Hurtling down the hill, the bus screeched to a sudden halt, as an elderly woman stepped resolutely into its path.
One of the neighbourhood eccentrics, this woman regularly assumed the role of traffic director. Impeccably groomed in a blue tailored suit, expensive shoes and stockings and a stylish red hat, she would step out in front of oncoming buses with raised arm, forcing the drivers to stop on the precarious descent down the steep hill to the wharf. What could they do but brake abruptly, or skittle her under the wheels? Then, with a forward sweep of her arm, she would beckon the vehicles onward.
‘You can go now, driver,’ she’d announce imperiously, before proceeding to her next shift down at the wharf, where she’d ply the ferryman with instructions.
‘Tie her up now.’
‘No. No. Wait for the people to get on. That’s right. Now you can go. Go on. Go!’
Or there was the woman I called ‘the dancer.’ She was slightly built, with long, dark hair that drooped lankly over her shoulders, and a vacant, cheery face that glowed robustly with generous daubs of rouge. Skipping out in the middle of the road, well clear of the pedestrian crossing, she would dance diagonally across the busy street, frequently stopping and curtseying to us, her audience. Oblivious to the hapless bus drivers who struggled to divert their cumbersome vehicles around her flighty performance, she would miraculously flit safely onto the opposite footpath, to the applause of a collective sigh of relief from anxious commuters.
But one day I realised that these women had disappeared. Where to? Had they had a ‘social assessment’? Been taken ‘into care’? Cracked the code of community tolerance and anonymous exits from the mainstream of life?
How to balance individuality and idiosyncratic intrusions on bland, gentrified demographics is a social conundrum that defies bureaucratic solutions. How to merge mental confusion with a dignified existence is a question that burdens families with guilty decisions.
My mother died in her late sixties, the diminishing quality of her life shackled to her shrinking brain. Having barricaded herself in a prison of grief after the death of yet another son, she maintained the illusion of independence by alienating herself from us, and finally defying, or perhaps denying, her landlady’s constant eviction notices.
‘I gave your mother notice six weeks ago and she refuses to budge. If she’s not gone by tomorrow, I’m putting her out on the footpath. I’m sick of her.’
The landlady’s voice shrilled down the telephone line when I picked up the receiver, over twenty-five years ago. We were in the midst of packing to leave for our annual holiday. The schedule underwent a hasty adjustment as all available family vehicles and members set out on a cavalcade to the south side to my mother’s rented accommodation.
Before embarking on this journey I sought help from the local health centre, but, although technically a community service, it delivered a judgmental and humiliating response. In patronising, pseudo-psycho jargon, the social worker pronounced huffily that ‘these old women were manipulative, and not until she was out in the street would she get the message. It’s the best thing her landlady could do.’
So my mother was removed from her rented flat, and her neighbourhood. We, her family, or specifically I, her eldest child, were confronted with decisions that deprived her of her independence and self-inflicted isolation.
The cold, clinical narrative of the pejorative assessment might have exposed cupboards crammed with cleaning products, but devoid of food. It might have discovered the hidden treasure withdrawn from the bank account, a strategy born of paranoia to protect financial assets. It would have offered the family insights into the relentless decline of this proud, unreasonable woman, their mother.
It might even have come across the small, brown, vinyl-covered notebook with its doodles of spelling in Mum’s neat backhand script. Mum had been a stenographer with an impeccable grasp on spelling and grammar, but the spelling doodles in the notebook told the story of a creeping awareness that she was losing this ability.
‘B-e-r-m-a’ and ‘S-u-n-g-e-r-p-o-u-r-e’ were written on the first page. Burma and Singapore, names all too familiar from World War II, now challenged her mental limits. And what was ‘SOUTLAND?’ Was it an interstate suburb, perhaps ‘South End?’ How must it feel to watch yourself disappearing into shadows, lose basic skills, know that all is not right, but be powerless to stop the decline? Is this how she spent her lonely days and evenings, coming in and out of lucidity, as a disease was shrinking her brain?
But our community experts had stereotyped her as ‘manipulative,’ and only the humiliation of being forced out of her flat onto the street, would atone for the sin of diminishing faculties.
For all its bureaucratic simplicity in its response to the complexities of the confused elderly, an assessment can offer alternatives to abject neglect and vulnerable situations.
Some years ago, as a probation officer, I made a routine home visit to a middle-aged client. A series of physical afflictions had left him severely debilitated, dependent on others for mobility, hygiene and survival. On this day he was in a sorry state, unkempt and abandoned. The young people whose responsibility he had become in return for sharing his accommodation had absconded on the wild goose chase of their lives, relapsing into habits that spruiked resilience against withdrawal into the harsh realities of a daily existence.
His name was famous, or infamous, depending on the observer, and having spent slabs of his adolescence in boys’ homes, he had acquired all the pre-requisites for graduation into the prison system, languishing in gaols for most of his adult years. Prison had been his home, and prison was where he’d formed family ties. A recent offending relapse had breached the trust of staunch supporters and his notoriety had now strained the limits of tolerance. There would be few community care options for him.
His very caring, idealistic doctor expostulated, ‘I can’t put that man in a nursing home, another institution!’
My psychologist colleague acerbically commented that ‘not to put him in an institution would be like denying morphine to the addict.’
I asked the doctor if he would take him into his care, with the result that he was admitted into a nursing home. But this had its positive side. The young people in the group home had not appreciated his criminal heroics; they hadn’t even heard of him, adding a dented ego to his other hardships. And he had no time for this new generation of ‘junkies’ who didn’t know how to conduct themselves, and besmirched the ethical standards of the respectable old time ‘crim.’
But at the nursing home he was a celebrity. The residents and staff had heard of his exploits, had followed his career in the press, and his arrival was a minor festive occasion. As his last parole officer, I continued visiting him until his term of supervision expired. For this man who’d never really integrated into society, the nursing home offered more dignity and safety than the fate of future abandonment in the community.
Mum would also have to be assessed. Moving her and her possessions out of her flat, I ventured into the rank recesses of her wardrobe, sniffing the odour of neglect clinging to the limp, hanging garments. As I surveyed them, I struggled to remember Mum’s fashion choices. My mind dredged up the drab, faded, grey overall of my childhood, which wrapped around her pregnant belly through most of the war years. Then came the dusky pink glamour of Dior’s post-war, mid-calf ‘new look,’ the creation of pattern, fabric and the Singer treadle sewing machine. No other childhood memories of my mother’s fashion preferences survive.
Now I am to become the parent and my mother, the child. I will have to make decisions about her future and choose her fashions.
We flapped around the flat, sorting out her melange of clothes and other belongings, while she trotted doggedly behind us, putting everything back into the cupboards. In desperation we bundled her into the car and buckled her under the seat belt until we had cleared the premises and placated the landlady.
Finally we drove her home, to squash her into a corner of our typical suburban sixties house, economic in its extended space and limited in its capacity to accommodate a growing family.
We settled her in with her retinue of handbags, makeup cases and small carry bags. Sitting in a chair unpacking and re-packing these bags was how Mum liked to spend her days. Like security blankets, these bags would have to accompany her to wherever she was sitting. And their contents increased exponentially, as did my children’s complaints of missing underwear and socks. These and other items were frequently added to her obsessive audits of articles in the bags.
Then began the assessment process. The prognosis was not hopeful, and back in the eighties, Alzheimer was a disease only breathed, rarely uttered. There was no widespread audience clamouring for education about this condition. With the help of a sympathetic local doctor and Mum’s War Veterans’ pension, a room became available at a local, well run nursing home.
But Mum’s move into the regulated nursing home environment entailed the removal of most of her bags, depriving her of her daily pleasures. Merely a nuisance in our home, in the nursing home the bags were safety hazards to visitors, staff and elderly, ambulant residents.
Bereft of all but the comfort of only one handbag, Mum compensated by cramming it with cutlery, drinking glasses, and numerous sets of false teeth that had been fished out of their bedside receptacles.
The situation was even more desperate when she had to be admitted to hospital. To maintain the Florence Nightingale clinical neatness of the wards, nurses removed Mum’s handbag and placed it in her locker, out of her reach. But schooled as she was in the adage that the devil finds work for idle hands, Mum applied herself diligently to removing the cannula from her arm. When the nurses wrapped bandages around the cannula to deter her from this activity, they would find small bundles of neatly rolled bandages laid out beside the removed cannula. Yes, bags may have been a hazard in a nursing home, but a handbag in a hospital was a sinister signifier of a calamitous morbidity!
The handbag was also a particular source of anxiety on shopping excursions to chain stores. With Harpo Marx ingenuity, Mum would transfer items from shelves and displays into her handbag. I would hold my breath at checkouts, hoping that my frantic searches of the contents had retrieved all unsolicited items, but there were some embarrassing moments.
Mum died in the nursing home, aged only sixty-nine. I am her daughter. I have marked each year as a survival post and have now outlived her, but as each birthday approaches, I contemplate the vagaries of old age, the exit passage from life.
The enjoyment from hobbies and activities has been overlaid with the obligation of stimulating brain cells, marshalling them into a neurological exercise regimen to protect them from insidious threats. Crosswords, dictionaries and thesaurus, music, physical exertion, reading, writing, are all subsumed into a litany of prophylaxis for failing faculties.
My mind clicks through its catalogue of memories and images: my mother’s fading life, local eccentrics, smelly old men on the bus. The clarity of the images belies the captions of invisibility: discomfort, denial, aversion, those social bulwarks against unpalatable predictions.
My generation has become the ‘burgeoning ageing population.’ With our increasing longevity, Alzheimer disease has slipped into the lexicon, a nervous catchcry for moments when names, places and facts elude our ageing brains. We inoculate our anxiety with jocular references to memory loss and its connotations.
‘Oh God, I must be getting Alzheimer’s,’ I exclaim in frustration as my memory refuses to cooperate.
‘No, Mum, you just have a lot on your mind,’ is my daughter’s consoling rejoinder.
When I was young we used to call this ‘senile dementia,’ but with our increasing life span, sixty has become the new young for the elderly. No longer a hidden scourge, Alzheimer’s stalks the families of the famous, the wealthy, the prominent, increasing imperatives for research, prevention and antidote.
New industries proliferate as Government budgetary projections are reconfigured to cater for the needs of the ageing demographic. Legal advocates are promoting awareness of unscrupulous offspring who manipulate the wayward faculties of the elderly into prematurely divesting their assets to their progeny. Geriatric, once a pejorative adjective, is now a respectable infiltration into the professional realms of health and retirement services.
In a Dr. Pangloss world, an assessment for care would provide an ideal environment for everyone. But in our real world, some assessments will deliver more than others. A War Veteran’s pension was the passport for good care for my mother. It is not available to me, a divorced old age pensioner.
But what I do have is a more enlightened understanding of old age, easier access to health and community services, opportunities to engage in stimulating activities, a vibrant social and cultural life, mobility to visit friends and go on holidays.
If Alzheimer’s strikes me I tell my family that I must eventually go into care, and have given my daughters power of attorney over my affairs. Conversations on this possibility threaten their comfort zones, but open discussion will allow me to have input into any assessments of my ageing process and my capacity to manage the changes.
And unlike my mother, I’ll be able to share with them the responsibility for decisions taken.
Cleo Lynch 2009.