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Losing Dad, Loving Mom

Now what will be the best care for mom when Dad dies and she’s left alone with developing dementia?

En español | Dad turned 84 on July 1. This birthday was probably his last. He has terminal bone cancer in his hips.

Three years ago, when he and Mom still lived in their house in California, Dad was diagnosed with prostate cancer and also underwent a gall bladder operation. His illness left him incapacitated and he spent several weeks in a special clinic. Mom was left at the house, alone and depressed. Finally, my siblings and I convinced them to move to an assisted-living home. We opted for Seattle, because assisted-living centers there are 50 percent cheaper than in California, and my younger brother, Jaime, lived right around the corner from the new home.

The past two years had been happier for all, despite Dad’s health. Mom and Dad blossomed at the center, and we were satisfied with the care they were receiving. Mom’s among the youngest residents, and she likes it. She’s charming, a real flirt, and gets a lot of attention. She takes yoga and plays bingo with the other ladies. Occasionally, she adopts an older resident who needs more care, and helps her along.

But when I visited them in February, I grew concerned. Dad was never a dashing dresser, but he had always been tidy. This time, he was wearing old pants and a T-shirt. His eyebrows were white with dandruff, and his nails were long. He’d had pneumonia and was still recuperating, so he spent most of the time in bed. In his small bedroom, where there’s only a television and a bed, there was a huge metal oxygen tank. Every time he took a nap or went to bed for the night, he was hooked up to the tank. Dad complained bitterly until he realized the oxygen helped him breathe better. 

Dad’s illness has left Mom depressed and sullen. On top of that, she’s showing some signs of dementia—she gets disoriented, exhibits changes in her personality, and forgets events after a few hours. Often she’s evasive and makes no sense. An avid reader, she used to be opinionated and funny. Now she can turn into a young child at the snap of a finger. My brother, the caretaker who sees her almost every day, often loses his temper. “She’s manipulative,” he tells me. And I respond that she’s losing some of her capacities, that I think we’ll all have to learn to deal with her frustrations and feelings, and go with flow.

She’s always upset when we pay attention to Dad. I’ve tried to tell her that he’s dying—she should enjoy her last days with him. But right now she doesn’t care. My brother takes Mom and Dad to church every Sunday. Mom now throws a tantrum every week because she doesn’t want Dad to go. My brother ignores her comments, telling her if she doesn’t act nicely, he’ll take only Dad to church.

The one lesson we learned through their move to the assisted-living center was to not procrastinate about making decisions about our parents’ living situation. Today, none of us are ignoring what is about to happen: when Dad dies, we will have to make a decision about Mom.

Dad’s cancer is progressing fast. The hospice nurses told us we must move him to a more intensive care facility. Jaime has found one run by nuns in West Seattle. We don’t know if the facility would have room for my mother. If it doesn’t, that would complicate matters for Jaime, who now schedules quick visits as he heads home from a demanding engineering job to his wife and two young children.

And what happens to Mom when Dad dies? They’ve been married for 56 years and, except for the year Dad first moved to the United States, they’ve never been apart.

Should she stay in Seattle or move back to California where my younger sister, Mae, a health management specialist at a California hospital, and my brother Jose, a retired engineer, live? Do we leave her at her present home, where she already knows people and they are used to her? We don’t know. Soon the time will come again when we must take away more of her freedom and privileges just to keep her safe and healthy.

 I think taking care of Mom’s needs will be an issue of getting the right care. Until now, we haven’t tested her for dementia. We’re also going to have to learn to validate her frustrated feelings; live with the reality of the moment; and use distraction, redirection, and memories to keep her happy.

And then there’s the financial aspect. We pay for their stay at the center from the rent we get from their Palo Alto home, Social Security, and Dad’s pension. But when Dad dies, we’ll lose his pension.

Just when we thought we had conquered all future problems with our elderly parents, life is changing again, and quickly. Dad and Mom emigrated from El Salvador in the early sixties. Both were accountants, but in the United States Dad worked as a chef at Stanford University and Mom as an accounting clerk. They had few friends and no relatives nearby. We were their family. They expected us to take care of them as they grew old in their home in California—which they bought with great sacrifices—until they died. That was the way they had been brought up. We’re probably not doing enough by them.

When she was younger, Mom never gave up; she always managed to come up with a solution to problems. Her biggest gift to me as a child was teaching me fortitude in the face of disaster.

I wonder what goes through Mom’s head now. Where have the shrewdness and insight that helped her guide her family from El Salvador to the United States gone? Is she afraid now as she contemplates her life, a life that will change drastically when Dad passes away? How will she face life alone, life without the husband who’s been her partner for more than half a century?

Facing Dad’s death is forcing me to ask a lot of questions about my own life. I know I didn’t accomplish the goals he had in mind for me. I didn’t have children, buy a big house. But both Dad and Mom were proud of the varied paths my siblings and I took. And I think Dad will be happy to know that the values he taught me—and which have stayed with me throughout the years as I have moved around many countries—are faith in my own strengths, honesty, and loyalty. 

What happens when your parents need to move to an assisted-living facility—but they don't think so? One daughter talks about the struggles she faced.

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