Tag: nursing home

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Lost Child

murphy nursing home

Murphy sits at Joan’s feet. Her hand finds his head and rests atop. Her fingers find their way through wiry fur to the bony skull beneath to massage his head. Her fingers are smooth and white. The fingers of an old woman whose hands no longer do work. Sometimes they wrap around a teacup, other times they rest on her lap. Her skin like latex. She once worked on the bodies of others as a physiotherapist. She would have touched a lot of skin. Kneaded many knots from muscles. Now she walks the corridors and attends any excursion she can. Anything to get out. The rest of the time she sits amongst the open-mouthed, the drowsy and the drooly.

She recognises us each time we visit, her face lights up, and she does not appear to have memory loss. The staff tell me she does. She cannot recall how long she has lived here. Today I find her standing outside one of the centre’s doors on a path through a manicured garden. Her hands come to her face that is breaking. I ask her, are you okay Joan, when I see her broken face. No I am not. I am trapped. I want to get away from here, she says, standing on the path and looking around, as if for the exit that is only metres in front of her. She has clear snot running from her nose and I say I will get you a tissue. No one wants to be without a hanky.

She takes it and holds it to her face. Murphy and I will walk with you, I say. Come sit in the garden. We sit. I offer suggestions as to things she might do. Others are inside playing Bingo after all. She is not the game-playing type. What about crafts or puzzles. Looking for ways to fill her time seems like asking her to pour sand into a bottle and then pour it out again. What would make you happy Joan? A dog.

Meanwhile a gardener is nearby and despite the heat is weeding, head down. Joan throws a question her way about her latest seedlings but the gardener doesn’t hear and so doesn’t answer. She is trying to make light of her tears now. I am sorry for being a bother. Joan tries again to question the gardener, and still she is not heard. She is an old unseen unheard woman, sitting. Beige and blending into paving. She is searching for conversation, for connection. She says she wishes she knew where the family of her dead husband were. Not her children, but still. She loved them, but they live far away and now do not visit. I don’t know where they are. Outside the gates somewhere. Her face is pained again like a small child lost. Gretel in the forest.

I wonder if audio books might be nice or even just the radio. There are so many interesting things on the radio, Joan. Like interesting matters. I don’t know how to use the buttons, she confesses. Come Murphy, sit here with Joan, and let her rest her hand on your head. Let her feel your warmth as giving and trusting as any human hand. Like family. He moves his head under her hand, shifts just a little to let her know she can leave it there as long as she likes. Good work Murphy.

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Doggy Dementia

winter

Just the other day I euthanised a pooch whose owner described him as having doggy dementia. She came in with him clutched to her. He was a sixteen-year-old little white fluffy who spent his days wandering the house, soiling himself and the floor, refusing to let anyone rid his coat of the tangled matts and deteriorating into a bundle of anxious quivering. She didn’t care that he stunk. She did care that he was in pain. If she could have admitted him to a nursing home for dogs maybe she would have. Maybe not. Recently she had had to go away and she’d left him with her sister. He’d not slept for three days.

Now I am reading Rebecca Mead’s absorbing article in The New Yorker about the advanced-dementia care at Beatitudes and I can’t help but think of the little white fluffy. Dogs get dementia too.

The director of education and research, Tena Alonzo, at the unusual and forward-thinking nursing home says, “All behaviour is communication.” With dogs it is even more so, since we never have a verbal language in common to begin with. We cannot ask them how they feel. To be a vet you must watch and listen. To know dogs is to observe and interpret their body language. To understand the demented human, body language needs to be read too. Alonzo gets the staff to practice interpreting non-verbal queues on each other, by having another staff member instruct them in a foreign language. She also gets the staff to brush one another’s teeth and to spoon feed each other – this is how you come to understand what it feels like to be the resident. The dedicated take to wearing adult diapers – to get a real sense of what life might be like for a dementia sufferer.

Alonzo says, “When you have dementia, we can’t change the way you think, but we can change the way you feel.” This might be true for dogs in distress too. We could always do with a little more empathy.

She describes how a black square of carpet at the entrance to the lift might stop a demented patient entering, since people with dementia have been shown to be unwilling to step onto such a black space, imagining it to be a hole. Reading this I thought – how like the cattle grid at the farm gate. Perhaps as we slide into dementia we are becoming more akin to animals. When Alonzo talks about her own old age – she says, “when I have dementia” knowing that cognitive decline comes to nearly all of us. Most of us will go there.

She says, “one of the things that create comfort for people who have trouble thinking is space. If you are too blocked in you feel frightened.” Think again of the animal that cage guards. Lunging and growling at anyone coming near, but as soon as the gate is opened and freedom is sensed, the animal can be handled.

When a patient can’t seemed to be helped with pain killers and distractions Alonzo says, “we’re going to try chocolate.” Hershey’s Kisses are a mainstay at the nursing home, because “it’s hard to feel very bad when there’s something tasty in your mouth.” We manipulate the behaviour of dogs with food rewards and lures too. Trainers and vets have long used the momentary pleasure of food to minimise distress. Keep feeding as nails are trimmed. Offer a popsicle coated in peanut butter to be licked while a coat is brushed. We can change a dog’s perception of something it is frightened of by repeated pairings of a food reward with the thing that is the dog’s monster. All the puppies I see for vaccination are injected, mostly without ever feeling the needle, as long as they are distracted by some tasty dog treat. As patients slip into deeper dementia it is as if the primitive structures of the brain take over. There is pleasure and pain. There is fear and anger. There is flight and fight. These core parts of the brain are similar across all animals so that in the end, when we are old and have lost our cognitive function, we are not so different from a frightened dog. Or horse, or cow. We may no longer be able to operate on a high intellectual level, but we still feel. Emotion lives on, sometimes stronger, unchecked, unleashed. Patients are described as “resisting care” when really they are like the dogs who are objecting to being restrained for grooming – they just want the man-handling to stop. In the nursing home the supply of pleasurable food helps avoid conflicts and makes people feel good, just as the only thing that could quell the white fluffy’s pacing was roast chicken from the corner store.

I think about how vets have learnt a lot from paediatric dentists. Today in the dentist’s there is no fear. It doesn’t even smell the same. Fuzzy green toys hang from the lights. Toys are handed out after the clean is done. The child’s dentist is so very different from what he was like when we were little. No white coat. Now they know how to distract and comfort rather than force and bully. The nursing home is changing too. It is no longer acceptable to bomb patients with antipsychotics (developed for schizophrenia) just to make them easier to handle for staff. Rather than becoming obtunded on Haloperidol, something as simple as Panadol may be all the patient needs to feel less pain and become more cooperative. It is better to lower the bed, so there is less harm in falling, than restrain people to their mattress. People need to maintain dignity, just as animals need to feel calm. It’s all about the kind of handling. You can take them gently by the hand and lead them or you can put a collar on them and pull. Which one do you do?

Just as humans are afflicted with dementia, our pets also suffer from cognitive decline. They seem to do the same things as our human relatives do. They mix day and night. Sundowning for dogs.They wander the corridors and holler for someone to help them. They don’t know where home is. They stand in corners. They forget who their relations are. They hear non-existent noises and bark at them. They are in pain.

Seeing others. Feeling like others. When we work well, at whatever we do, isn’t it because we recognise the emotion the other is feeling? Be it animal, be it human. We aren’t as different from other animals as some humans would like to think. Connectedness. When we strive to understand what another is feeling we make great steps to knowing ourselves.

 

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Missing

I think of her everyday.

I have a bookmark, made for her funeral, loose in the console of my car. As I drive to work and stop at the lights I handle the glossy card. The picture is of her on the phone, laughing. I imagine she is talking to a friend. Or perhaps she is talking to me.

She would be telling me about the Not Guilty verdict of Lloyd Rainey. Together we would scoff. She would be asking me to place a bet on a horse running in the Melbourne Cup. She would choose it because she liked the jockey or maybe the gelding’s name. She would be barracking for Obama.

I hold the card while I drive. Hi Mum.

I think of her everyday. I tell her stuff.

But it is different from when she was alive. Then, I was needed to do things. I had mandarins to buy. I had magazines to purchase. I had appointments to arrange. To drive to.

I grumbled to friends and family about the burden of the tasks. I felt smothered by her need to see me. Her joy, as a I entered her dimly lit room, only made me sigh.

To turn around now and say I miss her seems fickle. I feel unable to tell the people I complained to, that really it is simple, I miss her. I miss her everyday.

My life has a new rhythm without her in it. No nagging need to get this, do that. But. I miss her everyday.

No one is as interested in me in the greedy, consuming way she was. She had a need to know everything going on in my life. I, of course, hid it from her. I didn’t let her in. Not really. I kept it to myself. The way I do most things. From most people. Like a kid who shields their work with their cupped hand from the kid sitting next to them. Somehow petty. I wish I had shared more.

She would have been thrilled to hear about my recent trip to Sydney. She grabbed at stories. She gulped them in. She wanted my fulfillment. She wanted me to have happy experiences, with beautiful things. To stay in flash hotels and go to fancy restaurants. She wanted me to do the things she wished she had done, so I could tell her about them. I would watch her eyes fill with sparkle at the stories I would bring back from elsewhere. She could then have news for her carers and her hairdresser. She could be the entertainer then.

I imagine her sitting up in bed, watching the Presidential race. And Charles and Camilla happen to be in the country too. A feast of news. And Thank Goodness, no football. Her thin blue ankles on the plush throw rug. Her Hush Puppies by the bed. She will have a cold cup of tea on her tray. She will sip from it anyway. She will wrap the uninteresting biscuit in a Kleenex and put it with the others in the bedside drawer. I will attempt to ditch some older ones when she has her head turned.

I will give the flowers fresh water from the tap in her bathroom. I go through some letters she has piling up by the television and see what I can throw out. She will not allow any to be binned.

She will ask me to mark some dates in her diary. In here she writes which carer has given her the shower and who was on night duty. These are the things that are important to her. She will ask me to write when I am coming again. Is it tomorrow or the next day?

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Day Three of Dying

Her piano-playing fingers are swollen. Blue. It is not the hand I know. The one that has done so much touching, grasping, stroking, holding is in there somewhere, beneath the oedema. Today the memory of her bones are gone. The paper of her skin has turned to something like flesh. I think of Hansel and Gretel tricking the witch with their chicken bones instead of fingers. Too skinny,  the wicked witch would say. Not yet ripe for the cooking pot. What horror it made you feel as a child. Now I hold her hand, searching for the memory of it. Where have my mother’s hands gone? The image of them remains concrete. It cannot be changed. I hold it in my mind.

People who love her visit. They are shocked to find her non-contactable. June is there still, I say. The nurses said she could hear you if you spoke to her. I don’t know if this is true. To me she is asleep. And what do you hear when you are asleep? Your dreams. But this comforts those who visit. They sit and hold the puffy-not-her-hand and tell June how much she meant to them. They cry and say they love her. I give them some space to be beside her because they have only a visit and I have? How long have I to go?

Part of me feels as if she is on display. Some kind of exhibit. I am the museum guard. Making sure they don’t touch the artwork. Don’t nick anything. This is absurd. But there it is.

Maybe not having had the experience of being close to death makes us awkward. Our mind chooses other things to liken it to. I think of those red plaited ropes they set up in movie cinemas to make you form a queue for the box office. I think of those retractable barriers in airports that corral you into a zig zag line, heaving your unwieldy bag behind you. Even death has a form, a way of being. Form a neat queue behind the yellow line people.

There is sludge in the urinary catheter tube that leaves her body and fills a bag by the bed. It is not what is supposed to be in urine. The antibiotics are still not working.

Her lips are cracking. With a cotton-tipped bud I apply the lanolin. It is white and smeary. I like these tasks. I wish for more of them. I straighten the blankets. I smooth the sheets. I stroke her hairline. There is an inch or so of white hair now. Her hair is growing despite everything. She missed her last hairdressing appointment because of feeling unwell. She would hate the state of her hair.

Her tongue has some red blotches on it. It lies in her half-open mouth, flipped on its side, like a slug without its shell. Her breathing is slow and monotonous. It does not seem to be weakening. My sister will arrive tonight at 6pm. It’s not far off. Five hours.

At 1pm the nurse visits and they reposition her. We decide not to give June more morphine. She has been unchanged since her first dose and the nurse thinks that if she is dosed again she will not be alive for my sister.

I sit and watch her. I film her on my phone. I have captured her.

I write.

She would hate that I am doing all this. Recording such melancholia. She used to say, why can’t you write about happy things? She pushed away the deep and dark. She wanted lightness, frivolity, entertainment. She wanted Kate and Will’s wedding on the TV. She wanted a Silver Jubilee parade. She wanted baby pictures of the Danish Royals and for Molly Meldrum to pull through.

The silver chain nurse comes and examines her and gives her more intravenous antibiotics. We chat. When it comes time for him to leave he says, I won’t see you tomorrow. I answer, Oh.

I go through my mother’s address book for familiar names of people I should tell. I see a name Dossie. It is a name I know. Dossie this, Dossie that. But I have never met a Dossie. The number is a Sydney number. I ring it and tell the woman who answers that I am calling to tell Dossie some news. This is Dossie’s daughter, the woman says. Dossie died a couple of months ago and I wanted to tell June but hadn’t managed it yet. She is glad I called. Our mothers were close childhood friends. They played in each other’s yards. They put ribbons in one another’s hair. They had the same knee-high socks. They whispered through the pickets about boys. They stayed in touch for eighty years.

I am writing when I realise I have not heard her breathing and I look up from my notebook and spend a still moment watching the bed clothes. There is no rise or fall. I know instantly she is gone. I go closer. I go to the side she faces and look at her motionless face and watch it for a breath, for a sound. Oh. My first thought is that I was not paying attention. I should have been holding her hand. My second thought is of my sister. She has missed her. She is about an hour from landing.

Any moment now Graham and Jasper will be here to swap cars and go to the airport to collect Lisa.

I touch her forehead. I hold her hand. I watch her. My phone rings. It is my brother-in-law. He will be the first person to hear the words she’s gone. He is not expecting this.

Graham and Jasper arrive minutes later. Her hands are bleaching. No longer blue, but a deathly beige. Waxen. I tell them I will just sit with her till they bring Lisa. I will not tell anyone she has died. I want to keep it a secret for as long as I can. I want her to be like this when Lisa arrives.

I manage about forty minutes, just my mother and me, before a carer comes in with a cup of tea for me. I have to tell her June’s passed away. It seems wrong to not say. Are you certain? she asks. Oh yes, I’m sure. She is a little panicked by the fact that no one but us knows this fact and she must tell someone she says, and off she runs. Soon the doctor and nurse are in the room. I stand back. The doctor even warms his stethoscope on his own chest before he checks her for a heart beat. I guess it is automatic. We sit and talk about June. The doctor is sad. His sadness feels real. She had such a love for life, he says. I bet she gave a good party, he says.

I try to remember her parties. It is hard at first with so much death in the room. She loved celebration. I think of a surprise party she told me about that she had arranged for my father. It was for his fortieth birthday. We were only toddlers. She had no way of hiding from him the beer bottles in the bath, so instead she told him he would have to pretend to be surprised. And he went along with it. Faking astonishment to all their friends. She would have made devils on horseback and asparagus rolls. She would have worn strappy gold sandals and orange lipstick. The house would have been filled with the scent of Sweet Pea.

 

 

 

 

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Day Two Of Dying

 

I go to Myer to buy nighties. They are crisp and new. They are cotton with a delicate flower print. The woman serving me apologises for no one being in attendance at the counter while I was waiting to pay. I say the garments are for my mother. I think about adding – she is dying. But it is something that is just said in my head, to myself. It is a whisper under everything that I am doing. Like the rattle of the tracks under a train. Monotonous and keeping time. Outside the department store the arts market is going on in the square. The sky is ridiculously bright and blue. How dare it? I buy a takeaway coffee. In my head to the barrista; My mother is dying. The coffee machine has only just been turned on. It’ll take a few minutes; Is that okay? My mother is dying. Will she wait while I get takeaway coffee?

They already have her in a new nightie. It is pink, with flowers. I don’t think it is hers, but I don’t say. I put my two newly purchased ones, tags still attached, in the drawer. Tomorrow she can wear one of mine.

How are you Mum?

Better, she says. You don’t look better, I think, but do not say.

I am so thirsty. Still?

I check the fluids are working. Yes.

The tips of her fingers have changed colour. They have a blue hue. Think violet. Her feet too. In her outgoing breath there is a gurgling, fluid sound. On the inward breath too. She wants to cough but can’t seem to manage it. Her throat is like a frothy drain. What does it mean not to have the power to cough and clear your throat?

Visitors come. We sit around her. I give her globby water. I am careful to make sure she can swallow it. It isn’t much and does little to quench her relentless thirst.

She starts guessing her ailment. Appendicitis? Am I going to theatre?

Have you got pain June? the nurses ask. No.

Then she asks for Panamax. It has been her cure-all for many years, since the demise of Bex.

We conclude she must have pain.

The doctor has written her up for Hyoscine and Morphine. The drugs of the dying. At 3pm she has her first dose of Morphine.

Once she has had these drugs the gurgling stops and she closes her eyes. This is the first time she appears restful. It is a relief. It is like watching a baby sleep. It is peaceful. It is how it should be. I feel like someone who is waiting for a bus, but who isn’t in the slightest hurry to go anywhere. I feel like a person who is sitting in the sun, with my legs stretched out and crossed at the ankles. I have nothing to read and nothing to occupy my hands. I might just watch the traffic go by. I might just let the bus be missed. I will simply sit in the sun. And wait.

It is not over and I don’t know how much time she has but it is different now. There is no struggle to cough. There is not thirst. There is just sleep. There is just waiting and watching. I guess this is a vigil.

Dust is beginning to gather by the wheels of the bed because we have shooed away the cleaner. There has been no Leonie with her turned down mouth dragging her noisy vacuum. There are no stray mandarin pips. No crumbs from biscuits had with tea. Just dust.

From the en suite bathroom comes the burping sound of drains being unblocked. I think of Rolf Harris and the noise he made with his Wobble board.

I look through her address book for names of people I should ring. I ring some of her very old friends. They too are old. Some are older. Some still drive. Some have recovered from worse, or so they say. But they know what I am saying without me having to say it. It is in the croak of my voice. The child like sorry. They say, Thank you dear for letting me know. Give her my love. They say it matter-of-factly. How else should they say it?

Do all the dying look the same? She looks like Dad did now. Gone is the originality of her face. It is a dying face now.

 

to be continued…

 

 

 

 

 

 

 

 

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Day One of Dying

I go ahead of the ambulance that is transporting my mother back to the nursing home. Silver Chain has been arranged to come out and deliver the iv antibiotics. In my head I hear the parting words of the physician, she should recover from this episode.

I have confidence in his knowledge. He knows if someone in front of him is dying.

I give a heads up to the nursing home staff. June is on her way. Her room is readied, the bed turned down. Her favourite 100% polyester blanket with the pink love hearts is smoothed over. Sun has flooded her room. Light appears to have burnt off the illness that had pervading it. Here she will do as the doctor said. Recover.

I warn them that she will want to use the toilet. More than anything.

Seeing her in the arms of two of the most capable nurses, one on either side, assisting her to her bathroom, I feel able to go. I leave confident that on my return the following day she will be recovered.

I go home. I take Jasper to footy training. I stand in the cool evening air and watch ten-year olds run and kick and sling tackle each other to the ground. Mothers are talking about house prices and renovating vs moving. Jasper stays after training officially finishes to keep on kicking for goal. As it turns to dusk and he comes towards me I see his green and black stained knees. Anointed by winter grass. I sleep.

In the morning I go to the nursing home expecting; sitting up in bed, conversing, television on. Instead I enter a room where the curtains are still drawn. She has not recovered. No dirty knees. She looks worse. How can this be?

I buzz for the nurse.

What’s happening? I ask. Remember learning to ride a bike. Whose idea was it to start you at the top of a hill?  You’ve never gone down it before but once you push-off at the top it’s too late to change your mind. Did someone give you an almighty shove? Flying down. Fast. You don’t want to go faster. Already you feel out of control so you take your feet off the pedals, but you need your feet on the pedals of a back-pedal-brake bike to slow down and stop. Why were you given no instruction? And now you realise you don’t know how to stop. You crash onto the grass. You just want to get off this thing.

My heart has sped up, down-hill-no-brakes-fast, and won’t go back to resting for some days now. It is reminding me I am alive. This is me with grass-stained knees. Feel it.

A nurse has my mother’s hand and is working her rings off her puffy wedding ring finger. There are three rings that live here, two of which have stayed put for fifty years; an emerald engagement ring and her silver wedding band. The nurse says I should keep them safe till her fingers come down. I slip them on my finger. Just for now, Mum. She has on her worst nightie. It is bedraggled and fraying at the shoulders. I am embarrassed for her, but it seems they didn’t want her in a long-sleeve and could find no others. I will buy more. It seems important.

No one will say she is dying, so I ask. Is this the start of dying? I think I have asked this question before with my Dad. I am feeling on familiar territory. They are not words you articulate often. They are unforgettable as they leave your mouth. Maybe if I don’t say it, it won’t happen? But that just isn’t me. I say everything. I write it too.

I ask Marie, What do I do?

You should tell important people to come and visit, she says. This is an admission.

What now?

Yes, she says.

Remember being in the ocean and facing wave after wave. My dad was there with my sister and I, teaching us to be safe in the big surf. But he didn’t hold our hands. You take a big breath and dive under. It is calm beneath the surface. There is a pull. Outwards away from the earth. Is this something like an astronaut might feel, walking on the moon? It takes your feet off the bottom. It pulls you further from the shore. Your head pops up and another wave is on its way. You belong to the ocean now. It can take you from your family if it really tries. The next wave is bigger. Harder. Bam. In the washing machine of the surf. Over and over. What is bottom? What is air?

My heart has sped up, dumper-after-dumper-fast, and won’t come back to resting for some days now.

 

Home is the bed. White linen. Sponge bath.

I leave the room for them to give her a wash and reposition her. They are worrying about bed sores. You should make some calls, they say. I am in the corridor of the nursing home. I go to the dead-end, where the exit door to the garden is permanently locked. I ring Graham and tell him to bring Jasper from school. I ring Lisa. I am incoherent. She is dying, I am blubbering. My sister doesn’t understand. After all I had told her she was recovering only the day before.

I have to say it again. I am saying it between choking, sobbing tears now. I don’t know if you will make it even if you come now. But you should come. Do your best to come.

I ring some relatives. Ones who count. Ones who have visited her. I ring the long time neighbour of June who has been here along every step of the way. She will come. I ring my best friend. She will come too.

I speak to June’s GP. He has heard she is worse. He wonders if going back to the hospital would be a better plan. We argy-bargy back and forth. Can’t she have IV fluids here? It appears the nursing home is not classified to give acute care. An IV can only be looked after by Silver Chain. Okay then we ask Silver Chain, I say. Because she is better here. This is her home. The staff love her here. No one loves her at Fremantle Hospital. Why am I suggesting love is what she needs? I know love does not heal sepsis. I don’t believe that love can stop the progression of illness and disease. But somehow it seems important to keep her here now, rather than send her back to the hospital, where they may muck about adding wires and fluids and taking more measurements. I don’t doubt the outcome either way now. The hill has been scaled, we are hurtling down the other side.

Opera plays in the room next door. Non-stop loud. From the dining room the sound of afternoon game shows on the television clashes with the arias.

Graham brings Jasper from school. He is worried at being absent while the class is choosing the Olympic sport they will each research. He doesn’t want to end up with something he thinks of as a girls’ sport. Of course he wants road cycling. On seeing the boys Mum says, that’s a bad sign. People are standing around the bed looking at her. Taking her hand. I feed her spoonfuls of thickened water. It is like clear jelly but tastes of water. She can swallow it easily. She can’t get enough of the thickened stuff. She is thirsty. I give her spoonfuls of the globby water. She is still thirsty. She huddles in the child-like pose of the sick. Her hands are clenched when they are not in mine. Will I heal? she asks me. Yes Mum, of course. Even though she does not look at me I say it smiling, with brightness in my voice. A you-can-do-it, Rah-Rah kind of voice.

I am giving her the thickened water, when I feel a presence behind me. It is a nurse I don’t know and she is rubbing June’s upper thigh through the blankets. She takes her hand out of mine and holds it. Oh June, she is saying over and over. Love you, June, love you. I turn to see big, fat, wet tears running down her coal-black skin.

Just as the carers come and hold her hand or stroke her face, my feeding her spoonfuls of water, is all I can do. This delivering of a few mls of liquid into her dry mouth feels more important than it is. It feels essential, and healing, and nurturing. It feels life-giving and capable of staving off death.

In the afternoon the Silver Chain comes. The nurse has a bag of tricks; pulse ox, blood glucose measurements, stethoscope. She makes her assessments and rings the doctor. It is decided she can have subcutaneous fluids to avoid being over-perfused and getting a moist chest.

I stay till the sun goes down.

I don’t stay with her at night. She could pass away while I am gone. I accept that. I can’t stay all night. I wonder how long the night must feel when you are creeping towards your death. Does it pass by quickly or else eke? What dreams does she have? Does she feel the edges of her world closing in on her?  Are the corners all blurry?  Is there a central thread, an essence of self, which is clarifying? As sweet as the nectar sucked from the centre of the honeysuckle? As I leave her that night I place a hand on her forehead, like I am her mother and she is my child, and wish her sweet dreams, Mum.

 

To be continued…

 

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When my mother died…

It is Sunday and my mother has been dead for just over a day. We, the bereaved, are in the supermarket getting things for dinner. Because even when someone dies there is food to cook and dishes to wash.

We have spread out in the supermarket to get it done quickly. Lisa is sent to find toilet rolls. Graham is getting the mince. Jasper is taking a moment to check out the toys. I am getting Salada crispbread since there is still school tomorrow.

In the biscuit aisle I see a woman, roughly my age, with an older woman. The elder has a walker that she pushes in front of her. The older woman has on comfortable slacks and Hush puppy shoes. The younger woman pushes the trolley and loads it up with their groceries. She looks a little tired – like perhaps she wishes she were doing something else with her Sunday afternoon. They have a large collection of sweet biscuits. Monte Carlos. Mint slice. I imagine the younger woman is the daughter, (I can see the resemblance) and the older woman her mother. They are everywhere these pairs. I see them in the chemist and the waiting rooms of doctor’s surgeries, in the emergency room of the hospital, in post office queues and filling out withdrawal slips in the bank.

When I accompanied my mother on such journeys to the Captain Stirling shopping centre she knew everyone – the pimple-faced, flour-dusted girls in Brumbies, the aging pharmacist, the grey-faced newsagent, the grocer called George. She knew them by name and then the names of their children and their boyfriends and their spouses. She knew how many marriages they had had and the diseases they had recovered from. She knew the degrees their children had studied for and their subsequent careers. She knew when and where they were going on holiday and for how long. She knew how much money the girl in Brumbies needed to save to go on vacationing on the Gold coast. She brought them small going away gifts and welcomed them on their return. She brought them in homemade choc slice for their birthdays and told them if their star sign was one she was compatible with. She invested time and energy in the lives of other people.

June had a way of endearing herself to others. She was memorable, indelible. She thrust herself into their worlds with her inquisitive nature. As her daughter it could be mortifyingly embarrassing to have your mother speak to everyone and not in a hushed tone. At restaurants she always wanted to, and often did, stride back into the kitchen to congratulate the chef.

I was her source to the outside world; the bearer of mandarins, in winter, and grapes in summer, the deliverer of the Woman’s Day and Hello. She loved me and didn’t want to be separated from me in a way that is almost impossible to bear. Sometimes I felt like I was, for her, a reason to be alive. She fought her hardest to stay with us. I am thankful that I was able to be with her when she passed away and to know first hand she did not suffer, but simply seemed to seep effortlessly from this life to what is beyond. As those who have already lost their mothers must know, it is the strangest feeling to know that suddenly your mother, the woman who bore you and who indeed has been the one most intent on your happiness, is no longer watching over you. Now you are grown.

In the days leading up to her death the carers at Hilton Park would come in to speak of their fondness and appreciation for her. They did this because she had developed a relationship with each and everyone of them. It was immensely moving to watch them come in, one by one, and take her hand in theirs and thank her for her kindness and love. They told me how she didn’t complain, how she helped the other residents, how she complimented the cooking and how interested she was in everyone. I will be forever grateful and indebted to her carers and nurses and all the wonderful support they gave Junee from Room 25. That she was able to pass away in the home, she had quickly come to love and be loved, was indeed very special to us, as a family.

 

 

 

 

 

 

 

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And now to write…

I was planning to spend the morning writing, but instead I am at the nursing home watching my mother.

When I rang her all she would say was sick, then hang up. I wasn’t sure that she even knew it was me she was talking to. I know her hearing has been especially bad lately. So poor, that she responds to your questions with answers that clearly reveal she has not heard what you have asked. It makes conversation virtually impossible, and so I just listen to her. She is content with that. In the past she needed to have me tell her stuff; entertain her with stories of the outside. Now she merely needs me to hear who gave her a shower and what they were served for lunch the previous day. The fish on Mondays is her favourite. She complains about Leonie, the cleaner with the turned down mouth, who moves her stuff. She tells me about Joyce who, in her demented state, eats the paper napkins and other inedible items set out on the dining table. Lately my mother just likes to have me nearby. She likes to see me. She likes to hold my hand with hers.

Mostly I prefer not to hold hands. It is too restrictive. It means I have to stay put. But, I have to let her have my hand, today. She is child-like and small in the already small bed. She has many pillows around her, seeming to compete with her for bed space. They threaten to dislodge her from the bed. They are hospital white. She groans and moans. She has her legs up and then down. I look at the portrait behind her bed of her mother sitting at a dressing table arranging flowers. It is the image of a woman in a dark green full-length gown, almost with her back to the artist. Her auburn hair is loosely tied up, while her hands work on the bouquet. It is serene. It tells of time spent in a garden and then in a house. It tells of making a home. Flower scent. Jade velvet robes. Dark wooden boards. Dressing tables. This picture hung in my parents bedroom when I was a child. It has always looked over my mother as she has slept. With her always. Offering its solace.

I return her watch which I had taken to get a new battery. It has a gold chain band and a simple small black face. It slides on to her wrist and, as she feels me replace it, she fingers it to see its face and read the time. Her skin on her hands and arms have all the wrinkles and strange patches of old age. She has barnacles and seborrhoeic keratoses. She has flakes and protrusions. On her skinny arms, she has the stuff of witches. I take off the stiff leather-banded watch I lent her, with its hard black band so unsuited to her. She is pleased to have her old watch. It has no second hand. It does not count in seconds. She loves to know the time. Intimately. On a good day she will have the egg timer on to tell her how long it is till lunch, or dinner, or till I might arrive or I might leave. It is always set, ticking down the moments till something or other. Till Ready, Steady, Cook. At Langham Street it told how long till morning tea should be served, how long till the start of the ABC News, how long till Alex should come in from the garden and have his shower, how long till it was time to turn the sprinkler off and move it round the back. It was the tracker of tasks. Now it is silent.

There is the hum of the air conditioner set to heat the room. Twenty five degrees. It is stifling hot, while outside it is crisp and clear and cold. Outside the room there is life, rushing on. Even in the nursing home dining room, a few metres away, there is more activity. The old and demented are getting ready to eat. My mother has her curtains drawn to block out the sun. She is still in her pink cotton nightie. She has refused her shower today and is not drinking enough water.

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Easter

I make my traditional Norwegian Buns. They are oozing with melted butter and cinnamon sugar. They are Nigella’s – queen of sweets. It is a two-hour job, begun before the house is fully awake. There is the kneading, the rising, the rolling, the rising again and finally the baking. The rings on my fingers are glued to my skin with sticky dough. The stainless steel taps get coated with the stuff. Unctuous. The dishcloth becomes unusable. It is usually a messy affair with lots of flour across the floor but this year it has been better. Uncle Dave comments, Not So Messy, ah. The dog is doing an excellent job, tongue to the floor.

Easter is not a church-thing in our house. Graham barely knows Good Friday is the day of the crucifixion and Easter Sunday is when He rose again. Dead three days, Not bad, says Jasper. How is it that Graham can get the days confused? He is poorly educated in religion. And so too is our son. Neither do we do Eggs or Bunnys. What we do is watch the seasons change. Normally Easter signals the start of cooler nights. There might even be rain. Dew in the morning. A cardigan is retrieved from deep in the drawer. The leaves on the Robinia are dropping. The Western Corellas head North. The dog can wear his “doggy jammies” when he is put out at night. The fan goes into the attic, and down comes the gas heater and the donnas. The sun is still shining, but its heat is toned down. The roses will need pruning soon. The dome of blue is at its most brilliant. Best of all the wind has gone. Still, crisp air. A leaf let loose from its twig, free-falls straight down.

This year the boy is injured. A buckle fracture of the distal radius means he has a blue half-cast on his arm. It is cleverly made by Amanda the OT out in the burbs, with an electric frying-pan full of hot water and a hot air-blower. It has been three days since he tripped in the playground on a ball and came down on his hand. Three days since the phone call from the school where the assistant teacher told me, “he has washed his face and has ice on the injury, but still he would like his mother to come pick him up.” The green stick fracture is barely visible on X-ray. A mere blip on the periosteum. On the third day; the throbbing has gone away and now it is just inconvenient. Or else part of his make-believe armour in a game of Iron Man vs Batman. Reborn as Superhero. Alas; no skateboarding, no Footy, no tennis.

The neighbours have gone South. The houses around us are empty and quiet. Hollow of people. The clothes lines are nude. The bins are already out on the street, waiting. The mini has its car cover on.

My mother telephones in the evening; I’m in Agony. Agony. You must do something.

Her indwelling urinary catheter has blocked. Again. Unexpected. It is something that is happening to her more frequently these days. It is supposed to only need changing every six weeks, but lately it decides it will stop working somewhere around the four-week mark. When it blocks acutely it means her shrivelled bladder, the size of a walnut-shell, is asked to stretch. It doesn’t like it, so unused to being a container. The small muscular organ is not accustomed to filling. Its nerve endings fire off, indignant. It gives her great pain, as her ungenerous bladder expands, and yet the staff at the nursing home are slow to swing into action and get the thing changed. So she rings me. This can’t happen again, she says.

I ring the nursing home but no one is answering the nursing station phone. Perhaps they are eating Easter Eggs. Sucking the chocolate between their teeth.

She rings back. It’s sorted. The catheter has been changed. What a relief. I can hear the return of perkiness. A nurse appeared with a trolley. Hands washed; sterile gloves snapped on. Once the task has been started it is over in three minutes; a nurse has whipped out the old one and threaded up the new. The bag has filled. The bladder has wilted and wizened, back to its peach-stone pip-size. Huddled down into its pelvic bed. Back to slumber.

But it will block again. It is the nature of the thing. The bladder is irritated by the catheter sitting in its lumen and a biofilm (a nice word for gunk) forms around the eyelet of the catheter. Then the drainage gets poor and eventually it blocks, and no urine can drain away into the bag. The catheter needs to be changed for a new one. But it is only a matter of time before that too is coated with the cellular and inflammatory crud that plugs the catheter opening. Bladder failure is what she has. And there is nothing medicine can do to replicate the ingenious functioning of a normal, healthy bladder.

But nurses changing it quickly, when an old woman cries out, I’m in agony, might be a good place to start.

 

 

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Snezana

She is a new cleaner. Her name is unpronounceable to my mother. It is the word for “snow woman” she tells us. She says, making a gesture at her neck, that her country gets many feet of snow. Snezana – with a saucer of a moon over the z. But she is blonde and so the name makes sense and I can imagine it sticking for my mother. You can call her Snow. She squats down next to my mother’s chair to greet her. When she has emptied the bins and sprayed the bathroom sink and has gone my mother says, “It’s important to remember their names.” She didn’t say that it humanised her to them. But that is what she meant. If she remembers their names it shows them she is not like all the others, who don’t recall their own name, let alone someone else’s. Maybe they will answer her bell, when she rings it, believing she really does need something. Maybe, if she calls them by their names, they will treat her nice. Like she is their captive and she is softening them up, making ready her escape when their backs are turned.

Mother tells me they all have Alzheimers here. And she is right about a lot of them. One man lights up when he sees Jasper and speaks to him in an excited foreign language. He is always in the corridor, with his slippers on, his hands clasped behind his back. He loiters about the intersection of the corridors as if he is on a street corner waiting to cross a busy road. Sometimes he sings softly to himself. He has large, unblinking eyes.

My mother’s nails are beginning to deteriorate. They were strong and clean most of her life. Despite gardening. Often they were expertly painted a soft pink. They are the long slender fingers of a piano player. Is it a sign that she is deficient? She eats two bananas a day. Egg sandwiches every night. But she does tip the protein drink down the toilet. Sometimes I do it for her.

I have to cut the right hand for her. She can do the left herself. I don’t like to do it because it is difficult. The nails seem to shatter as they are cut and she makes out like I am cutting her when I am not. Careful careful. Today she has a reddening at the side of her finger. I go out into the corridor and find a carer walking past. One who cares. She is svelte. Jane was a dancer. She moves like someone coming off stage. She calls the thing on my mother’s finger a whitlow. Mother winces at the cutting of the nail. Her hands are barnacled. Fixomul covers something that has recently bled. The hands don’t hold a pen well these days. They can’t seem to work the battery cage on the hearing aid. They can’t manoeuvre a hearing aid into the shell of her ear. They have lost their strength to do up a seat belt or turn on a tap. They have forgotten about buttons and zippers.