The Birthday Party

Today is my father's birthday. He is 78 and still vigorous enough to inflict dark bruises on my mother's arms and shoulders. For a while she had fingerprints on her neck but I knew better than to ask about that.

My mother baked a chocolate cake and frosting sweetened with Splenda, half honoring his diabetic diet. She asked me to come for the birthday celebration, to help make the event more festive. "We are a loving family," she said. "We will surround your father with love and familiar faces even if he seems not to recognize us."

My mother's greatest joy is to bring my father home and feed him lunch or dinner, or both at once. She pays the aide an overtime rate for this outing, but no matter. Recently I stopped in during lunch and found them all together in a scene reminiscent of a Dickens nightmare. The television was tuned to a football game, cranked loud enough to hear the players' helmets crash together. Dixieland music seeped from the Bose sound system in her bedroom. "Isn't it great music?" She vamped her shoulders, dancing in place. "That's your father's favorite CD." The furniture was pushed to the side, the rug was rolled up along the wall. The aide, a lovely Nigerian man who claimed to have a Masters degree in business, stood near the wall of the tiny apartment bemoaning diminished funds for the civilian police forces in his home country. My mother sat on the sofa, knitting and waving gleefully. "Come in! Come in!"

My father walked up close and peered at the shiny charm hanging from my necklace. I leaned in and kissed his forehead. "Hey, Dad." He bent toward me and my heart skipped. He was going to hug me! Instead, he lunged and tried to bite the heart-shaped charm at my throat. "Be careful," my mother laughed. "Your father is feisty today!"

On the table was a single setting: placemat, linen napkin, three colorful plates loaded with food. "Lisa, let me make you a plate," she said, rising. "We're having short ribs and mashed potatoes, three kinds of vegetables and a big caesar salad just like your father likes." She had poured diet Coke into a wine glass for him.

"What did you eat?" I asked her. She shrugged. She wore rumpled pants, held around her waist with one of my father's old neckties. Her shirt was untucked, unbuttoned and stained. She was not only thin; she was sunken. "I'll eat if you'll eat," I challenged. She smiled and danced past me to retrieve a cup of Ben and Jerry's ice cream from the freezer. "I'll eat later," she lied as she speared a spoon into the cup. "Your father loves ice cream."

I'm guessing right about now my mother is serving a plate of chocolate cake topped with ice cream to my father. I am not going to the birthday party. In truth, my father never really liked that sort of thing anyway.

Missing

Here's the problem with dementia: you do not get to grieve. I miss my father. I miss his humor and his strength. I miss asking him how to adjust my computer settings and how to dissolve the corrosion on my car battery. I miss telling him about my sons, and listening to him laugh when I complain about their antics and about their mischief. I just miss him. Instead of grieving I am supervising the care of my living father, my demented father who wears a diaper and speaks in gibberish.

Today I will sit with my father at the window where he will try and grab the raindrops speckled on the outside of the glass. I will watch him apply all his energy toward this task, toward capturing a raindrop. He will not know that I am silent with missing him, and aching with love for him.

Turnover

There were three deaths in the dementia ward this winter. I don't know the names of the people who died but I know their sounds: one belongs to The Moaner, who emitted a sonorous wail with every exhale, even in sleep. Her bed was along the hall at the nurse's station, parallel-parked in a row of other 'mostly dead' inmates. There is someone else parked there now, half dead, mouth agape.

The man who wore the helmet is gone, along with his incessant and relentless knocking. He never spoke. Instead he rapped his knuckles on any surface within reach: on the table that trapped him against the wall (for his own safety, or so they said), on the window or wall behind him, on the wheelchair parked next to him. He even knocked on his own helmut.

The woman who masqueraded as a staff-member is among the dead and the ward is strangely muted without her vile language and passionate accusations. She used to push other residents around in wheelchairs, bashing into tables and walls, shouting obscenities and threats to anyone or any thing in her way. In truth, I was a little afraid of her. But now that she's gone I will miss the boisterousness of her voice.

Oh, I just realized that The Folder is missing! She needed to fold. My mother surmised that this woman had once been in the linens business - she was never without a pile of towels that she'd fold and unfold and fold again, saying with each completion: "there you have it." I can guess where she is now. No one leaves the dementia ward for a better life. It's a one way place.

There are several new faces, new noises. I'm only getting to know them now: the man who pulls his shirt up to hide his face inside the collar; the woman who puts her hand in my pocket as soon as I come into the ward.

My father is still there. Still walking, still eating, still talking in his peculiar gibberish.

Stages

For a while, my father was in an amiable stage. He seemed to enjoy our visits. We walked with him outside. We read Curious George and National Geographic magazines together. We took rides in the car. It was a good stage.

But it's over.

I arrived early and peered through the glass panel in the security door. I saw him immediately, walking the length of the ward. At each half door, he stopped and tried the handle, shaking, twisting, trying to wrench the door open. After a time, he moved on, walking jerkily like a zombie from Invasion of the Body Snatchers.

I stepped inside and pulled the door closed behind me. He looked right at me but didn't see me. I was about to approach him when Reggie, one of the day aides, touched my arm. "Don't maybe interrupt him." His voice was gentle. "He is uneasy all the time. Better to let him fuss for now." Fuss. That was a good description of my father's behavior.

I moved to the key panel, feeling the panic rise as always. What was the code? I punched the numbers, stifling a sob: I didn't get to kiss him! I didn't even get to say my favorite words of all - "Hi Dad."

The unlock tone sounded and I saw my father move with sudden focus. He crouched, lowered his right shoulder, tucked his chin, and sent out a singular jab with his right fist. Like a boxer, I thought, staring. Reggie moved quickly, but could not escape the fist completely. It caught him on the back, just under his ribs. I slipped out, securing the door.

This stage is going to be hard. This stage demands that he be left alone, cut off from us, inside that ward, with only the sounds of dementia to keep him company.

Sometimes I think I will not survive the sadness.

Not Yet.

My father is having trouble with his gait. He doesn't shuffle; rather the toe of his sneaker catches on the floor with each step causing him to lurch. The aide walks next to him, holding on to the wide canvas belt knotted around his waist.

"He's a fall risk," the nurse reported to me this morning. "He should not be walking around without a helmet."

A helmet? I don't know if I could handle seeing my father in a helmet. I watched him stumble.

"Dad!" I shouted at him. He froze in space - I'd scared him. "Dad." I said, softer now and patting the chair next to me. "Dad. Come and sit next to me." The aide maneuvered him to the seat, sliding him close to the table. "I brought a surprise for you." I tore open the small bag of peanut M&Ms and leaned in close. "Don't tell anyone," I said. "It's a secret." I put an M&M in the palm on my hand and held it out.

He stared at it.

"It's candy," I said. "You like it. Try one."

He pressed the M&M with his thumb, mashing it into my skin. "No Dad, it's food. Look. You eat it." I held out another M&M, only this time, I held it to his lips. He sucked it in, chewing with great concentration. "Good?" He nodded. One by one, I handed him a candy and watched him pop it into his mouth.

Behind my father, Mr. Lentin was strapped into a wheelchair, held erect by a thick harness that encircled his torso like a straight jacket. He shook the table that barricaded him in to a corner. He pushed at the table, sliding it this way and that. With every shove, he grunted. His head was encased in an oversized grey helmet that snapped under his chin. He looked like one of those bobbleheads on a taxicab's dashboard.

I'd been distracted by Mr. Lentin's attempt to escape his enclosure. When I looked at my father, I saw he was eating the tab I'd torn away from the bag of candy. I pulled it from his lips. I laughed, and then he laughed, and I saw his silver hair shimmer in the harsh florescent lighting. Even now, he has such beautiful hair.

No. My father does not need a helmet.

Yet.

The Other Guy

The other guy is dying. He'd had a parallel experience to my father's: laborious decline into dementia, a stint in a psych hospital and then, the dementia ward. Like my father, he was combative and aggressive. Like my father, he had a strong and healthy body. The wife was bereft. We'd stood together in the hall, the wife, my mother and I, listening to his sputtering rage. We huddled in the lobby. We compared. We commiserated. We held hands.

Now they've called in hospice. His body is trapped under a belt, his wrists strapped to the bed rails. The medication has reduced him to silence.

"How're you doing, Mr. Hale?" I shout into his room as my father and I pass by. My father walks with a staggered gait, a ghost in orthopedic sneakers. Our elbows are linked; I clench his arm to my side. He is not dying.

How're you doing? What a stupid question.

Don't Pick Up That Phone!

He bit someone. My father bit someone. The man known throughout his professional life as "creampuff bob" bit an aide on the arm. It was an unprovoked bite; he wasn't angry or defensive. Like a shark nibbling on bait, he simply sank his teeth into any arm that presented itself. The aide was taken to the clinic and my father was given a sedative.

The nursing home is required to report violent behavior, so my phone rang soon after nine. "Your father had an event," the nurse started. An event. That's what they call everything. Like they're having a party or something. I wish they didn't call me. I wish I didn't know anything. I prefer my original perception of my father. I prefer thinking about him as funny and inspiring, thought-provoking, challenging and intellectual and witty. I am trying so hard to remember him like that. But then, the phone rings.