Chapter One: Guilty
“My recommendation for your mother’s recovery is to place her in a nursing care center. Life Care has openings. They will take good care of her as her pelvis heals from surgery.” Elizabeth only half took in what the surgeon recommended. Her mind wandered to the many times her mother had taken care of her, through childhood bullying at school and through a couple of divorces. Could she REALLY place her mother in a nursing care center without feeling guilty? She shook herself as the surgeon prompted, “Ma’am?”
“Do I have any other options? I would rather care for her at home, with an outside caregiver coming in to help with her bathing needs. I think I can handle the rest of her care at home… It’s just bathing time that kind of scares me!” The surgeon snapped his clipboard shut, shrugged, and replied, “You would have a much easier home life if she were taken care of around the clock at a care center, just saying! But ultimately, it’s your call. It’s not like she can make that decision for herself…”
Elizabeth reached over for her mom’s frail hand, upset at the callousness of a doctor discussing her mom’s dementia in front of her, as though she were not in the same room. A knot formed in Elizabeth’s throat as she gazed upon Astrid’s pain-etched face after the doctor departed. Even with morphine in her system, any movement Astrid made in her bed caused her to whimper. Guilt stabbed at Elizabeth’s heart. She had lost her grip on her mom’s arm while helping her stand up out of the car after a trip to the grocery store. Astrid had fallen and shattered her pelvic bone in two places. “No! I just can’t do that to her! I’d feel even guiltier!”
When the nurse assigned to her mom’s care came in with release papers, she asked which care center she was headed to. Elizabeth, her mind made up, replied that Astrid was coming home with her. “Woah! Do you realize how much work that’s going to mean for you? Do you have anyone else living with you who can help out?” Elizabeth shook her head then, trying to sound more assured than she felt, she replied, “I’ll find help! I just can’t bear the thought of my mom in one of those places!” The nurse looked skeptical but told Elizabeth that she would arrange for transport home via Cab-ulance and busied herself checking Astrid’s vitals one last time. She removed the IV and told Elizabeth she would need to pick up pain medications for her mother from the hospital pharmacy before they headed out.
As she stood at the pharmacy counter a few minutes later, after having somehow navigated the maze of corridors, Elizabeth still hesitated. Could she REALLY do this on her own with occasional outside help? What she nuts to even try? She picked up the hydrocodone and made her way back to her mother’s bedroom. Nursing staff had helped shrug Astrid into her coat and into a wheelchair. The ambulance driver was a burly red-faced man with a beard that put Elizabeth in mind of ZZ Top’s Dusty Hill. Elizabeth followed the ambulance home in her own car, her anxiety mounting, two questions playing on repeat in her brain: “Am I crazy to try this on my own? Will my brother Redford be of any help if I call him?” The Cab-ulance driver helped wheel Astrid to her bedroom and even helped Elizabeth transfer her to her bed. She accompanied him to the door, thanking him for the help, closed the door and leaned against it, her heart thudding faster with anxiety. She shook the fear off, somehow, and went upstairs to the kitchen to busy herself cooking chicken soup for dinner. She checked in on her 88-year old mother from time to time. She looked shrunken under her blankets, eyes closed, clenching one of Elizabeth’s old well-loved stuffed toys. The sight tugged at Elizabeth’s heart. The onset of her mom’s dementia coincided with her mom’s anesthesia. Astrid had gone into surgery with her brain intact and had come out of it with a scrambled brain. Even though she was told that as the anesthesia wore off, Astrid’s mental capacities would return to normal, her mental lapses that had become more and more frequent as her body healed. At times, she did not even know who Elizabeth was and called her Mom.
After giving her mother a sponge bath before bedtime, and a dose of pain medication mixed into mashed strawberries, Elizabeth stood in a steaming shower, trying hard to help the tension knot between her shoulder blades to resolve. She prayed hard at bedtime to be up to the task of caring for her mother at home. What had she done? Was she up to the task of mothering her mother and keeping her safe from another fall? Sleep eluded her as her brain refused to shut down. Guilty! Guilty! Guilty!
Chapter Two: Exhausted
Two weeks later, Elizabeth looked out her kitchen window onto the meadow. A deer was munching freshly grown baby leaves on her apple tree, but she was just too dang tired to care! She put the final touches to her mom’s breakfast: Swedish hardtack with a thick layer of butter and Kaviar paste from a tube, with soft boiled eggs sliced on top. A bowl of freshly washed strawberries on the tray as well. Her mom’s favorites. If her mom still had her mental faculties intact, she would balk at the extravagance of having fresh strawberries in early March. “För Dyrt!”, Astrid would exclaim in her native Swedish! But Elizabeth did not care about the “too expensive!” cost of the strawberries. She meant to make her mother’s end of life as sweet as possible.
The past two weeks had blurred into an endless series of chores, trying her best to keep her mom comfortable. She had lost track of which day it was. Once her mother was settled from bed to armchair, Elizabeth turned on the radio, simply to hear another adult voice. Her mother rarely spoke anymore, and when she did, it was in Swedish. “Coronavirus outbreak kills elderly patients at Lifecare Center.” Elizabeth turned to volume up. Lifecare? Where her mom was supposed to go recover post-surgery? Where, in her current state of exhaustion, Elizabeth was seriously reconsidering sending her mom for care? Yikes! This stuff sounded serious! And scary!
She checked on her mom and popped an old classic Musical DVD into the player to entertain her for a couple of hours. She booted up her laptop and started searching for more information about the Coronavirus outbreak at the Life Care Center. “Oh, my goodness! This could have been my MOM!” she exclaimed. People at this nursing home were dying as the Coronavirus raged unchecked. She felt a mixture of sadness for the passing of so many patients and relief that she had not sent her mom there for her recovery. With each news article she read, she became more anxious! In moment of intense fatigue, she often wondered if she had made the right decision keeping her mom at home and tackling her care by herself. Now… she KNEW… but where did that leave them? And how long would this last? Was everyone coming into their home a risk to their health? The governor was closing down schools until May, so maybe this would be short-lived and she could get help then, once this health crisis was over? She snapped the laptop lid shut and sat near her mom, watching the end of “Singing in the Rain” with her. Her thoughts were a million miles away from Gene Kelly and the cheery tunes grated on her nerves. Frayed RAW!
Chapter Three: Survival Mode
Life used to be simple before my mom’s fall! Life used to be easy before Covid-19! Now, Elizabeth felt like a prisoner in her own home, going out on parole from time to time if a kind neighbor, double-masked and gloved, came to granny-sit her mother. Astrid was no better mentally. She was making progress physically thanks to visits from home visits by a physical therapist. Could she even trust the kind neighbor to be disease free? Could she trust that the physical therapist, a young woman in her prime, was a loner who never partied, as she claimed? She saw other patients during the day… What if she brought Covid-19 to their home during one of her visits?
Shopping used to be an easy social activity. It used to be anytime she felt like it! Now, it was a scary adventure into the unknown… Yes, people masked up by now. It was mandatory in their state of Washington. May 2020… The deadline for kids returning to school had come and gone, and the governor had extended the closure of schools to the end of the year. As a former educator and school counselor, Elizabeth felt awful for those high school seniors who would miss their senior proms and their graduation ceremonies. If they could not go to school in person, was it even safe for her to be out shopping at Safeway? Should she start ordering food online and have it delivered to their home? Should she lose that “once a week” getaway from 24/7 care for her mother? Picking up Panera soups at the curbside pickup, one of her mom’s favorite treats, felt fraught with danger. What if the food workers there did not disinfect their hands?
Nightime was the worst… The anxiety monster had come out from under the bed and lurked, keeping her brain from fully shutting down. At the slightest whimper from her mom, she woke up and checked on her. Potty trips three times a night felt like having a 120 pound newborn baby to change and diaper… Elizabeth did not have any kids of her own, so she had never experienced the sleepless nights of young motherhood. This had to be worse, didn’t it? The lack of sleep was killing her slowly! She did not use to be THAT forgetful before Covid-19, THAT anxious about strangers coming into her home, THAT trapped into an endless cycle of care without relief.
Chapter Four: Relief
May had given place to June. Flower gardening and weeding in the yard with Astrid sitting on the patio, all bundled up against drafts, was a relief of sort. Beautifying the yard took the sting out of their isolation. Watching the hummingbirds flitter to the feeders brought a smile to Elizabeth’s face. Then, on the way back into the house, Astrid lost her grip on the walker and fell. Elizabeth did not have the leverage or strength needed to help her mother back to a sitting position, much less get her back on her feet. Nothing seemed broken. Calling 911 was like admitting defeat… “That’s it! I can’t do this on my own anymore!” Tears stung at the corner of her eyes. The EMTs who showed up a few minutes after her 911 call reassured her. Astrid was a bit shaken, but nothing was broken. They helped her get Astrid into her bed after they checked her vitals. They asked, “Do you have any help at all? Care Centers are now safe places! They are taking super good care of disinfecting every surface. They check temperatures whenever their staff come in.” The tears came after they left. If she DID put her mom in a care center, she would not be allowed to visit since those places were in lockdown with no visitors…
Later in the day, as Elizabeth was cleaning up a desk drawer, she came across a phone number for a woman she had met at a local church she attended… before Astrid’s fall… before Covid-19. She knew all churches were now at 25% capacity after months of virtual meetings only. She had not seen this woman for at least 2 years, but the thought struck her. The last time Laura had visited her home, she had really hit it off with Astrid on account of both of them being native of Europe and immigrants in the USA. As she went about the tasks of putting together a dinner tray for Astrid, Laura’s face kept popping back into her mind. She recalled Laura telling her, during one of her visits, that she had taken care of her own grandmother with dementia, and that she had done at home nursing care for her husband’s grandmother as well before she passed on. Laura’s last words to her had been, “If it ever gets too lonely or too hard taking care of your mom on your own, you know where to find me!” She picked up the phone, started dialing, then, hung up… What if Laura did not even remember her, or Astrid, or her offer to help?
Screwing up her courage, she dialed and felt nothing but relief as Laura’s first words to her were, “Hi Elizabeth! Has the time come for me to help out?” Things got slightly easier after that. Adult conversation every other morning as Elizabeth and Laura bathed and dressed Astrid. Laura helped “granny-sit” often so Elizabeth could go to her medical appointments or simply took long drives. Gifted with an ability with foreign language learning, Laura, who already read Greek and Latin, and spoke her native French, as well as English and Spanish, took on the challenge of learning Swedish. When Astrid’s 89th birthday came in August, Laura had memorized the Swedish Birthday song and sang it to Astrid, bringing a genuine sparkling smile to her face and a twinkle to her limpid blue eyes. It was only an hour of Laura’s time three to four times a week, plus the occasional getaway without Astrid in the car. Because Laura always masked up, no matter what, and washed her hands thoroughly before interacting with them, Elizabeth felt reassured that she was trying her best to avoid bringing Covid-19 into their home. “When did I become so concerned about people crossing my threshold?” Elizabeth pondered. “What has this pandemic turned me into?”
Chapter Five: A Covid-19 Anniversary
“Almost a year since Mom broke her pelvis!” thought Elizabeth as she stared at the calendar on the kitchen wall. “And what a year it has been!” She reminisced about the hard days going it solo in her mom’s care. She smiled as she heard the now familiar cadence of knocks on her front door. “We’re upstairs!” she said, poking her head around the wall to let Laura know whether to come up or down the stairs in the split-level home. As they bathed Astrid, there was much bantering and laughing, their friendship now concrete-solid: So much heartache shared over those days when Astrid’s dementia stole her Mom away from them! So much joy shared whenever Astrid had good days and was back to her old self, recognizing them and even speaking in full sentences. So much HOPE that there was light at the end of the Covid-19 tunnel of darkness. “One of the ladies from your Church found us appointments for our first dose of the Moderna Covid-19 vaccine at the same pharmacy! It was super helpful since I could not be online at all times to try and snatch two appointments back-to-back! When you come on Wednesday, can you help me get Mother into the car so we can drive to our appointments?” “Sure thing” Laura replied. “I am super glad you are getting your first shots! I hope you and Astrid don’t get too many side effects, but you know where to find me if you need help at home!”
March 12th, 2021, exactly a year after the outbreak of Covid-19 at the Life Care Center, Elizabeth and Astrid returned home from getting their second dose of the Moderna vaccine. Laura had arranged a substitute caregiver so she could fly out to meet her granddaughter Lilian for the first time! Born at the end of March 2020, Baby Lilian was almost a year, almost walking. Laura was so eager to finally hold this baby in her arms. The pandemic had canceled her initial flight out to go help out after her daughter gave birth. Concerns over bringing Covid-19 back with her to Washington State from Florida had kept Laura from traveling to meet that grandbaby. She cared too much about Astrid and Elizabeth to take that travel risk until both were immunized against the disease.
Elizabeth felt at ease about the chosen substitute helper, who was fully immunized and came from the same Church Laura belonged to. Elizabeth rejoiced that her best friend would meet her beloved grandbaby, whom she had only met virtually and had watched grow from afar in many a Facetime meeting. Covid-19 was not behind them yet, but someday soon, it would be a thing of the past, remembered in history books just as the 1918 Spanish Flu pandemic… Astrid was getting better and better every day, be it physically, and on occasion, mentally as well. The dark year of confinement and fear was over. A second year of pandemic was starting, but with three types of vaccines and more and more people immunized, there was hope that in August, when Astrid celebrated her 90th birthday, it would be surrounded by loved ones at a big garden party in her backyard, and with Laura singing, “Ja, må hon leva, Ja, må hon leva, Ja, må hon leva uti hundrade år. Ja, visst ska hon leva, Ja, visst ska hon leva, Ja, visst ska hon leva uti hundrade år!” while Elizabeth played the tune on her viola.