A Daughter's Journal

Birthdays & Denials

by Ann D. Gross

As I approach my 50th birthday this August, my always feisty mother, whose greatest joy in life (in addition to her husband and children) has always been being in control, is fighting her way through life in a skilled nursing facility (SNF) in Florida. When I was a little girl, Mom was the major force in our home. Life in and around our home depended on her agenda and idea of what should go on. Now, as far as she's concerned, the universe has spun out of control. She has lost control, not just over her living arrangements, but also of her body, her sleeping and waking times, her mealtimes--even her choice as to when she bathes.

Recently, Mom began showing signs of early dementia. The signs manifest in patterns nearly impossible to predict. To me, these are her coping mechanisms for adapting to her lack of control. If she can't run the show, then damn the torpedoes and full speed ahead with anger, difficult behavior, quarrelsomeness, and a bit of forgetfulness thrown in for good measure.

Lest I give the impression that I'm blaming the victim, keep in mind that I'm reluctant to unseat Mom from her leading lady role. I'm facing my 50th birthday with my mother confined to an SNF. I desperately want her to be as she always has been--I want to remain the supporting role to her leading role. I'm even willing to go back to the days when she tried to control my thinking and decisions on just about everything. (Easy for me to say now.) Clearly it's my way of denying my own aging process, as we Boomers are famous for. But it's less visible, ostensibly, than plastic surgery.

Mom's difficulty with short-term memory frightens her; it frightens me, too, so when I speak with her by phone, I am complicit in her denial. We frequently have nearly the same conversation Tuesday as we had that Monday (barring any exciting incidents that have happened on Monday night). I never remind her that we had the same conversation yesterday, or that I answered that same question 15 minutes ago. Like her, I hope that if I don't mention it, it will be OK.

In my opinion, denial must not to go unappreciated. It helped my dad live until nearly 94, as he refused to bother himself worrying about what the doctors said was wrong with him. When he felt short of breath from congestive heart failure, he simply rested and watched television or stared at the horizon to calm himself. He loved being alive. The doctor said he needed heart bypass surgery, but at 90, surgery was contraindicated. That never bothered Dad in the least, nor did it stop him from living an additional four years.

Mom's denial proves extremely helpful to her. Presumably, my denial about Mom helps her as much as it helps me when it comes to her aging and health status. While my brother (the practical one in the family) wants to talk to me about the specifics of Mom's medical condition and her likely prognosis of having to remain in the SNF for the rest of her life, I refuse to look at the overall picture.

"I don't want to characterize her situation," I tell him. "I just want to help her get better."

I've worn out so many pairs of blinders since Mom entered the SNF last August, I have had to change them daily. My dad had this same knack. Why characterize a situation with stark, cold reality, when--with foolish optimism mixed with a healthy dose of denial--anything could happen? And for him, anything did happen for a good four years, give or take. He enjoyed every day of his life until Jan. 18, 1999, when he stopped breathing.

The Child as Mother

As I reach my half-century milestone this summer, my blinders work well when it comes to refusing to think of Mom as old and frail. But, when it comes to my experience of myself, it's a more complicated matter.

Last week, I came down with the worst stomach flu of my life. At its zenith, I had no control over my bodily functions. Besides feeling terrified of the violence of the illness, I experienced a more enduring, visceral terror in its aftermath. I woke up in the morning, worried about stains that might appear on the sheets. My skin on my back and buttocks was sore. I wished someone might rub my skin all over with cocoa butter.

Suddenly, I had a flash of understanding about the terror that comes with no control. With a quickening in my stomach, I started to think of myself as old, unable to control my body. How long would it be before I was in Mom's situation? Instead of seeing last week's experience as something that everyone--even a healthy person--experiences, I projected my fears about my mother's aging on myself.

I thought of Mom and her terror at the SNF. The terror of having to wear "special underwear," as one of her caregivers puts it. And her skin: I remember fighting so hard to get her an air mattress so she wouldn't experience the skin breakdown that happens so quickly to an older person who spends a lot of time in one position. As I shifted to my side, off of my sore buttocks, I thought of how the nurses prop Mom up on her side, so she won't be on her back and butt all night.

What must Mom feel like in her small bed, in a tiny room, with a window overlooking parking lot construction instead of the Atlantic Ocean with ships on the horizon? What must she feel when waking up in the middle of the night and reaching to hold her husband? Or tell him that she is afraid? She can ring the buzzer, yes, and someone will be there. On a good night, the overnight nurse won't be angry with her. The nurse will be kind, speak to her in soothing tones, and listen to her bad dreams. But the nurse will still smell like the corridor or the last patient, and she won't have the wonderful clean, musky smell of my father's skin. And when Mom awakens in the morning at 7 when the new shift comes on, her life will still be a solo one in which she'll always feel the sting of missing her husband.

Who wouldn't adapt to these painful, frightening changes with anger, memory loss, and quarrelsomeness?

Should I "become" Mom some day and need to be cared for in an SNF, I'm sure I will be on the Alzheimer's floor. "Oh, her?" they'll say. "Poor thing. She keeps talking about a bright apartment on the Gulf of Florida. She thinks it's the 1970s and wants to go disco dancing, and she keeps asking for her husband and wondering when her mom is coming home."

So what does this have to do with my mother being confined to an SNF? Well, try as I might to continue to see her as the leading lady, I am growing too old myself, even, to wait much longer to ascend to the role. I feel a quickening in my gut thinking about how I must assume that role, and now would be a good time.

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