My father is in the hospital. He’s been in and out in recent years, usually driven their by fainting spells, dizziness and lightheadedness, fluctuations in his blood pressure. He’s lived with Parkinson’s Disease for about a decade now, and was recently diagnosed with Congestive Heart Failure. His current journey into the medical otherworld was triggered this past Thursday, when my brother went to visit him, and found him falling repeatedly. Despite his protests, my brother called 911, and Dad’s been hospitalized ever since. Now a team of medical folks are reviewing his medicine and trying to figure out just how all the pieces of the puzzle that is his medical history and condition fit together.
But wait, it gets worse. We’re beginning to see signs of dementia — not vascular or stroke-related dementia such as has placed my mother in a nursing home, but dementia related to Parkinson’s: which has led to a cluster of conditions my brother and I have described as "goofiness": mild (and mostly harmless) confusion, odd and unusual word choice when speaking, and increasingly, an inability to think abstractly. Having been so blithely ignorant of mom’s nascent dementia over the months leading up to (and following) her stroke last June, we’ve been perhaps hypercritical of dad: so this is no real surprise. It feels like part two of a two-part story: my brother mentioned last night that dad is now where mom was, functionally speaking, about a year to a year and a half ago. In other words, now it’s reaching the point where it’s affecting his life. He is unreliable with his medications, and since he’s been hospitalized he’s expressed some mild paranoia and delusional thinking. It all adds up to a recognition that it’s time for him to move out of independent living into a more structured environment.
He wants to be with mom. Perhaps that’s less than ideal, as she is in a nursing home and his functionality is still largely intact: an assisted living center with the resources to deal with dementia would be ideal. But it’s time for him to stop driving, and intuitively it feels wrong to separate them, just in the interest of preserving what little independence he has left. What would he use that independence for, but to try to go see mom? Since she’s been institionalized he hasn’t missed a day with her, unless he himself were in hospital. And he doesn’t just pop in for an obligatory fifteen minutes with her. He sits with her for hours, in silent devotion, perhaps holding vigil, perhaps just hoping. My brother has learned that on some occasions he’s stayed at the nursing home with her so late that the staff there was not comfortable with the idea of him driving the two miles back to his apartment, so they’ve found a bed where he could "sleep over." Now it seems like it is time for him to just move in.
Needless to say, this is all a bit of an emotional slam. My brother, of course, is taking the brunt of this. Last year, during the aftermath of mom’s stroke, I was still self-employed and could manage about a week a month to visit him and the folks (they live in Virginia, some 550 miles from me). But now not only do I have the day-job at the Abbey Store, but this is a crunch time, as we are preparing our fall catalog to go to press October 1 (to be in consumers’ hands by the first of November). On top of that I have four teaching commitments over the next seven weeks, and I’m ghostwriting a book with an 11/1 deadline. It’s about the worst possible time for me to take time off. My brother knows this, and hasn’t asked me to come up. But that does not alleviate the sense of conflict I feel, that I cannot help but let somebody down — my brother, my father, and/or the monastery. No easy answer, except for a promise to my brother that if things got really bad, somehow I’d manage to make it up there. And so I am left praying: for grace for my father, strength for me brother, and the hope that nothing "really bad" emerges, at least in the next few weeks.
Yesterday Fran and Rhiannon went to an arts festival with a couple of friends and I spent the day at home reading. I was restless, bored, jittery. At five o’clock I called dad, and we chatted — something we never used to do, it was always mom who wielded the telephone. Always the good soldier, he shrugged off my attempts to engage him in conversation about his health; when I brought up the idea of him moving into the same facility as mom, he said, "Yes, that way I won’t have to drive." But I know how much driving means independence to him, so it was almost too cheery a response. Still, he did a great job at wearing the dad mantle: he asked about my writing, and inquired if I had finally gotten rid of the dead pine tree in my back yard (which was already dead the last time he visited us, over two years ago). I made an excuse, and told him we planned on having it cut down this fall (which is true). We talked for ten minutes, and then I asked him to be sure to take care of himself, and said good-bye.
Every good-bye could be the last. That’s true of all of us, at any age. But it seems like the light shines just a bit brighter on that unavoidable fact, when dementia comes to call — and moves in, alongside Parkinson’s and heart failure.