February 11, 2012


My grandfather took fifteen years to die. Newly-retired, he was on vacation with my grandmother in Asheville, N.C., when he had a heart attack. My mother flew there from Indiana to be with my grandparents; “Grampy” spent 10 days in a Hendersonville hospital. My father flew down to drive the car back, and my grandparents and my mother flew back.
Because I was a fortunate child, I had not suffered any early loss. Still, I remember the shock of hearing that my beloved only grandfather had suffered a heart attack.
He was a large man, tall and big-boned but tended to eat from a diet schooled in German traditions and red meat. For much of his career he worked for “The Prudential” as he called it, buying, selling, and appraising land. Six days a week, he wore a suit and tie at work and for church on Sunday. A handsome man with a twinkle in his eye, he often waved the red flag against the bull that was my grandmother.
You couldn’t help but like him.
One autumn, Grampy crossed state lines in Ohio with his physician friend to hunt quail, and filled up the trunk of his large Oldsmobile with many birds over the limit. When stopped in a little border town by the Ohio State Police, my grandfather told him that the doctor accompanying him was on his way to a difficult surgery at a Fort Wayne hospital. The cop passed them through, never looking in the trunk.
When I think of my grandfather, I remember a happy person who always lived life large.
His wife, my grandmother, was a registered nurse and constantly warned him to watch what he ate, and he would say, “One meal at a time, LeNore.”
His dietary habits, combined with genetics, caught up with him in the Blue Ridge Mountains.
The vascular dementia that killed his father and sister was also coming after him, and would later get his brother. In the last year or two of his life, he lost that sparkle in his eye. While he was still the man in the suit, he was lost to us.
From that day of his heart attack until his death 15 years later, he had amazing care. He had the kind of care that everyone wants— his family.
No one takes care of you like family.
My grandmother had decreased ability to care for my grandfather, as she had problems of her own. My parents lived ten miles away and went to extraordinary measures to keep them at home. After my grandfather died, my grandmother visited Florida for a few winters but Alzheimer’s disease was already putting its mark on her forehead.
She spent eight years in the Alzheimer’s unit of a facility; my parents made the 60-mile-roundtrip journey once or twice a week until her death.
# # #
My mom began showing signs of the disease in her sixties, but she was the master of the slick cover-up. Her lifelong social graces stood her well as she knew how to cover a misstep or misstatement. Eventually we began to catch on. I don’t know why we were surprised considering the genetic lottery ticket she holds, with its low odds.
The light-bulb-above-the-head moment came when Mom’s sister was visiting from the East Coast. Mom always drove to the beauty shop for her weekly wash and set. That day she couldn’t find her way home, even though it was less than a mile away. My aunt was more cued in, and alerted my father and me.
Reminds me of the old story about making frog soup. A frog won’t willingly jump into boiling water, but if you convince him it’s a day spa you can slowly turn up the heat. Dementia was slowly heating up, and despite all our family experience we couldn’t see it without the help of someone not normally around.
Now it is my mother who is in a skilled nursing facility. She is in the end-stages of vascular dementia, and finally her body is letting go. She can’t stand, walk, eat by herself, and doesn’t communicate well. She still talks, but has few moments of lucidity.
Ten days ago I was present when the doctor finally came to see her, two weekends after ER visits and three days after admission to the nursing home. Dad and I listened carefully to everything he said. When he said, "Il think you need to look at end-of-life measures" I asked if we could all step out in the hallway, away from my mother. While she doesn't understand, it just seemed rude to me to have this discussion in earshot of her. It seemed disrespectful.
The doctor asked about her advance directive, which is in place and expresses her wishes, and then he said he thought she needed Hospice.
I worked in and around hospitals for 30 years, but Hospice is still a difficult word to hear even when you know what you know and know where this is all headed. All of my knowledge and experience and understanding of how health care works totally went out the window in that moment and I just hugged my dad and told him everything would be okay.
# # #
For all of my life, my mother’s eyes have been bright blue and engaging; now I look in her eyes and see my grandfather looking back at me just as he did at the end of his life.
My father has fought the good fight, and has cared for her for many years including the last seven in a retirement home. He often refers to the vows he took nearly 57 years ago, and says he would have it no other way.
What do we do now?
My father’s primary job has been to ;lovingly provide direct care, now he is her advocate while someone else provides the care.
I try to support my father with cards, letters, and old pictures, and daily phone calls. We’ve encouraged him to stay on his schedule and take advantage of his usual activities at the retirement home.
Of course, this is so difficult for him.
I can’t imagine. I don’t ever want to leave my husband of nearly 30 years, so I cannot imagine what more than half a century must feel like.
People are so kind to my family. I’ve personally received dozens of notes from her friends asking how she is and telling wonderful little stories about her.
And I’m overthinking it. Why can’t I just be at peace with what is? I’m not sure I’ve ever accepted the expressions, “there but the grace of God go I.” or “bad things do happen to good people.”
When some family members were involved in a horrible tragedy years ago, well-meaning people said, “That must be God’s will.” I don’t think so. Nor do I think it is God’s will that an acquaintance of mine recently loss twin grandbabies, due to prematurity. Nor do I think it is God’s will that anyone have cancer or ALS or dementia.
There are, indeed, some things worse than death, particularly when one has lived a good full life.
But it isn’t my call, and I am trying to wrap my arms around what is, and be so very grateful for what was.
God’s will is, I believe, the gift of grace. It is finding something deep within to sustain you in the difficult times. I seek to help my father find that grace.
Maybe God’s gift is strength or a good sense of humor. My parents’ graduated from rival universities and live in a university town. The rivalry has been one of the themes of their life together.
Shortly after my mom went to the skilled unit, her team beat dad’s team badly in basketball on their home turf. Everyone in the family supports dad’s team, except for me. I knew in my heart that her team would win that game. I just knew they would. That’s timing or luck or sense of humor, or maybe God is trying to tell us something. I don’t know.
Grace appears and we reach out to grab it, like the tiny, milky seeds from a dandelion plant on a hot summer afternoon. I find it in the old stories, in the connecting of the dots, comfort in the words. Maybe it is telling this story for others who are beginning the journey. Maybe it is just learning to absorb and soak up every ray of sunshine, every glorious blooming flower, every child’s toothless grin, and fill one’s soul with the goodness that is ripe for the taking. I don’t know.
© 2012 A.M. Abbott  This essay was recognized as an Editor's Pick on Open Salon February 13, 2012 and was featured on the cover page.