said it would clear up.

My father, at 83, can be what we call “mule-headed.” He is as stubborn as the animals he plowed behind on a farm in the sand hills of eastern North Carolina during the Great Depression, which he still calls “Hoover Days.” When he doesn’t want to discuss an issue, he is a wall of silence, deaf and mute. He wouldn’t discuss his back problems and he wouldn’t discuss assisted living. He was a civil engineer and had carefully plotted out the end of his life: He would drop dead one day and that would be it.

That’s not the way it turned out. He had made many plans, but none of them included the scenario that found my sister and me scrambling crazily to get our father emergency medical care against his wishes and to rush my ailing mother into assisted living, even as she suspected we were treating her shabbily. We did it on the fly, under enormous stress. We found what so many of our contemporaries are discovering: The Greatest Generation is moving into walkers, diapers and assisted living, and they’re not going gently.

The U.S. Census found 13 percent of Americans in 2000 were 65 or older. As baby boomers age, the senior population will reach 20 percent of the population by mid-century and number 82 million. Each year, more and more people will experience what my family has been through. Baby boomers are putting their parents into assisted living now and will be headed there themselves in another 20 to 30 years—if they can afford it.

I come from a long line of semi-immortals. Some members of my family just don’t seem to die. They drift on and on in a state akin to suspended animation. But I knew at some point my parents would have to go into assisted living. It’s the step between independent living and a nursing home. An assisted living facility provides help with bathing, meals and other activities of daily living. It does not provide nursing care. Staff members transport residents to doctor’s appointments. They have autonomy, yet they are looked after.

I discussed it with a minister at their church. He gave me a booklet of assisted living facilities in metro Atlanta, marked the ones he liked the most and warned that the best places have waiting lists of more than a year. I showed it to Daddy. He set it down on a pile of magazines and letters beside his burgundy recliner and laughed: “Oh, we’ll talk about that when I get old.”

Unfortunately, he got old much sooner than he expected.

The journey from feisty independence to depending on others can be heartbreaking and infuriating for parents and children alike. It is a sad rite of passage on both sides—for the parents who see their freedom slipping away, and for the children who must assume the unnatural role of caretaker. For my sister and me, it opened up every old wound and stirred the cauldrons of the past that had sat dormant for years. We found that no memory was left undisturbed, no feeling forgotten. It all came back in a rush. It seemed we ripped aside the Leave It to Beaver curtain to reveal the set of The Glass Menagerie. But it also enabled us to talk more frankly and lovingly with our parents than we ever had before.

The trouble started early last summer when I went on vacation. I came back to town and checked in with my sister, Trisha. “Things got a lot worse while you were gone,” she said. “You won’t believe the shape Daddy is in.”

Trisha and I had alternated what we lightly called “The Feeding,” when we would take a nice Sunday dinner to my parents at their home in Stone Mountain. I usually picked up carryout for them at The Colonnade Restaurant on Cheshire Bridge Road, which prepares food that reminds my parents of their Deep South childhoods. Mama liked the fried shrimp and Daddy usually went for fried catfish. When I took the meals, we ate and talked. Their lot backed up to a deep pond and we discussed the geese and ducks that gathered there, not to mention the colony of feral cats they let live in their basement.

After Trisha’s warning, I picked up dinner and headed to Stone Mountain. When Daddy came to the door, I nearly gasped. He wore only boxer shorts and a ragged undershirt. He had never come to the door undressed before. He used a cane and could barely walk. He had not changed or bathed or shaved in days. His grisly white beard accented a face that was caving in with pain. His eyes were dark and sunken and he grimaced as he moved. His hands trembled. The house smelled of old food and cat urine. Daddy had let an old stray cat, “Gigi,” move into the house several years earlier. Gigi had started urinating on the utility room floor; Daddy just tossed cat litter on top of the puddles “to sop it up.” It didn’t work.

“Dad, what’s going on with you?” I asked him.

“Oh, I’m a little sore,” he said, hoarsely. He was in the kind of agony that throws your eyes out of focus, yet to him that amounted to “a little sore.” He tried to carry on conversation as usual, pretending nothing was wrong, changing the subject to ask, as always, “How’s your buddy?” He was referring to my deranged, pointy-faced cat, “Possum.” Possum was fine. It was Daddy I was worried about.

My mother, who injured her back when she fell on ice on their back porch several years ago, was almost immobile. She wobbled about on a cane, refusing to use the walker I bought her. Over time, she twisted her body sideways to accommodate the cane, giving her a slow, crabwise gait. Daddy waited on her, hand-and-foot, for years. He wouldn’t discuss getting a maid or a nurse. He took on both those roles himself, and wore himself out.

He sat in his recliner in his underwear and I told him that it was urgent that he see a doctor. I told him Trisha and I would make him an appointment with my mother’s doctor—he didn’t have a regular internist of his own—to check on his back. He said, finally, that might be a good idea. He admitted that when he tried to lie down in bed at night the pain was so severe that he was soaked with sweat from the effort. He couldn’t stand the pain any longer. He said it was so bad he was taking medicine—one Advil a day. But I noticed that the jug of bourbon on a table in the breakfast room seemed to be getting plenty of work.

My mother’s doctor agreed to see Daddy a few days later. When Trisha and I got to the house to pick him up for the appointment, I was shocked again. Daddy had deep gashes in his face, where he sliced into the skin trying to shave. He had used an old-fashioned safety razor and had not tightened the blade. It looked like he had shaved with a hatchet. The blood was dried like a crust in each wound. He had managed to pull some clothes on.

He was in excruciating back pain. Trisha and I persuaded him to let us get a wheelchair from the doctor’s office and bring it to the parking lot. We got into the office and the doctor ordered X-rays and a bone density scan, which took us the better part of the day. When my father had to lie down on a table for the tests, his mouth sagged open in a silent scream.

After taking a look at the X-rays, the doctor jokingly told him, “Well, partner, it looks like you made one parachute jump too many.” He said several of the vertebrae were compressing and that my father had arthritis, osteoporosis and some symptoms of Parkinson’s disease. He gave him prescriptions to reduce the inflammation and to strengthen the bones.

Daddy asked what he could do about his back and the doctor suggested that he pray.

“I forgot to ask him,” Daddy quipped later. “Should I pray to get better or pray to kick the bucket?”

My father was suddenly a very old man.

In my mind, he had always been a tall, muscular, dignified man in his 30s, with his dark hair swept straight back and a pair of wire-rim glasses. He was decisive, strong and brave. One time he saved me when a fireballing neighbor boy threw an errant fastball over our fence straight at my head. Daddy reached up with his bare hand and caught it. You could see the imprint of the ball’s seam in his hand.

Now he was bent, pale and weak. For the first time our roles were reversed: I was taking care of him. As I looked at him, I remembered driving him to his father’s funeral 30 years earlier and thought ahead to the time when my son will play out the same disturbing scene with me. But there was no time to think about that. I had to focus on the reality of the situation with my parents and one simple truth: It was only going to get worse.

We took my father home from the doctor’s office and got his prescriptions filled. As Tricia and I left, I said, “It’s only a matter of time until one of them falls.”

It took less than a week.

One afternoon in June, I was working on my computer, using my one phone line. When I logged off, I checked my messages. I had two. One was my mother’s little voice saying, “Doug, your daddy’s had a bad fall. The ambulance is coming.” The other was from Trisha: “Well, you were right. Daddy fell down.” Her husband, Jack, was headed over there to help.

I called my parents’ house. My mother said the ambulance had arrived. I asked to speak to one of the emergency medical technicians. A woman took the phone and said, “Your father refuses to go to the hospital. We’re getting him to sign a release.”

“What?” I shouted. “Doesn’t he need to go?”

“Yes, of course,” she said. “He had a bad fall and we recommend that he goes. But he won’t go. We can’t force him. That would be kidnapping. He just wants us to put him in his chair.”

His old burgundy recliner was stained and scratched to shreds by cats. But he clung to it as if it was his final refuge, his last little pod of freedom on his own terms.

I jumped in my truck and headed to Stone Mountain through the afternoon traffic. By the time I got there, nearly an hour later, the ambulance was long gone. Daddy was in his chair, shaken and disoriented. He had fallen in the driveway while getting the mail. He hit his head when he fell. He had then crawled about 100 feet across concrete to the house. He couldn’t get up on the porch, and a neighbor had seen him slumped across the steps and called the ambulance. My mother had been sitting inside, worrying about why it was taking him so long.

“Dad, I’m calling the ambulance again and getting you to the hospital and we’re not going to talk about it anymore,” I said.

He started to protest and tried to get up. He couldn’t. His legs were shaking too badly. He finally relented. His independent life ended at the precise moment he sagged back into his worn-out old chair and agreed to go to the hospital.

It was the first time in my life that I had ever successfully stood up to him. And then only when he thought he was on the verge of dying. In a shaky and unrecognizable voice, he told Jack and me his final wishes: graveside service only, medium-priced casket, or “outfit” as he called it, and no flowers, with donations to be made to his church instead. He had purchased burial plots in a cemetery I’d never heard of.

We were in the emergency room nearly 12 hours. About halfway through the vigil, a nurse had him remove his baggy old jeans. His knees were bloody; he had scraped all the skin off while crawling across the concrete trying to get back into the house. As the sun came up, he finally got a private room and the nurses went to work on his knees and to shave and bathe him.

I headed home across town for a quick shower. I had to appear on a TV talk show that morning. I was so tired I couldn’t remember what I said. Trisha, who had spent the night with Mama, hadn’t slept at all because her mind raced with memories and because she could hear roaches scuttling around the house. We had often offered to help clean up the house, but our parents absolutely refused. They had clearly reached the point where neither of them could bend over to clean. They couldn’t bend and they wouldn’t accept help.

The doctors discovered my father’s prostate gland was badly swollen. He would need surgery on the prostate and rehabilitation for his back. In the meantime, they temporarily put him in diapers. And with Daddy in the hospital, that meant there was no one to wait on Mama.

I spent a couple of nights on her sofa and worried about her through the day, while I tried to work. The first night I went back to her house and found her calmly staring at a ballpoint pen. She was moving it up and down and examining it carefully. She looked up at me, puzzled, and said, “The eye drops won’t come out.”

It sent chills up my back.

“Oh, Mama,” I said. “That’s not your eyedropper. That’s a pen. Let me look at your eyes.”

My first concern was that she had put ink in her eyes. But they were clear. She was just confused.

We had to find a safe place for Mama. Trisha had often offered to find a way to let Mama and Daddy live with her and Jack, but my parents always declined. They were simply unwilling to give up their sense of adult freedom. But we had to find alternatives immediately.

With advice from the hospital, Trisha located a little assisted living home off U.S. 29 with a good reputation. They agreed to take Mama. She didn’t want to go. I tried to explain that Daddy would be in the hospital for weeks and that Trisha and I couldn’t just leave her there. I told Mama that moving her into assisted living would be temporary until we found out what was going to happen to Daddy. But we each understood that it was one of those little lies designed to protect from an unpleasant truth. Mama seemed to instinctively know that she wouldn’t be coming home again.

“This is terrible news,” she said. “What about the kitties?” Her colony of wild cats had reached about a dozen, and they hung around on the back porch waiting for food and waiting to have more kitties. It was the sort of absurd scene you’d see in The New Yorker cartoons.

“I’ll feed the kitties,” I said. But that was another little lie. I knew I would have to get them rounded up and removed. Trisha had hired a woman to capture the cats about a year earlier. The woman set non-injuring traps but discovered that my father, like a rebellious environmentalist, had calmly released every cat, possum and raccoon that was captured. The woman furiously took her traps away and refused to return Trisha’s calls. We were later told that once a feral cat escapes from a trap, you never could catch it that way again.

Before we could put Mama into any kind of home, we had to take her to the doctor for a physical and a certificate saying she didn’t have tuberculosis. We took her to the little assisted-living house on a cul-de-sac in a quiet neighborhood in Tucker. Two other women stayed there, both considerably older than Mama, who was 83. The women were both named Ruby and were mute from strokes. We began calling them “Ruby” and “Ruby Tuesday” to tell them apart.

We got Mama to the home in time for lunch. She sat down at a clean little table in front of a ham sandwich on white bread, vegetable soup and grapes. This was probably the first time she’d sat down at a table for a meal in months. Daddy would just bring her a plate of food to eat in her chair as they watched TV. When I brought over food, they both ate out of their laps without leaving their recliners.

As she sat at the bright table in the clean little house, I said, “Mama, that lunch looks so good that I might take a bite.”

“You’ll have to fight me for it,” said Mama, who has never been at a loss for something funny to say.

The ladies who ran the house said they would give her a bath. And they required Mama to use a walker. I felt relieved that she was safe, fed and clean. But when Trisha and I walked out to my truck, I burst into tears because my mother was so old and helpless. It felt like I was leaving a small child at camp for the first time.

When I went back to visit Mama the next day, I thought she would be happy and relieved. Instead, she seemed confused and offended about why she was in the house. She wanted to go home.

“These other ladies here won’t even speak to me,” she said.

“Mama, they can’t speak to you—they’ve had strokes,” I said.

For another thing, Ruby Tuesday watched Christian TV all day, listening to the harsh caterwauling of white gospel groups. It was driving Mama nuts.

At one point in the day, we got Daddy and Mama together on the phone. She tenderly asked him how he was doing. I let her have some privacy as she talked with her husband of 55 years.

Trisha visited Daddy at the hospital. The nurses had called in a podiatrist, who clipped his long toenails, which had such dogleg curves that they looked like they belonged on Howard Hughes. A nurse glared at Trisha and snapped, “Why’d you let it get this bad?”

“Because he’s a stubborn old man who wouldn’t let us help him,” Tricia snapped back.

Daddy just grinned, like a wily old possum. He was finally clean, shaved and getting the attention he needed so badly. He even became a born-again medical patient, urging Jack and me to get our prostates checked. He was cheerful and talkative. We could stop worrying about him for a while and focus on Mama.

Trisha talked to a friend whose mother was in a large assisted-living facility near the DeKalb Medical Center. The friend was happy with it. We were relieved to find it had no waiting list. Trisha called and got Mama admitted, with plans to move Daddy in following his rehab. We went to the little house in Tucker to take Mama to her new place. I wore my typical summer weekend clothes—a Hawaiian shirt, shorts, sandals and my Georgia Bulldog baseball cap.

Mama looked at me and asked, “When did you start dressing like a honkie?”

“I always dress like this,” I said. “I am a honkie.” Mama can buzz through a Nora Roberts romance trilogy in a couple of days, so I brought her a stack of books to read. She had just finished reading about a family of witches, and said she was quite fond of one character: “I just love Sebastian,” she said with a wicked little grin.

We moved her into the high-rise assisted-living facility and took her to a room on the fifth floor, which houses the patients who need a higher level of care. You can only operate the elevator from that floor if you have a key. One day, I forgot my key and was waiting by the elevator until a caregiver came down the hall. An agitated woman in her 80s waited beside me.

“I’ve got to get upstairs right away,” she said.

“Ma’am, there’s not an upstairs,” I said. “This is the top floor.”

She adamantly insisted there was a floor above us and she had to get there. After I got on the elevator and left, I wondered if she was making a metaphor about heaven. I never saw her again.

When Trisha and I went back to visit, Mama expressed her displeasure with her new digs. She was in a clean, one bedroom apartment with a kitchenette, a small dining table, a living room with a TV, a sofa and a hospital bed where Daddy would stay when he finally arrived. She had a roomy bedroom, a double bed to herself and plenty of closet space. The facility has a friendly and thoughtful staff. A caregiver brought her every meal. But she wanted to go home.

“You put me in the slums,” she complained. “All the people on my floor are retarded.”

They were just old. She wasn’t used to being around old people. The whole building is filled with old people on walkers. I have come to admire the ones who fix up, who dress as nicely as they can and put on makeup and brush their hair and struggle to the dining room for Sunday dinner.

After his surgery and rehab, Daddy moved in with Mama. The rehab work was effective and eased his pain to an amazing degree. Using a walker helped him keep the pressure off his back. The prostate surgery was successful as well. Daddy began to drink 12 glasses of water a day, under doctor’s orders.

“That seems like too much,” Mama said.

“It’s supposed to be good for you,” I said.

Mama looked at me and said sarcastically, “Then why don’t you do it?”

At first, my parents were reclusive, unwilling to socialize. The caregivers brought all their meals to them. Now, they make a little procession with their walkers down the hallway for lunch with other residents in a little dining room on the fifth floor. But they still don’t venture to the main dining hall on the first floor.

With Mama and Daddy safely in the care of others, I talked to the minister who had visited my parents over the years. He agreed they should remain in assisted living because they couldn’t care for themselves on their own anymore. When we told Daddy what the preacher said, he calmly accepted it. We planned to clean out the house, fix it up and try to sell it. It took a long time for Mama to understand. She wanted to go back home. But Daddy knew he couldn’t wait on her anymore.

Working every weekend over the summer, Trisha, Jack and I carted out something like 300 big garbage bags full of trash, old clothes and old magazines. Whenever we would find something awful and decide to throw it away, Mama or Daddy would ask for it. I threw out some moldy old shoes from Daddy’s closet, including a cracked and worn-out pair that was almost red in color. The next time I visited, he said: “Bring me my good red shoes.”

“Dad, I’m sorry,” I said. “They were moldy and I threw them out.”

We also threw out some worn-out plastic furniture that had been on the back porch and was covered in slick black mold. “Who’s going to get that good plastic furniture off the porch?” Daddy asked the next Sunday.

“Trisha,” I lied.

Mama developed an uncanny knack for asking for things we can’t find. She became obsessed with a box of costume jewelry. We think it’s in one of the dozens of boxes we packed up and stored. We can’t find it to this day.

As we worked toward exhaustion, we kept unearthing memories. One day Trisha came across a stack of six old photo albums. It was like a treasure trove of memories—or so we thought. She opened the albums and was stunned to find that each of them was filled from front to back with stories, recipes and diet secrets that Mama had clipped over the years from The National Enquirer. Book after book contained such gems as “Lose Weight While Daydreaming.” Later that day, Trisha found a pile of family pictures on the floor. They were covered with cat droppings.

We masked the hurt by laughing until we were sick, but we couldn’t erase it. Trisha and I talked on the phone, long into the night. We recalled every trauma. We recalled the funny stories. It all flowed out. The good stuff. The sad stuff. Sometimes we laughed. Sometimes we cried. Sometimes we blew off steam. Trisha and I have depended on each other; no one else could begin to understand the depth of our emotions.

We cleaned the house into the fall. One day I picked up a little notebook beside Mama’s recliner. Mama is an artist who painted in the style of Marc Chagall. She has beautiful, clear handwriting. She had been writing on a page in the notebook, probably on the day we took her away. All it said was, “Sebastian . . . Sebastian . . . Sebastian.”

I hired an animal trapping company to catch the cats. They grabbed the young ones in a net, and set traps for the older ones. They weren’t able to catch them and the cats drifted off into the woods. We couldn’t find Gigi, the stray cat that Daddy let live inside. We figured she had gotten out when the door was open. But one day I saw a gray streak run past me in the house into the utility room. I closed the door behind her. The trappers finally caught her in a cage. They set the cage down in the driveway, waiting to load her into their truck.

Gigi looked at me and I looked back. I thought of this wild, old cat sitting in the lap of my father, who grew up wild and poor deep in the country and came to town and made something of himself and became a kind and generous man who graduated from University of Florida and took care of a family and sent two kids to college and designed and managed water and sewer systems from Thailand to DeKalb County. Both caged. Both trapped. Both taken from their home, never to return.

For a short time, after his fall, Daddy was in such bad shape that we thought he was going to die. But he pulled out of it. He is going blind from macular degeneration and can no longer read. But we still laugh at his great triumph, last spring, when he was able to get his Georgia driver’s license renewed despite being unable to see. The woman running the license station at the Kroger on Ponce de Leon Avenue was so busy that she stopped giving vision tests to people in line, including my father.

My mother, who used to be stout, has shrunken into a tiny little thing you can hardly see when she is in bed under the covers. She reads all day. Daddy listens to CNN on the TV. I got him an electric razor and he shaves several times a day. I am amazed at how much my parents have stayed in touch with the world around them. Mama still gets her National Enquirer.

Yet everything has changed. Daddy and Mama seem small and old in their tiny apartment. Daddy can’t get up and pour himself a drink of whiskey when he feels like it—booze is not allowed. But they are clean and fed and they use their walkers. I try to visit every week. And whenever I see them, I find it very easy to say, “I love you.” They say it right back. When I get up to go, Mama says, “Don’t leave.”

Daddy and I talk a good bit these days. He loves to keep track of my cat, the four grandchildren and one little great-grandchild on the way. My niece, Rebecca, let Mama and Daddy watch the video of her baby’s ultrasound. They were amazed and talked about it for weeks.

One day, Trisha said, “Daddy, Rebecca thinks this baby is God’s way of letting you see your first great-grandchild before you go blind.”

Daddy started crying.

Mama started laughing.

We’ve talked about what happened over the last year, about moving into assisted living. “It’s just so hard to give up,” Daddy said. “You just don’t want to let go.”

We’re fortunate that Daddy has pension income that pays for their accommodations. Their assisted living facility costs them nearly $4,000 a month, which is just under the national average of $25,000 per person per year for assisted living. Nursing homes’ costs average twice that much.

Daddy had built his plans around taking care of Mama. “All I wanted to do was provide enough insurance to take care of Mama,” he said. “I always thought she would outlive me. Now it looks like I might outlive her. Or we both might outlive each other.”

When I asked Daddy if the experience of moving into assisted living had stirred up his memories, he said: “Sure. It made me remember when I was still alive.”

A few months ago, the lady in the room next to theirs celebrated her 98th birthday.

“Just think, Mama,” I said. “When you turn 98, it’ll be the year 2016.”

“Don’t say that!” she snapped. She looked like she meant it.

Trisha noticed that Mama, who has never been deeply religious, has taken to singing a soft little prayer, “Mary, mother of God, bless me. . . . ”

When Trisha told me about it, I knew instinctively what was going on: “Mama is singing with the angels.”

Sometimes Mama is as sharp as ever. Sometimes she forgets things. They both eat a lot of ice cream and drink a lot of Cokes. Daddy eats salted peanuts and Mama eats chocolate candy. One day drifts into the next. Trisha and I still talk to each other almost every evening.

We think we did the right thing.