Thanksgiving at the Assisted Living Restaurant

Despite what you may have heard, assisted living - even the skilled nursing unit - has its pleasures.

Hello friends!

First off, thank you for the positive response to my first Stony Creek Diary post two weeks ago - I was truly astonished at the high open rate. I hope you’re enjoying these and finding some of it helpful. I think there is probably a “How to Manage Your Very Elderly Parent” guide buried in all my notes somewhere waiting to come out and maybe this is the start of it.

This weird, liminal, not-terrible-but-disorienting-and-exhausting transition year continues and we have reached the holiday season.

From my social media feed and other Substack newsletters I subscribe to, it seems everyone dreads the holidays? There’s a lot of grim posts about “getting through.”

While I think we are all set up to be let down, and there is an awful lot of things to cram in if you decide to do all the things in this six week period, I always find a lot to like, even if it’s just the lights, an excuse to drink cider and bourbon cocktails and the appearance of dark chocolate star cookies at Trader Joe’s. 

For many years, we had a really festive Thanksgiving hosted by my sister and brother in law, Marie and Michael, at their lovely home. It was like a cross between a family Thanksgiving and a Friendsgiving as there was always the same group of family friends joining us around the table. Kids were born, grew up and left for college in the lifespan of this annual party.

And it was a party - for any of you who have been fortunate enough to be hosted by Marie and Mike, a) you never go hungry b) their house and table are stunningly decorated c) they keep a well stocked cellar and liquor cabinet d) the conversation will not be dull. There is also the added bonus of dogs, increasingly more of them over the years.

My mom and I were usually key assistants in the set up and execution of this event. But just be glad it was not only me in charge of the table set up. Wednesday night we would leave to go to our hotel and then Marie would work until late getting chair covers on chairs, arranging flowers, the works. I always thought it looked pretty good when we left but by Thursday morning it was spectacular. 

Late morning until early afternoon, Marie and I and usually one lucky assistant would be in charge of getting the food on the table. Even though my feet would hurt by the end of it, I feel nostalgic about it now, getting things in order as the guests started to trickle in. There is something about preparing a meal for a crowd that is particularly and specifically satisfying, even when all the dishes were not scratch made (tip o’ the hat to the former Mt Vernon Fairway). Everyone was always so happy to be there, catching up, talking football, complaining about the nuts who came out for Black Friday.

Things change. People get older and no longer can navigate stairs or long car rides or stays in hotels. Teen kids have other obligations. The band breaks up.

This year, I am joining my mom at her assisted living for Thanksgiving dinner. We will of course visit my dad. Marie, Mike and my niece Emma will come up Friday to avoid the brutal holiday traffic and we’ll take my mom out.

I know there is the school of thought about the horrible fate of “ending up” in assisted living or nursing homes and it is desirable to stay in our own homes as long as possibleI There is truth to it, certainly, because for the vast majority of people, they turn to the assisted living option not because they don’t want to leave their single family home unattended when they winter in Florida. Usually the choice is driven by a decline and an inability to keep up with the many demands of home maintenance. (And maybe being sick of figuring out what to have for dinner after figuring it out thousands and thousands of times - I wouldn’t discount that one.) 

I am here to tell you that yes, it is another world. Yes, it is a population with an unusual amount of rolling walkers. There is a lot more bingo than probably has happened in the prime of your life. BUT… but… it is actually very pleasant. It does not seem like a prison sentence or a punishment. It’s a community. In my experience, the vast majority of residents are beyond sweating the small stuff. Just because one is an oldster doesn’t mean one is sweet and lovely = as my dad said many years ago, as they age, people tend to bend like small trees in the wind - in whatever directions they tended to to begin with. Everyone is figuring out their old age just like we are all figuring it out as we go along at any age. But the majority seem to be, in the words of my sister, enjoying every sandwich. And the people who work with them, at least where my parents are, generally could not be nicer and most of them have a pretty good sense of humor.

Bingo is not so bad and afterwards there’s usually wine and cheese.

My dad started on hospice a few weeks ago. It felt like a kind of a scary leap into the unknown originally but all those people who have been saying “hospice is great!” - yes, hospice IS great. Once you make that major decision, basically saying the quiet part out loud about where all this is heading, it then takes a whole raft of lower-level but consequential decisions out of your hands, the most impactful one being the “should we send him to the ER or not” decision. For any of you out there who have been through this, you know it’s not as clear cut as it is with a younger, healthier person who is in medical distress. The line is fuzzier and the whole process is pretty terrible for the elderly sick person, who is more vulnerable and has less coping capacity for the noise, lights, and jarring motions that happen when you go from a bed to a gurney to an ambulance, etc.  And once you’re in that system, you’re in that system. It was almost a year ago when we decided to have my dad taken to the hospital when he started getting pretty sick with COVID 19, even though he was vaccinated. He’s been taken to the ER a number of times over the past few years and it never got easier and everyone felt like they needed a valium after it was over, however nice the police and the EMTs were. 

Now that he’s in hospice, if he needs hospital care, he has a beautiful room in the hospice section of the local hospital. He rolled out of bed last week (I had never seen this until about six months ago but if you’re a fall risk, they ratched down the bed to the lowest position so that you’re sleeping a few inches from the floor. It looks weird and then you get used to it and it’s not so weird. Almost everyone in skilled nursing sleeps like that.) The nurse called me (another sidebar - a weird thing is, despite having both of our numbers, the skilled nursing unit only calls me, and the local hospital only calls Marie. So if they don’t get the one of us theu typically call, they don’t call the other. Weird.) He had bumped his head slightly. He isn’t really talking any more so he couldn’t articulate what had happened. They put him back in bed and he rolled out again a few hours later. The nurse left me a VM message saying they thought they should send him to the ER.

By the time I called her back, she had realized he was in hospice. Hospice makes the call. He didn’t go to the ER and hospice supplied a special scooped mattress because apparently this is a thing. (Like sleeping pretty much on the floor, you realize things are things when all of a sudden it’s someone in your family’s thing.) It is such a blessing to have hospice make the call because making the call yourself feels like a no win situation - either way, your elderly loved one is suffering and you aren’t really sure which choice will decrease or increase the suffering.

Although I should not complain because my sister is a really good partner in this and we basically always agree, so it’s not like I’m making these calls alone. It was also more complicated when my mother was more involved. It used to be she made all the calls, so many years ago, when my dad first started having dementia symptoms and he would fall in the night going to the bathroom, she would put a pillow under his head, wait for their neighbor who was a nurse to turn a light on in her house next door, and call her to come help my (tiny) mother get my (less tiny) father up. She does not like a fuss and she is incredibly (stubbornly?) self reliant (hmmm - well, that part feels somewhat familiar…)

When we first started hospice we were thinking that my dad might only last a few weeks, but it’s been a few weeks and he seems to have settled into a new baseline. He has pretty much lost all speech and although he seems to recognize us, depending on the day, he is more responsive or less responsive. One day we were able to get a chortle out of him about Trump and try to explain the white booted phenomenon of Ron DeSantis (a character whose pomposity and arrogance he would hold in unreserved contempt). Another day you get more of a blank stare. He is sleeping more, although some days more than others. He is still eating, although he has lost a lot of his ability to manage utensils at this point and needs assistance.

I know what you are thinking and you are right - this is horrible! Maybe assisted living isn’t so horrible but this is horrible. What a terrible way to go! Please, someone kill me before I get to this point if I get this diagnosis.

Like most things in life, it’s complicated, though. It is excruciating to watch someone as dignified and funny and sharp as my dad decline slowly and inexorably. On the other hand, he is still here and what I mean by that is that he is still a presence in a meaningful way when you go sit with him. His eyes brighten when we walk in. Some days he is more “him” than others and it’s hard to explain but it matters and it’s not just in my head because there is a difference between the times he can still connect and the times he can’t. The mind and our humanity have a mysterious dimension that makes us, us and it transcends language and expression.

And for him, skilled nursing is his daily reality; he’s not in pain and he’s not suffering. He seems to enjoy meals and he is certainly part of the warm little community in the unit. The nurses love him and up until his speech trickled off, he could still joke around in his signature dry humored way. He has always appreciated the absurdities life hands us and accepts them, along with gratitude for the good fortune life can also bring.

And like assisted living, living in skilled nursing is actually a blessing and not a horror show. It has truly changed my opinion of a “nursing home.” It is a chance to be part of a community and to have a community that operates at your level and your speed, rather than being at home and knowing everything needs to be adjusted or that you are slowing things down for everyone else. You can still have your own life in a manner of speaking, a life sequestered from the world, true, but a life you can handle. The residents have relationships with each other and they are kind and invested in each others’ well being. They enjoy taking meals together. Many enthusiastically engage in the daily activities and others, like my dad, enjoy watching others participate. The social director is funny and kind and clearly loves working with the elderly. She is endlessly patient and cheerful and doesn’t mind moving at two miles per hour. 

I have been thinking about this need for community as I have buckled down the last few days to really try and finish this phase of unpacking. I am also thinking about how I can’t find any warm socks because in July, you are not prioritizing having warm socks handy but come November, it’s a different story. But mostly I am thinking about feeling at home and finding community in a new context.

(I will say I feel better because now most of the stuff I am not using and/or don’t know what to do with (i.e. should have been offloaded when I moved) is now safely out of sight in the not quite finished third floor. So like most normal humans, I have stuffed all the things I don’t want to deal with into a space where I can pretend day to day it doesn’t exist.)

Where will things be when this hospice phase is over? There will be my mom of course and likely another hospice phase at some point. I miss certain things about being a part of a school community, mostly those times you had a meaningful moment with a student or family, or the times you had a really nice chat at lunch with someone and most specifically, at Westover, I miss pre-pandemic “couch time” in the head’s suite. The heads suite was made up of three offices - the head’s and assistant head’s, joined by an assistant’s office. The assistant’s office has a sofa. It was not uncommon a few times a week for someone to plant themselves there around 3pm, enjoy some candy that was a feature of being an assistant in the heads suite, and hope that other people would intuit your gravitational pull so you could all complain about your day. Which usually ended in both solving all the world’s problems and much, much laughter, most particularly on Fridays. I particularly enjoyed starting couch time by lying on the sofa and putting my feet up, lengthwise, so that people would walk by, look through the glass, and ask me how my day was going. :)

On the other hand, it is pretty nice to take a long dog walk in the morning and not wake up and check my email first thing. It is also nice to be sitting in a cozy kitchen on a November afternoon, drinking hot chocolate, and writing my own thing rather than a Thanksgiving letter to the school community. I am trying to figure out the balance between my social animal, my iconoclast and my introvert. Depending on the day, it’s unclear which one is winning, or which one I am rooting for or if there’s space for all three.

Despite hospice and all the unknowns, though, I have a good feeling about 2023.

Have a wonderful Thanksgiving -  with hope you find your version of 2022 joy in the holiday.

Julie

PS = Raccoon update - adding a splash of ammonia to the garbage bags seems to have motivated the raccoons to move on, but they did terrorize my neighbor’s garbage last week. My contractor was telling me that when they were working on the house, they found raccoon prints in the dust on the first floor and apparently they were living under the house and had created an entrance into the mechanical room (a basement equivalent on the first floor as there’s not basement). He boarded it up with some shingles and the next day, he found it politely rearranged - and then permanently sealed it. I am shaking my fist in the direction of the salt marsh!