Grading Visits

Good or Bad

“She smiled and acknowledged us. It was a good visit.” My friend Ira described a 15-minute interaction with his mother who was confined in a memory care facility during the height of the pandemic. With plexiglass restrictions and no-touch rules, it was especially heartbreaking. That Sunday, receiving a smile from his mother made it a fraction more bearable.

Similarly, my friend Jackie, whose father had dementia and lived at home with a full-time caregiver, reported: “It was such a good visit today. He ate his entire lunch and grinned when he saw the cookies we brought.”

These reviews make total sense to me. I did the same and graded my visits. It was a good visit, bad visit or a hard visit. I couldn’t help but to call a visit “good” when my mother was more alert and engaged.

The best visits were those when Mom looked content, calm and comfortable. When her eyes smiled and she was happy to see me. When she came out with a surprising expression or used certain vocabulary that I didn’t think she still knew. Those were good visits.

Difficult visits were when Mom was off. When she didn’t look happy or register emotion. When she wasn’t put together or looking pretty. When her hair wasn’t the way it was supposed to be. When her fingernails were dirty because she was picking at something nervously.

Bad visits were those when the environment was off. When there was a chaotic energy with too many people coming and going. When the noise level was high with multiple conversations taking place in one room or a TV channel was too loud.

Bad visits were when I was off, upset that I had arrived later than intended or in a hurried mode. Bad visits were when my attention was diverted away from Mom.

As I look at these descriptions, I see my old friends behind the scenes: Acceptance and Control. The environment, for example, was something I could impact but could not control completely. The symptoms and side effects of Alzheimer’s were definitely beyond my control.

I realized that as Mom’s condition declined, I could either get swallowed up by the sadness and awfulness of the disease or I could be present to her as she was, even when she could not be present to me. When I did this, the visit was good.

When there was nothing more to fix, I learned to soothe.
When a mood could not be changed, I learned to allow.
When her vulnerability was exposed, I learned to protect.

I learned that becoming frail or losing your faculties does not mean losing your dignity. It is the witnessing of someone’s experience – with love as your guide – that offers dignity.

Scoring it Differently

In the first year as Mom was adjusting to living in the care home, my visits sometimes interrupted the rhythm of her day and resulted in her being agitated after I left. Perhaps on an emotional level, it reminded her that she wasn’t living with me and that I was leaving her there, again. Fortunately that phase passed and she adapted to the routines of the care home as well as our visits.

Over the years, there were always things to monitor, manage or adjust to make Mom more comfortable, however those eventually settled down and were somewhat cyclical in nature as changes occurred. There is more to taking care of your loved one than being a manager. After the details are addressed, there is simply the visit – the being with – the acceptance of it all and the many things to discover about connection.

As time passed, I learned to judge a visit as “good” when I was unhurried and open, even if it was a short visit. Was I able to be fully present 100% of the time? Definitely not. There were times I was rushed, on my way to another appointment or distracted with a work issue or other obligation. For the most part, the visits became a time that allowed me to be present and to leave everything else on the other side of the door.

For the span of our visit everything slowed down and that was a gift, its own type of mindfulness practice. Being present to Mom also meant connecting with the full picture of her life in the care home. She enjoyed my interactions with other people in the house: caregivers, residents and their families. These interactions were mutually enriching and they gave Mom and her fellow companions a break from the pressure of having to engage in every conversation.

There was a balance between having private time with Mom and shared time with others. Whether alone with her or together with the group, these heart to heart exchanges were the sweetest times.

In the later years, the nature of our visits changed. There were fewer words and more sitting by Mom’s side as she stared into the distance or napped. There was a great deal I learned about a deeper level of connection in this phase as well.

Because We’re Together

“It’s all good.” We use that expression even when we don’t mean it and especially then. It’s even become an irritating phrase.

What are we trying to say?

That there is good woven throughout the difficulty.
That there is a larger picture we cannot see.
That on some level all is well.

It is not the kind of good we had pictured. It’s something else for which we did not ask. More than fixing it, we can only try to make it as good as possible.

When I look back now, I recall all kinds of visits: imperfect, disjointed, unremarkable, fun, happy, heartwarming and heartbreaking. Some visits were extra special. Some were upsetting. I began to see that the good in each visit was because we were together. That’s how it is when you’re taking care of someone you love.

——

Grace and Ginny

The morning of Christmas Eve, 2012. Winter in Scottsdale meant cool air and sunshine. As I pushed Mom’s wheelchair through the neighborhood, I pointed out the variety of trees and flowers. I remember feeling grateful for a longer than usual walk and for the opportunity to be together in the fresh air. On the way back we were greeted by a neighbor and her dog, a sheltie. It’s a visit that has stayed with me and one of my favorite memories with Mom from that time.