Bethany Reid
In July of 2014, my mother had a hemorrhagic stroke, “a brain attack,” as the doctor described it, “massive,” “debilitating.” On a CT scan, images of a hemorrhagic stroke show an eruption of light as fluid balloons into a weak blood vessel and bursts it. In its wake: an ash-colored, light-less waste. My father had died of a similar stroke several years earlier. He died quickly, before my siblings and I were prepared to lose him. With Mom, it felt different: she had been diagnosed with Alzheimer’s around the time of Dad’s death; two years later we had moved her from our family home—the house where she was born—to an apartment near one of her older sisters; more and more support had been required to keep her living independently. Dementia, thus far, had not robbed her of her essential self. We told ourselves that her death, now, would spare her further indignities. Family from three states poured into the hospital to say goodbye.
Mom, too, expected to die. In one of her few lucid moments, she told us, “Bury me on the hill beside your dad.”
But my mother did not die.
A week after her stroke, Mom was moved by ambulance to a high-tech rehab facility, paid for by Medicaid. Here began the “further indignities.” The stroke doubled or tripled Mom’s dementia, and it robbed her of the use of her left side. She could no longer walk and was moved from bed to wheelchair in a Hoyer lift, her left hand and arm hanging limply in a sling. She could see us only if we stood to her right. She no longer had control of her bladder and bowels, was catheterized, wore diapers. “It can all come back,” the physical therapists said, but none of it came back. If Mom had been able to remember the PT appointments from one day to the next, perhaps that would have helped. Instead, every session was a fresh torture.
One afternoon my youngest sister, Sharyl, and I were waiting in Mom’s room while she was in PT, when the physical therapist returned without her. She sat down, looking exasperated. “Can you tell me who your mother is,” she asked, “besides an old lady in a care home?”
Sharyl turned to me and said, “Tell them the story about Mom going into labor with me.”
**
Picture my mother, aged thirty, nine months pregnant, balancing on top of a cord of firewood in the back of my father’s red Ford pickup truck, her auburn hair tucked into a kerchief, hands encased in work gloves. Her job was to throw each stove-length piece of wood out of the pickup and down the concrete steps to the basement, where my dad stacked it in long rows next to the furnace. My older brother was nine years old. I was seven. Either of us could have tossed the wood out of the pickup. A piece of firewood is not heavy, less than the weight of a healthy newborn.
Not a difficult task, though the repetitive motion of bending down and picking up chunk after chunk of wood, lifting it, throwing it, does not sound to me like an obstetrician-approved exercise.
This was September 2, 1962. I know school had begun because I remember coming home a day or so before and Mom taking my white and blue Barbie lunch pail from me while telling me the baby would be here any day. If Dad was hauling wood, an all-day job, then it was a Saturday. Weekdays, Dad worked long, brutal hours as a logger, and he did not haul wood on Sunday, which was the Lord’s day. I don’t remember the particular event, only Mom’s retelling of its central drama, though I imagine the day summer-warm with fall’s crisp edge coming on, like a Gravenstein apple that’s been lying in the sun, yellow with streaks of red. I imagine Mom’s crotch and her pant legs suddenly soaked, Mom straightening, leaning back, gloved hands on her bottom, stretching the way I do after pulling weeds in a flowerbed.
When another piece of wood didn’t drop in the steady, expected rhythm of the work, Dad came to the foot of the basement steps and yelled, “What’s wrong?”
“My water broke,” Mom said. “I’m having the baby.”
Dad sighed (or, I imagine him sighing). “Let’s finish this load,” he said, “then we’ll get cleaned up and drive into town.”
My mother was not a mouse. She could hold her own with anyone, including my father. But where any other woman would have climbed out of the pickup and said, You finish, I’m having a baby, Mom kept working. Later, I would overhear her tell her sisters this story. They said she was crazy and they would never have done it. Mom just smiled, a bit smugly, proud of herself for being a hard worker, for being the sort of woman who did not leave a job half-done.
**
Prior to the stroke, although Mom was fully aware of her Alzheimer’s diagnosis, she was not one bit happy about it, and she resisted our efforts at providing more support. After the stroke, she didn’t understand what was happening to her. “Help me up,” she’d say, “I need to get out of here.”
Sharyl and I usually didn’t argue with her, as it never did any good, but on one of her better days, I tried to explain. “Mom, you had a stroke. You can’t walk, you’re in a wheelchair.”
Her intense brown eyes fixed on me, those eyes that had always been able to penetrate any child’s petty theft or lie. “Of course I can walk,” she said. “How do you think I got here?” She waved her good hand toward the window. “I walked through those trees.”
**
Among Mom’s many appointments in those first days at the rehab facility was her assessment by a swallow therapist. The job title brought to mind birds swooping out of our barn in slanting summer light. The diagnosis made me think of the tight little nests the swallows made under the eaves of the barn and how sometimes the nests fell and we children found the eggshells broken on the ground.
In other words, Mom didn’t pass the assessment. From then on, the rehab facility kitchen delivered food reduced to the consistency of pudding: pork chop pudding, pale brown; potato pudding, a grayish white; string bean pudding, a sickly shade of green; apple pie pudding, yet another shade of pale brown. Now and then they served butterscotch or chocolate pudding for dessert, and Mom usually found these acceptable.
Food was “pudding-thick”; beverages were “nectar-thick.” Juice is sort of okay; thickened 7Up does not taste like 7Up; thickened water makes no sense at all. I couldn’t help remembering our water on the farm, how my uncle Billy when visiting would always go straight to the kitchen tap and pour himself a glass, knocking it back as if it were whisky, remarking, “Man, now that’s water.” It tasted good because it was ground-well cold and so mineral-rich it stained the porcelain in the bathroom. The thickened water at the rehab facility was not only room-temperature and viscous, it was tasteless. No, not tasteless. It tasted awful.
“Mom would really like a cup of coffee,” I told a nurse’s aide one afternoon. When the aide argued that any addiction to caffeine was surely past, I said, “She’s been a coffee drinker all her life. She wants a cup of coffee.”
Half an hour later the nurse’s aide returned with a plastic tumbler of thickened coffee, about the same shade of amber as the tumbler. I don’t know if the thickened coffee was cold or warm. Mom didn’t try it and neither did I, not even for purposes of research.
My mother had struggled with her weight for decades. At the rehab facility, she lost forty pounds in a matter of weeks.
One day as we helped Mom navigate lunch, Sharyl said, “I should try Mom’s diet.”
I gave her one of those looks that Mom had once been known for, head tilted, eyebrows arched. “The stroke diet?”
**
We began looking for long-term care homes. Mom’s neurologist advised us not to “split the distance” between us in choosing a place. “She needs to be close to one of you.” I lived in greater Seattle, lots of choices, most of them shockingly expensive. Then Sharyl discovered Homewood, five minutes from her house, a ferry ride and a one-hour drive from my house. I had been on leave from my teaching job, and I made the difficult decision not to return to the college that fall. Although the youngest of my three daughters was only fifteen, and a handful, I contrived to drive over to see Mom almost every week. I got very into audio books. Often, I stayed overnight with Sharyl and her husband.
Homewood was owned by an RN, Gloria, and her husband. Two of their daughters worked there alongside a colorful collection of other employees. Homewood had numerous benefits, compared to the fancier, Medicaid-funded facility. Mom would have a private room at no extra charge, and the cost would include everything, no additional bills for adult diapers or transport to doctor’s appointments. We could visit anytime we wished, day or night. Regarding the thickened diet: “We don’t have to do that—we’ll watch her,” Gloria promised. “We’ll have her eating again in no time.”
Although Homewood was categorized as assisted living, the residents needed more care than the white-haired, affable people we had met while touring assisted-living complexes with Mom the previous year. The people at Homewood needed help taking their pills, help eating, and help toileting, bathing, and dressing. Even so, the other residents at Homewood worked crossword puzzles, read mystery novels, played board games, did art projects, chatted at dinner, enjoyed listening to music from the 50s and 60s, rooted for the Seahawks on the big-screen television in the living room, watched sappy Hallmark movies. They could go out to restaurants for lunch or dinner with their families. Most of the residents could walk, and one woman, Jessie, was an escape artist. Once while I was there, she went out the door and before an aide could catch up to her, she fell and rolled down the hill. He brought her back, her face smudged with dirt, leaves clinging to her sweater. After that Homewood installed door alarms.
Before her stroke, Mom, too, had enjoyed music and reading. She had enjoyed watching TV and talking to her sisters on the telephone. Now, all of that was gone and she needed more care than the other residents needed. She had to be attended during meals, and soon she had to be fed. She still required a Hoyer lift for being moved from bed to wheelchair. Her catheter was changed monthly by either Gloria or the other RN who worked on call. The nurse’s aides at Homewood were not certified nursing assistants. If they were working toward a CNA degree, they would soon be gone to a better job with benefits and a higher hourly wage. The aides were, nonetheless, competent and caring. We loved Mom’s main caregiver, Marlon, who had a shaved head and tattoos and rode a Harley. There was a problem in the early months with Mom thinking his wife was going to find out how much time Marlon was spending with her. His daughter also worked there, and they called Mom, “Grams.” They doted on her.
One day a few months along, Gloria took us to her office for a talk. “The way you girls mope around here, it’s like you’re visiting a mausoleum. You live until you die! Make new memories with your mother!” This advice was much needed: Mom lived at Homewood for four more years.
**
One thing the stroke had not taken from Mom was speech. During her first year at Homewood, talking was what she enjoyed most. She would get into a loop and we would hear the same story over and over. If we dared interrupt or, God forbid, correct her, she’d raise her eyebrows, widen her eyes, and say, “Who’s the mother?”
She often talked about her parents, “Mother and Daddy,” as she had called them, and told us they were there at Homewood with her, or they were on their way to pick her up. She sometimes asked us to call them. At one point, she must have despaired, because she began saying, “Mother and Daddy died and I buried them myself.”
After hearing this repeated over several days, Sharyl decided to challenge it. “You buried them? How did you bury them?”
Mom held up her right hand, as though for us to admire. One of the aides had painted her nails a dark crimson. “I buried them with my hands,” Mom said.
When I said, “Oh, Mom,” my heart sort of breaking, she dropped her hand to her lap and, with a little huff of annoyance, said, “That’s just how people did things in those days.”
Except when she was ill with one of her relentless urinary tract infections, or UTIs, Mom talked non-stop. Once Marlon scolded her, “Grams! Doesn’t your throat hurt from talking so much?” He then asked us, “Was she always like this?”
“No,” I told him. “Her sisters close to her age could always out-talk her. Mom was the quiet one.”
“Well,” Marlon said, crossing his inked arms and frowning as he considered this information. “I guess it’s her turn.”
Mom’s moments of clarity often caught us off guard. Once, when she was quite ill and not talking at all, her niece Mary visited. Before leaving, Mary took Mom’s hand and said, “Beverly, I’m going now.”
Mom opened her eyes, pressed Mary’s hand tightly, and said, “I’ll get my purse.”
Another afternoon I found Mom in the common room, not watching television. She began telling me that a horse had come into the building. She pointed at the carpet and trotted her fingers to show how it had gone. “They wanted me to ride it, but I said no.”
This was too much for me. I fetched us each a cup of coffee from the kitchen—my strong first half of a Keurig brew, hers watered down—and sat beside her, determined to get her interested in another topic. One of the aides came by, beaming, and said, “Did Grams tell you about the horse? A girl rode it right inside the door.” She pointed where Mom had pointed. “It was right there!”
**
In the first couple of years Mom lived at Homewood, we brought her to Sharyl’s house for family visits. If she didn’t know exactly what was going on, we enjoyed these reunions staged around her, and so did she. Visitors always made Mom happy, even as time went on and she began to forget their names. When I looked at photographs of her five children with her, she didn’t know who Matthew was—my younger brother who had died twenty years earlier—and she didn’t always recognize the two who lived too far away to visit often. Eventually it seemed their names had dropped entirely from her mind. She did not forget Dad’s name, and until almost the last would call out, “Ivan!” as though he were in the next room. She also called our names—“Bethany! Sharyl!”—as though we were still children and would come running. Then, even our names seemed in jeopardy. One day she introduced me to one of her caregivers as though I had never been there before, saying, “This is my sister, Evelyn.”
“No, Mom,” I said. “I’m your daughter, I’m Bethany.”
She drew back, her eyes wide. “Who?”
“Bethany,” I repeated. “I’m your daughter. I’m Bethany.”
“Why do you keep saying that?” she said, looking aggrieved.
“Because Bethany is my name.”
“Well, my name is Beverly,” Mom said, “but I don’t go around saying it all the time.”
**
Mom was a faithful Christian, and had attended the same rural Pentecostal church for almost eighty years. As a teenager, she taught herself to play the piano and the guitar and sang with a trio that traveled to churches throughout southwest Washington State. My parents were not merely church goers. After the death of my grandparents, who had founded our church, they kept it going financially and with gifts of food and labor. They both taught Sunday School. When we didn’t have a pastor, they made sure the pulpit was filled, and we often had visiting evangelists at our house for Sunday dinner.
Sharyl and I sometimes felt that God had forgotten Mom, but for Mom, he was omnipresent. “Don’t sit in that chair,” she told me one evening. “Jesus is sitting there.”
More shocking, Mom would tell other residents that they were going to hell, or curse at them. More than once, I dropped in at mealtime to find her at a table by herself, her wheelchair turned away from the other residents because of one of these outbursts. She cursed her caregivers, too, though they didn’t seem to mind. In one memorable exchange, Mom told Gloria’s daughter, “I’m going to tell Jesus on you.”
Gloria’s daughter put her hands on her hips and dished it right back: “I’m going to tell Jesus on you.”
**
My weekly trips were hard on my family, so as the months turned into years, I visited less often. My difficult teenager, who had been half of my excuse for retiring early, grew up, and I went back to teaching part-time. “Mom will outlive us,” Sharyl and I began to say. We called in hospice for her multiple times; twice, she graduated from hospice. Gloria and her staff saw this as a triumph. We did not.
Friends suggested that I tell Mom that it was all right to die, but when I dared, Mom looked right into my eyes and said, “I have to be brave.”
“You’re the bravest person I know,” I told her.
There were more and more of those further indignities we had feared. Her catheter gave her UTI after UTI. She had additional strokes. She lost more weight. Her unused left side atrophied and then began to clench up, pulling her sideways. I lost track of how many times we had called our siblings and Mom’s surviving sisters, saying, “Mom’s dying, you’d better come,” only to have her rally. My theory: she would see everyone and think, “My family is here, I’d better stick around.”
Gloria told me one afternoon, “I think your Mom just loves life.” Marlon—famous in my mind for his description of Mom’s showers: “it’s like showering a cat!”—got his CNA certification and moved on, but not before telling us, “Your Mom will die when she’s good and ready. You’re not in charge. She is.”
Not that there weren’t bright moments. Even four years in—or three and half, anyway—Mom continued to perk up for visitors, especially her sisters. She loved to have company, and it wasn’t only the living who visited her. The dead were more and more present, as though Mom were already half in the spirit world. When one of her sisters died, we didn’t tell Mom, but weren’t surprised to hear her report, “Aronda was here for dinner last night.” She probably was.
It feels cold-hearted to say it, but we wanted Mom’s journey to be over. Or, as Sharyl—the better Christian of the two of us—would say, “to go to her reward.” We were worn down and tired of being sad. In our defense, we didn’t want our mother to suffer any longer.
Her third stint with hospice came in the late summer of 2018. Our out-of-state sister came for a final visit. Our brother came. Mom’s sisters, too. Summer turned to fall. Mom turned 86, and Gloria insisted on having a cake and balloons, a Homewood tradition that always seemed infantilizing to me. Besides which, Sharyl and I had to clean out Mom’s mouth after the aides fed cake to her, as she no longer swallowed anything. We had for a long time appreciated the way they babied “Grams,” but now we talked about moving her to one of our homes. It seemed the staff at Homewood was never going to let her go. This time, though, they knew we were talking about weeks, perhaps days, certainly not months. Marlon’s daughter, who still worked there, called him and he visited. The last time I heard Mom speak was when Marlon told her he had come to give her a ride on his Harley and she said, “Okay!”
Then Mom slipped farther from us, becoming unresponsive. Hospice sent a chaplain to offer communion, but Mom never woke to appreciate it. “She’s alive but not living,” a hospice nurse said. Would she rally again? We called her sisters and our siblings, but told them not to come. “We need to let her go,” we said, though by that point there was probably nothing we could have done to keep her from going.
On what turned out to be the Mom’s last day of life, we debated taking shifts to sit with her, but were told, “It will be a few more days, you should pace yourselves.”
Sharyl and I stayed up late that night. We drank too much wine and told stories and wept. At midnight we called Homewood, thinking maybe we should be there. The aide who answered the phone said Mom was still with us. “Don’t worry. We’ll call you.”
But a few hours later, despite our cell phone numbers written on the white board in Mom’s room and “Call If Any Change” written beside our numbers, they did not call us. They waited for the morning shift to arrive and let them do it.
We were dressed and in her room by seven a.m. We waited with Mom—or with her body—until the hospice doctor arrived to declare her dead, and then we sat a few more hours waiting for the funeral home to collect her. Our older brother and his wife joined us. A cousin came. The hospice doctor told us we shouldn’t feel bad about not having been with Mom, and claimed that 75 percent of people “transition,” her verb, only when loved ones leave the room. “It takes a lot of energy to be with people, and it takes a lot of energy to die.”
Even so, it has been hard work to let go of my resentment toward the Homewood night shift for not calling us, and it’s been hard to let go of my anger at myself for not having chosen to stay with her. Sharyl has gone through the same struggle. In writing about Mom, I found some peace in remembering Marlon saying, “Your Mom will die when she’s good and ready.” If she wanted to die with her family sitting beside her, holding her hands and singing “The Old Rugged Cross,” she certainly had every chance.
People say that when a loved one has dementia you lose them before you lose them. I have been guilty of saying this. I also subscribed to the belief that I would be relieved when Mom died. Hadn’t I already grieved for her? It turns out I was wrong. After Mom’s death, grief slammed me. Five years later, it can still wake me in the middle of the night.
Of course I miss the mother I knew in childhood and young adulthood. I miss the turkey dinners and dozens of people crowded into the farmhouse at holidays. I miss the grandmother who welcomed my children for farm visits and drove to my house to help when I was overwhelmed. I’ve been missing that mother a long time.
But I also miss my mother as she was when she lived in care. I miss the way her eyes sparkled with recognition even when she no longer said my name. I miss the way our family united around her. I miss the weekly ferry rides and the salmon dinners my brother-in-law served on nights when I stayed over. I miss the wine and late-night conversations with my sister. I miss singing hymns to entertain Mom, and I miss the way Mom sometimes sang along. I miss reading aloud to her from the copy of Murder on the Orient Express that lived in the drawer of her nightstand. I miss raiding the stash of Almond Roca her sisters would leave with her. I miss holding her hand. I miss her, that essential someone who changed so completely and yet never stopped being my mother.
The way Mom died, alone, in the wee hours of the night, has—to my mind—something to do with my story about her balanced on top of the woodpile. My young mother: aged thirty, freckled, pants soaked with amniotic water. If she had wanted to get down from the pickup bed, take a shower, and get to the hospital on time to have her baby in a delivery room rather than the hallway, she could have. It suited her, on that long ago September day, to finish the job at hand. After her stroke, she wanted to live, no matter how diminished her life may have seemed to those outside of her mind and her body. On that October night when she finally died, maybe a thought flashed through her mind, like a final sparking of light through her brain.
My work here is done.
—
Bethany Reid’s fourth book of poems, The Pear Tree, won the 2023 Sally Albiso award from MoonPath Press. Her stories, poetry, and essays have recently appeared in One Art, Poetry East, Quartet, Passengers, Adelaide, Kithe, and Peregrine. Learn more at http://www.bethanyareid.com.