My mother died recently, in a nursing home near where she had lived for over fifty years—in Gloucester County, New Jersey. She only spent a month and a half in the nursing home. Before that she had spent three years in an assisted living facility in another town. When she began to have difficulty swallowing even pureed food, the people at the assisted living place advised my brother and me that she needed to be placed in a nursing home. They said that she was choking on her food more and more often during meals. What was not entirely clear to me at the time was that my mother was at the point of aspirating her food. Aspiration occurs when the aged throat muscles grow so weak that swallowed food gets into the lungs, inevitably causing infection and death. When death came for my mother, the assisted living people didn’t want it to be at their place, on their watch.
So late one winter afternoon, a medical transport van came to take my mother from assisted living to the Willow Valley Nursing Facility. I had already researched Willow Valley via the Internet and found it had gotten good reviews. In fact, it had gotten four stars. Also, I had learned by word-of-mouth that it was a well-run place. Still, of course, the transition was unwelcome. Although my mother was somewhat senile, she knew what was happening. The nursing home was to be the last stop on the road to oblivion. Willow Valley, indeed.
“When are they taking me?” she had asked me the day before.
“Tomorrow,” I had told her. There was little time to prepare her emotionally for the transition because a bed had just “opened up” at Willow Valley. You’ve got to say yes quickly when beds open up in reputable nursing homes. Otherwise, you lose out.
“I’ll be here tomorrow, too,” I assured her.
By this point, my mother knew the move was inevitable. That didn’t mean she liked it. I’ll never forget the frightened look in her eyes as she was lifted into the transport van. It was one of those vans that have a lift, so the person being transported never has to get out of her or his wheelchair. It was a frigid evening. It was December. I had dressed my mother warmly in her sweater, knit hat, and red wool coat, but she still looked frail and vulnerable, her white hair reflecting the cold glow of the streetlights.
I had assured her I would follow the van to Willow Valley, and I did. But on the way, we were separated by a red light, and I wound up taking another, slightly longer route. By the time I arrived, the head duty nurse and her assistant were already checking my mother in. This meant, in part, that they were checking her body for bedsores. They didn’t want to be held responsible if the assisted living place had let things get out of hand.
“She’s so cute!” they were exclaiming. I found this comment a little odd. Here, my mother was 95 years old. “Cute” wasn’t an adjective I would have used to describe her. Old, decrepit, somewhat senile, nearly deaf and blind, incontinent---yes. But cute?
I tried to look at my mother through their eyes. She was very little, shrunken from what had been an already petite 5-foot frame. But she was still a rather pretty woman. She had good bone structure and a pink, unblemished complexion. She had a certain refinement that was hard to describe--a quiet, self-containment that suggested a complex inner life. Plus, she was meek. Always intimidated by authority, she let the nurse and her assistant examine her without saying a word.
“Her skin hasn’t broken down,” the head nurse Karen assured me after they had put her into bed.
This wasn’t exactly news to me. I knew they had taken good care of her at the assisted living place. They had been paid big bucks to do so.
“Oh, she’s just so cute!” Karen’s assistant Lisa again exclaimed. Before Karen and Lisa left the room, Karen said they would send someone around with a tray of food, since my mother seemed too tired to go to the dining room this evening.
My mother watched from her bed as I unpacked some of her clothes and began to put them away. I had also brought some of the family photos we had displayed at the assisted living place.
“Here’s Father,” I said, handing her a framed photograph of my father, her husband of thirty years. She held it in her hands. Then she brought it to her lips and kissed it fiercely. After she handed it back to me, I placed it on the nightstand beside her.
I had also brought some photographs of her great-grandchildren—Ona, Roberto, and Braun. These went on the TV stand up above the TV. I knew that my mother, with her macular degeneration, wouldn’t be able to see these photos from her wheelchair or bed, but there was nowhere else to put them. I also took out my mother’s teddy bear and placed it on a chair. It had been a Christmas gift from my sister, Lynne. My mother had asked for it. It seemed a comfort to her in her extreme old age.
A few minutes later, a young red-haired woman came by with a tray of pureed food—mashed potatoes and some kind of pureed meat and a vegetable, plus thickened juice.
As she sat spoon-feeding my mother, the young woman suddenly turned to me and said, “Your mother’s so cute!”
I must have looked amused.
“We have some residents around here who are really difficult,” the young woman quickly explained. “But your mom seems darling….so pleasant and easy-going!”
I had to smile at this. My mother had always put her best face forward with strangers. But there had been many times in my youth when she had been anything but darling.
“Not all the time…” I began to say.
“Oh, well everyone’s mother is like that sometimes,” countered the young woman.
It was clear she liked taking care of my mother. That was a good thing. It saddened me to watch my mother eat, though. It was so slow, so hard for her. And a few short weeks from now, the food that should be nourishing her would begin getting into her lungs, leading to the inevitable decline and fall.
After a little while, the young woman asked my mother if she had had enough.
My mother nodded.
A few minutes after the young woman left, I kissed my mother and said good-bye. I told her I would visit her again the next day.
“Alright,” she agreed. She seemed comfortable—calmly resigned to her new surroundings.
It took me several minutes to find my way out of Willow Valley. I’ve never had a very good sense of direction, and I found myself wandering down the same corridor more than once—looking for the exit. As I did, I noticed the residents. Although some still seemed in relatively good shape, others were decrepit, with drooping heads and dazed eyes. One woman, whose hair was incongruously black, had a large bandage over her nose and cheek that made her look clownish. Still, she smiled at me as I walked past her for the third time, looking for the exit. She must have thought I was demented.
Finally, I did find an exit. It was past the main dining area. As I walked outside into the parking area, past piles of snow, under the cold moon, I decided that there were far worse things to be called than ‘cute.’ I guessed the people at Willow Valley had the right idea about my mother. Although they would never know what she had been at her best, they would treat her gently, as if she were a delicate doll.
Since my mother had to go, as everyone must, I supposed she might as well do it here.