My mother was a very intelligent woman and until about the last six weeks of her life, she was in possession of darn near all her mental faculties. As I've mentioned here, I spent much of the last decade hearing many of her many doctors hint or even state that she wouldn't be around much longer. She outlived all those predictions and even outlived one of those doctors.
In the last few months, two things made me realize they were the last few months. One was her primary care physician Dr. Wasserman changing his tone. He never said "Your mother's going to die soon" but he didn't have to. To be a good doctor, you obviously have to know a lot about how the human body works and what kind of pill or procedure fixes this or that. You also have to know how to talk to patients and their loved ones; how not to exaggerate or underplay what you know with reasonable certainty. I once asked my own doctor if in Medical School, he had to attend classes called "Breaking Bad News." He said yes, sort of. They weren't called that and there weren't enough of them…but it was a skill he had to learn just as sure as he had to learn how to stop bleeding or cure migraines or write illegible prescriptions.
Dr. Wasserman is real good at speaking between the lines. What he said and what he didn't say made me realize that the end was near for my mother.
The other indicator was that she was starting to get confused about things that had never confused her before. What day of the week it was. Names of people she'd known for years. I had long since taken over all her finances and bill-paying but about two months before she passed, she wanted to sign a certain check herself. And when she couldn't figure out where to sign, that was a bad indicator.
Before that, I used to tell friends, "She's a smart lady but when she gets sick, she gets stupid." That was why she needed me around. When she was well, she was fine at running her life and getting things done. She might need me or one of her endless stream of caregivers to drive her somewhere and then push her about in a wheelchair but she always knew where she was going and what to do when she got there. It was mainly her eyesight, not any mental deterioration, that prompted me to assume checkbook duties. When alert, she could take care of herself…and did.
She insisted on living alone after my father died. Other arrangements were proposed and rejected. Throughout four decades of married life, she'd lived by his timetable — and for a long part of that, mine. She got up when it was time to get him off to work and/or me off to school. She ate when we ate…and between his food preferences and my food allergies, it was usually a matter of eating what we would/could eat. When there was but one TV in our house, it was usually set to what he or I wanted to watch. Later, when I got a set for my room, the one in the living room was sometimes tuned to what he wanted to watch but not always.
Shortly after we lost him, I sat her down and told her I wanted her to be self-indulgent; to make wishes that I could make come true. She no longer had to cater at least in part to his needs and since I was living elsewhere, mine were of near-zero concern. It was time, I told her, to reorient her thinking to what she wanted and only what she wanted. She said, "Let me think about this for a few days." A few days later, she told me, "I've decided I want to live on my own schedule. I want to eat when I want to eat, sleep when I want to sleep, watch what I want to watch. Would that be okay with you?"
It was, of course, okay with me. How could that not be okay with anyone? So to the extent her eyesight, limited ability to walk and a few doctor's orders would permit, that was how she lived…and in the same house, with my old room converted to a den where she could smoke and watch TV at any hour.
She couldn't get out of things like having to go to the hospital at a certain time for a doctor's appointment but to the extent she could, she eschewed all demands to do anything when she didn't want. It was understood that when we had a date for me to take her out to dinner, she might just call me at the last minute and say, "I don't feel like it tonight."
For years, she'd loved Cirque du Soleil and I took her to see it whenever one of its traveling companies ventured near. One time, I called her and mentioned that a new Cirque show would be in Santa Monica in a few months and I was going to order tickets. "Don't get one for me," she said — to my great surprise. I was expecting joyous anticipation and when I didn't get it, I asked how come…
"Because the night your tickets are for, I might not feel like going. If you buy me a ticket, then I have to go." She still loved Cirque but she loved even more having no demands on her time.
That was why she recoiled in horror whenever I mentioned the dread words, "assisted living." She accepted the need to have a caregiver around a few hours a day, though she resented having to get up at a specified hour to let one in. She hated the idea of having one on the premises full-time and would often send one home early. The idea of relocating to an Assisted Living Home was even more dreaded. "I'll die before I let that happen," she'll said…and I knew she would. It was bad enough that she had to spend as much time as she did in the hospital with all those strangers around telling her when and what to eat.
Those who observe the time stamps on these postings note that I keep odd hours. In her final decade, my mother's were odder. She was as likely to be up watching TV at 4 AM as at 4 PM. She ate meals so irregularly that she couldn't classify them as breakfast, lunch or dinner. They were just meals.
I arranged with two nearby restaurants to deliver to her and to charge everything — the meal, the delivery fee, the tip — to my credit card. She just had to call one and say, "I'd like chicken tonight" (or shrimp or beef or…) and within the half-hour, a man would bring a freshly-prepared, low-sodium dinner to her door. The problem with this system? She might not feel like waiting the half-hour. Or she might not get the craving 'til after 10 PM when both restaurants closed. So she'd pop a Stouffer's frozen entree into the microwave and that would be dinner…or maybe breakfast.
MSNBC used to air three hours of Don Imus from 3 AM to 6 AM on this coast. Who would be up watching at that hour? Often, my mother. She didn't like Mr. Imus but she liked the lively discussions on his program and enjoyed, she said, when his guests often put him properly in his place. In 2007, he got himself fired because of one particular remark that many took as racially-offensive. My mother was disappointed to lose her middle-o'-the-night entertainment and a bit bewildered. As far as she was concerned, this was like firing Don Rickles for calling someone a hockey puck. Imus, she felt, said something stupid and insensitive about as often as he threw to commercial. Why did that offensive remark doom him when the eighteen the day before hadn't? Or the 143 the previous week?
She never warmed to his replacement, Joe Scarborough. She thought he was just as miserable a human being as Imus but Imus at least didn't pretend to be anything else. Imus also didn't talk so much about the boring minutiae of Congress and he gave his guests a fair shot at telling him he was full of crap. She found her way to other 3 AM programming (often QVC or some other channel via which she squandered my inheritance) and when I later told her Imus was back on another channel, it was like, "I'm over that." In my ongoing monitoring of my mother's mental state, I thought that was a good sign.