Angst of Aging

I knew there was trouble when I heard the breathing before the door opened.
Sounded like air blowing through a straw in a glass of water. My neck muscles tightened when I looked into the red-rimmed eyes of the elderly man at the door. His ruddy face with several days old stubble carried a pained expression. Dressed in wrinkled clothes that looked clean, the plaid shirt collar frayed, there was a familiar odor of decaying sweat.

“Hello, Mr. Fedele...my name is Marie Henson,” I said.

He stood just inside the doorway, peering at me from under a frown, panting breaths making greetings impossible.

“Bruce, your son in law called and asked me to come. I’m a nurse.” I said
pointing to an identification badge clipped to my blue jacket. He nodded and motioned for me to follow him. The cluttered living room air was stale and damp like entering a tomb, drapes were closed over windows, but a small ceramic table lamp cast a dim glow near the doorway.

The long distance phone call from Bruce Mason had come after office hours for the
home health office. My work was finished for the week and I was headed for home. If this call had come just a few weeks earlier, there would have been no hesitation. As it was, my mother was temporarily living with me, and dependent on my fixing supper. She spent daytime hours sitting in the same blue chair watching television until I returned.

Maybe it was the fear in Bruce’s voice that had sent a chill like icicles down my back, and caused me to agree? Perhaps it was just another way to delay returning home where my mother would be waiting? I agreed to make this stop, walked into this chaos and was, now, seriously second guessing that decision.

The elderly man sat at the edge of a small couch just inside the living room. On a nearby table was an array of prescription bottles with cardiac medications that I
recognized: Lanoxin, Lasix, Potassium Chloride. Placing my bag on the floor, I sat at the opposite end of the couch. His shoulders seemed to rise and fall with each breath as if every muscle strained to pull in air. Veins in his neck bulged and I noticed perspiration on his forehead. No need for a stethoscope to see he was critically ill.

“How long have you been breathing like this?” I asked before realizing the
impossibility of taking a medical history. He merely shook his head and mouthed
something that looked like “today.”

“You need emergency medical help, Mr. Fedele. Let me call your doctor.” Without
waiting for a reply, I reached into my bag and pulled out a cell phone and ballpoint pen.

He opened the table drawer, retrieved a grey address book with a business card paper-clipped to the front cover, and handed it to me. The card was well worn around the edges: Dr. Gilbert Adams, Family Physician.

As I dialed the number, my eyes swept the dimly lit room. Then I saw her sitting on an upholstered chair across the room silently staring into space, her bony frame dressed in a flowered housedress, now several sizes too large, hands clutching the edge of a knitted afghan on her lap like a child holding a favorite blanket. Her feet were enclosed in purple slippers that matched the veins on her bare ankles.

“Mr. Fedele,” I said while waiting for the phone call connection. “Your doctor may
want you to go to the hospital.”

“No, no, can’t leave Millie,” he said shaking his head. He glanced at the elderly lady sitting across the room and wiped his mouth. “Won’t leave Millie alone,” he said in a whisper.

Millie began to rock back and forth on the couch, making chewing motions with her
mouth. It reminded me of my mother’s problems that began just after her seventieth birthday. Neighbors noticed papers collecting on her doorstep and went inside to find that mother hadn’t eaten for days or taken her medications. As an only child, I felt responsible to move her in with me, at least temporarily, until I could find an apartment in the area.

How I missed the freedom that comes with being a single and successful woman.
Until mother was moved to her own place, I had to turn down spur of the moment invitations to dinner, couldn’t sleep in Saturday mornings. Mother and I had never been close but any suggestions to place her in a nursing home made my skin crawl and I vowed to not let that happen. It was a promise I had made to Daddy before he died.

Dr. Adams answered the phone on the first ring. “Hello, this is Marie Henson with American Home Health,” I said. “I’m with your patient, Joseph Fedele. He has extreme dyspnea, his breath sounds are full of moist rales and his skin is ashen grey.”

“Hmm, yes…Joe has a history of severe congestive heart failure. Sounds like he
needs to get to the E. R., I’ll meet him there.”

“But, doctor, he’s worried about Millie…”

“Marie, he needs emergency medical care. Get him to the hospital…or he may die.”

“Right. I’ll call for an ambulance,” I said, closing the cell phone.

Joe began to cough, his body convulsing with each expiration. I felt my stomach knot and I counted the seconds between each breath he took. Millie looked at me with vacant grey eyes. Her tiny frame seemed lost in her clothes, scrawny elbows sticking out of sleeves, hands lifeless in her lap, a small gold band visible on her finger.

“Joe, I’ll stay with Millie,” I said impulsively. Anything to get him off to the
hospital emergency room, and not to die on my watch. This seemed to be the only option.

My hand reached out to touch his shoulder as he looked into my face and continued to shake his head. His breath carried a sickening sweet odor like rancid fruit.

“You’re struggling to breathe, Joe. Dr. Adams believes it’s congestive heart failure,
like you’ve had before. He’ll meet you at the E.R.,” I said.

Across the room, Millie mumbled something incoherent like a babbling child. She
shifted the afghan on her lap, crossed her legs and continued the rocking.

“Millie needs you to be well, Joe,” I said quietly. Light from a streetlight filtered around the drapes creating shadows on the worn carpet. My mind rehearsed the motions of cardio-pulmonary resuscitation, praying it wouldn’t be needed.
Joe hung his head, closed his eyes and shrugged his shoulders, then nodded to me.

I went to work calling the emergency service and giving them directions. The next
phone call was to Joe’s son-in-law, Bruce in Massachusetts, explaining what was happening.

An audible sigh came from him, as I continued. “Right now, I’ll stay with your mother until I can find an aide to stay around the clock.”

“Yes, yes, of course. Whatever it takes,” he said.

Joe stood, using the chair for support, and slowly made his way to a small oak bureau at the side of the room. From it, he pulled his wallet out, stuffing it into his pocket and rearranged papers, before locking the top drawer. His eyes scanned the room as though memorizing the scene.

“Does Millie take any medicines, Mr. Fedele?”

“No, she’s good…‘cept for her mind.” Using furniture for support, Joe walked slowly
over to Millie and mumbled something, leaning over to hug her shoulders. She smiled, unaware of the commotion in the room. His shoulders hung down in resignation to what was happening.

There was a knock on the door. I opened it to let two male emergency medics enter. They placed a portable oxygen mask over Joe’s face before loading him on to a gurney. He grasped my hand, eyes filling with tears, before being carried out the front door.

The chime of a grandfather clock interrupted the sudden silence of the room. Six
o’clock, Friday night, and that nagging ache in my back returned. I walked to sit next to Millie, moving a pile of newspapers. She continued to gently rock holding her arms in a self-hug. A faint odor of urine kept me from getting too close.

“Millie, it’s you and me for a while.” She tilted her head and looked at me. Pulling
a phone list of home health aides from my briefcase, I started making calls. No answer to the first three numbers on my list. Working from the top of the list to the bottom, one by one, names are crossed off. Friday night is the worst time to find an available aide, I thought.

On the fourth call, a female voice answered, “No habla Ingles.” My Spanish is poor
and, much as I tried, we could not communicate. The only other possible option, I thought, was to take Millie home with me. I knew my mother needed supper and her evening meds. If I didn’t find an aide within the next fifteen minutes, I would have to take Millie to my house: Plan B, I thought. The bizarre idea of mother and Millie spending the weekend in my apartment seemed surreal. This ironic turn of events was pushing into my private life and spinning out of control.

There were only two names left on my list, and three minutes left on my time
limit before moving to Plan B. Dialing Addie Johnson’s phone number, I said a silent prayer.

“Addie, this is Marie and I need your help,” I said. I explained the situation,
realizing that my words tumbled out like water over a dam. Addie is a favorite aide with years of experience in helping folks . She agreed to help and could stay until Monday morning, if needed.

Closing the cell phone and putting the phone list back into my briefcase, I turned to
Millie. “Let me find you some supper,” I said. She looked at me with a faint smile and I noticed remnants of dried food on her bodice.

I walked into the narrow kitchen just off the dining area, finding a light switch just
inside the doorway. The smell of garbage met me from the overflowing trashcan, soiled dishes piled in the sink. A coffeepot with remnants of morning brew sat on a linoleum countertop. I opened the yellow refrigerator door to a white plastic bowl of soup, congealed fat clumps floating on top. A quick sniff and I judged that it was not spoiled. A half-full bottle of milk and a bagel half occupied another shelf.

My mother’s refrigerator was a sign of her mental deterioration just before I moved
her in with me. She once bought bottles of shampoo and absent mindedly put them in the refrigerator. Tears clouded my eyes as I remembered cleaning out moldy leftovers.

The mystery soup it is, I thought, pulling the bowl out and placing it on the counter.
Searching through a cupboard, I found a pot and, before long, the aroma of chicken vegetable soup soon filled the small kitchen. I dug through the pile of dishes to find a medium-sized bowl, washed it and ladled soup for Millie’s supper.

Bringing the soup bowl to the table, I motioned to Millie. “Come, have some
soup, Millie.” She stood as if unfolding in slow motion, and shuffled to sit at the table. I watched her hungrily spoon the soup into her mouth. Dribbles ran down her chin to the soiled front of her dress. The noise of raindrops against the window signaled that the typical late day storm had arrived.

Within a few minutes, the doorbell rang announcing Addie’s arrival. “You’re an
angel,” I said as she removed her sweater and put her overnight bag down. I introduced her to Millie and gave her instructions.

“Just do your magic, Addie,” I said. “Millie looks hungry, but I couldn’t find much
in the cupboards or refrig. She needs a bath and shampoo. I haven’t looked around,”

Driving home, I turned the radio on to a talk show. Sometimes the senseless chatter relaxed my mind. Making a mental note to check with the hospital emergency room in the morning, my attention turned to home. Suppertime and I was hungry. Mother must be hungry too.

The door to my dark apartment was ajar and I cautiously stepped inside looking
around. Mother was not sitting in her usual blue overstuffed chair watching television.

Perhaps she was in the bathroom or taking a late-day nap. The empty silence was broken only by a crash of thunder as rain continued to pelt the pavement outside.

“Mother, sorry that I was late,” I said. No answer. The apartment was small, it
took only a few minutes to check the rooms. Certainly she had not wandered outside, into an unfamiliar neighborhood. My heart started to race and that nervous twitch below my left eye returned. My stomach groaned from hunger and anxiety. My arms felt like lead from a long work week, but I needed to find Mother.

Grabbing an umbrella from the closet, I walked around the outside of the apartment building looking for any signs. At the rear of the complex was a small pond rimmed by palms and a gushing fountain in the center. I heard the sound of mockingbirds making plaintive calls as if to warn away intruders. A shape at the edge of the
pond was barely visible in the evening light. Leaning forward, I stepped through the tall wet grass toward the pond. “Mother?”

“Do I know you,” she asked, looking at me with a vacant stare that pierced
through my soul. Her white tennis shoes were splattered with mud almost ankle high. She was dressed in a pink blouse and blue denim skirt with a triangle tear at the bottom. Rain had plastered her brownish grey hair down. Her wet clothes clung to her, water dripped from her chin and elbows.

“Mother, it’s Marie. Come home, it’s time for supper.” I took her cold, wet hand
and helped her to her feet, putting my arm around her shivering body for the walk to the apartment.

The evening was a blur as I went through the motions of helping Mother to bathe,
eat supper and dress in pajamas for bed. She watched me with dark brooding eyes and several times asked to go home. Each time I reminded her that she was home. My self confidence sunk lower as if gradually sliding down a slope toward a bottomless pit. When she finally fell asleep, the tears could not stay inside any longer. I fell to my knees and sobbed. Just months ago, I had been a strong independent nurse who enjoyed privacy and solitude. Now, a promise to care for Mother was changing my life in ways I had not anticipated.

Sleeping seemed an impossibility, with the need to check on Mother frequently. At
midnight, I tried to read a mystery novel but found my mind wandering. Every sound in the apartment sounded foreign to me. When finally exhausted, I fell asleep and dreamed about trying to save myself from a gigantic flood where my possessions were being swept away.

Maybe it should be different, but Mother and I were never close. Her career as an
opera mezzo-soprano ended when she became pregnant with me. She referred to me as her “little albatross” when adult friends came to visit. I was almost eleven before I learned the meaning of this, but her scowl told me it was not a good nickname. Once when I was six and late coming home from school, she threw my homework in my face, and told me I was responsible for ruining her career. It was a guilt that I swallowed deep inside.

My first sense of freedom came when I left for nursing school. People said that joy was written on my smiles and came through the lilt in my voice. My nursing self was confident, attractive and capable.

Six o’clock in the morning and I glanced in the mirror. Staring at the dark hollows
under my eyes and lines that marched across my forehead, I seemed to have added years to my age last night. I ran a comb through my hair and splashed cold water on my face, then quickly pulled on slacks and a casual shirt, sliding my feet into worn sandals. The apartment was quiet and I peeked into see Mother sleeping, her eyelids fluttered as if dreaming. I tiptoed into the kitchen and watched as the morning light brightened the horizon.

The smell of coffee soon filled the tiny kitchen. I watched ducks swimming on the
pond. Grimacing and shaking my head, I remembered the puzzled look on Mother’s face as though I was a complete stranger. Would she remember me today? Hearing soft shuffling footsteps, I turned as Mother entered and sat at the small kitchen table.

“Morning, Marie,” she said.

I hesitated and smiled. The confusion with dementia becomes worse as evening
approaches, I knew. Talking about last night’s events would add to Mother’s confusion and serve no real purpose, I thought. Pouring coffee for her, black with two sugars, I joined her at the table. We drank coffee in silence, except for the stirring of her spoon.

“Need to make a few phone calls this morning. Checking on someone I sent to the
hospital,” I said. “Will you be okay if I go out for a few hours?” Why was I asking this question? What foolishness to expect a realistic answer from a lady with dementia! It was as though I was trying to convince myself that her wandering out to the pond had not happened. That suffocating feeling was returning, like a candle about to be snuffed out.

She smiled and finished her breakfast, carrying the dishes to the sink. “My
television programs will keep me company,” she said and left the kitchen. I watched through the doorway as she reached for the remote and slumped into her chair. Seconds later, Saturday morning cartoons appeared on the screen. She rocked back and forth reminding me of Millie.

The hospital reported that Joe Fedele had been admitted to third floor telemetry. My decision to get him emergency help had been right. How unfair that I had good judgment for my patients, mere strangers, yet wavered like a branch in the wind with choices for myself.

“Addie, are things okay,” I asked when she answered the phone.

“Beautiful, Miss Marie. Millie slept all night. She really relaxed when I gave her a
shower and shampoo. Looks like a new lady.”

“Nice…” I said. “Need anything?”

“We’re fine, just fine. A neighbor stopped over with some groceries, so we’re okay.
Oh, and their son called this morning, Marie. The’re driving to Florida and should be here by Monday.”

“M-m-m, that’s good,” I said. “Keep me posted…I’m keeping my cell-phone on.”

Pushed just under the edge of the wall-phone was a business card. I pulled it out
and looked at it for a moment, Alzheimer’s Day Care Center. Last month, I had attended a networking wine and cheese social event sponsored by the Center. I’d met Gloria Brookdale, a Social Worker, who had given me her card. I closed my eyes and visualized the dark haired woman with an inviting smile. Pursing my lips and glancing at the clock, I decided to try the number.

“You have reached the Alzheimer’s Day Care,” started the message. There was a
click on the line and then a voice: “It’s Gloria, can I help you?”

Sunshine poured through the kitchen window and birds began their morning
chatter. I sat at the table and spoke in a light voice. “Hello, this is Marie Henson.
Don’t know whether you can help, but I need some advice.” My voice cracked. Was it the stress of a long week at work or Mother’s change that brought emotions bubbling to the surface? Could it be the guilt about my promises to Daddy that made the stabbing pain in my gut?

“Marie, from the home care agency?” Gloria asked.

Surprised that she had recognized my name, I pushed my hair back from my face and felt relaxed as though I was speaking to someone I could trust. “Yes, but I need to talk about a personal situation,” I said. “Any chance I could see you?”

“Sure, I’m working on paperwork, and will be here for a few hours. You have
the address?”

Mother was smiling at the television shows when I left. I leaned over to give her an
air kiss on her cheek and she patted my arm.

The Day Care Center was in a large one-story building at the corner of a busy street. Trees shaded the patio in the back where Gloria ushered me to a relaxing wooden Adirondack chair. The warm breeze was building and we sat near a garden tended by the day-care participants. “Something about working with the earth seems to be good for older people with memory problems,” she explained.

“Gloria, thanks for giving me time today,” I blurted out like a schoolgirl.

“Sure…what can I do?”

My throat felt dry as I told her about Mother’s memory decline and my decision to
move her to my apartment. She gently touched my arm when I related the events of last night, finding Mother sitting pond-side in the rain.

“Just can’t take care of her like I promised my father,” I said. I bit my lip thinking that I didn’t want to change my lifestyle and longed to have that freedom return.

“Well, you’re not alone,” she said.

I looked into her face and realized how much she reminded me of Daddy. Her dark eyes and dimples that grew deeper when she smiled, just like his. It felt secure to be in her presence.

“Bring your mother here on Monday and let’s see how she does,” said Gloria. “Day
Care may take some of the pressure away, and you can still have her home in the evenings.”

As I left our meeting, I felt my shoulders relax as though a weight had been lifted.
I was beginning a journey that had been traveled by others and knew it wouldn’t be easy. Daddy recognized that Mother was becoming forgetful. He protected her by covered for her memory lapses. He had confidence in me and I wanted to keep our promise.

The sounds of an opera aria from the car radio interrupted my thoughts. My radio
was routinely tuned to this station and played when I turned on the ignition. I listened intently to an aria from Carmen: “fate is unavoidable for the cards never lie”. My thoughts drifted to the dilemma between mother and me. Was it fate that brought mother into my life at a time when everything seemed so perfect? I had my career, my friends and my independence…the longing for family left me after Daddy’s death.

How unpredictable life was, I thought, as I drove out of the parking lot. My mother’s
promising career was interrupted by my birth. Her anger and resentment at being plunged into a care-giving role left a divide that has never healed. Now, several years later, mother was thrust into my life and is dependent on me. For the first time, I began to understand her bitterness. A feeling of sorrow crept over me like clouds covering the sun and I breathed deeply to keep back the tears.