Visiting dad.

My father lives in a residential home for people with memory impairment.  The place is pretty nice, as far as these sort of places go.  He is one of many residents in different states of mental and to some extent, physical deterioration. He has lived there for about two years. Before he lived there he owned an apartment in Westchester and before that, a house in Queens. Now he has a small room of his own and a bathroom.  Everything else he does is in a communal setting. Now he has to share his small room with his 24/7  carer.  Every time I visit him his world gets smaller and more limited, both physically and mentally.

Each time I am about to set off for an American visit it is primarily to see my father.  There are always side trips - to see friends, other family, sightseeing, but it is really all about my dad.  And yet, I dread these visits.  I am not alone in experiencing these feelings of trepidation and hesitation.  Most of the people I speak to who have parents still alive and living in nursing homes, assisted living places or other residences go through the same feelings, almost always accompanied by guilt.  Guilt over having to leave our loved ones to be cared for by strangers, guilt over feeling relief that there are  kind and compassionate strangers able to give our parents that which we are not able to offer, guilt that our fathers and mothers, once so vital and alive, are not able to look to us, their children, for the care they need.  This is the reality of getting old in the 21st century.

My father is cared for really well.  The people who run the home he is in are skilled and caring.  They try to ensure that all the residents are involved in day to day living.  They make sure that the old folks are not heavily medicated so they can still engage with each other in some small ways.  They wash, shower, shave, clean and feed them with sensitivity.  It is a good place.  Literally, the best that money can buy.  I hate seeing my father there.

It's not that I am willing to care for him myself.  In his present state I wouldn't be able to lift him and help him do all the things he needs done.  I would also not have the patience to deal with his mental state.  Sometimes my father responds to communication in a sort of appropriate way.  He is usually four or five conversations behind and will eventually pop up with a sentence that shows he was listening and processing thought, but very slowly.  At other times he sits stone-like with his eyes shut, but not sleeping.  He will nod and grunt, but refuses to participate. At these times the visits are very short.

Last week when I was visiting my dad I sat with him and had lunch.  He still feeds himself with some help.  He has an eye condition called macular degeneration.  This means he has only some peripheral vision and this makes it even harder for him, in his dementia state, to make sense of the world. As he was eating I would help him get the food on his fork and help guide the fork on his plate.  I realised that I was thinking of him in the same way I thought of my children when they were learning to feed themselves and that I was watching my father unlearning to feed himself.  It was, for a moment, as if I was watching human development in reverse. What a sad thing the approach of the end of life is.

I watch the other residents in the home.  Some are unfailingly cheerful.  There is Violet, a bouncy beautiful woman with her make-up just so and her jewelry and coordinating clothing.  She always carries a handbag and is always on her feet and helping others.  She is 92 years old and has no real idea where she is.  She still likes to sing and dance and always gets my dad to smile by joking with him.  Then there is Henry.  He is about 86 but tells everyone he's 102 and he also tells us repeatedly that he is a millionaire.  Henry mostly sleeps on one of the couches in the communal living room area.  He used to like to sleep with a pair of underpants over his face, but the staff have now substituted these for a towel - much more aesthetically pleasing!  Nelson is one of the younger residents at about 70.  His dementia is at first difficult to identify. Nelson looks so vital and healthy that he seems fine until you engage him in conversation and realise that every few minutes he asks the same questions and is really confused.  The list goes on and each one of the residents has their little quirks and ways and the staff always find a way into each person's personality in order to help them connect.  I am in awe of the way my father and his fellow residents are cared for.  I know I could not do this.

I am happy that when I saw my dad this last time he seemed to know me (I think).  He also knew Ralph, for a brief moment.  We cling to these brief moments as if they are some sort of proof that my father is still my father.  I find myself speaking Yiddish to him now completely effortlessly.  This was the language I spoke to him in when I was a little girl and indeed, I feel both very old and very young when I am with him.  All I can really do is hold his hands and sit with him.  I don't know how much comfort he takes from my being there and I can only fantasize about what he can still understand.  Holding his hands, stroking his arm, these things are now for me. I do know how much comfort I take from these tiny actions.  My once strong and vital father is disappearing.  The knocks and hiccups along the way take more and more away from all of us each time he goes through them.

I found myself just staring at my dad as if I wanted to imprint him on my memory.  I stare at the Holocaust evidence of the tattooed number on his arm.  This concrete proof of his past is an important reminder and at 87 he is one of the older survivors still alive. I look at his hands again and again.  Long, artistic fingers that spent their useful life sewing and cutting clothes that can now barely feed him.  How easy it would be to be angry at the unfairness of it all. But he would never question the unfairness of life.  My father's way has always been to accept the next step with enormous equanimity.  If he could tell me what his life was about, it would not be about unfairness.  It would be about family and heart and success and grandchildren and 'naches'.  It would be about love.

My father is still teaching me about how to live. He recently broke his hip, he has Parkinsonian symptoms that make it hard for him to move freely, he has lost a great deal of weight and recovered from a nasty bacterial infection.  He cannot walk or stand unaided and yet, the other day, he stood up on his own and will continue to stand up and try and walk, even if he might fall and it might be dangerous for him.  His spirit just keeps him going and keeps him looking forward.  To him the past is past - not just because he has dementia, but because this is the way he has always lived.  One day at a time.