This book paints a picture of life inside a care center for those with Alzheimer's. It helps us understand a little bit better the challenges faced by those living there and those working there. Obviously this can be a little bit depressing and hard to read, especially if you are close to a similar situation, but from my experiences and observations much of the information here seems very accurate. This story is told by a writer whose mother recently died of Alzheimer's. To try to understand better and eliminate some guilt she goes to work at a care facility. She deals with a lot of hard things, but learns a lot and I think helps each of us reconsider the value of life and humanity.
A couple of times while reading this I stopped to ask myself why I was reading it. It is sad, but it is real. This is life for many people and I think it's important to try to understand where others are coming from and to consider challenges others face as well as the value of each life....and hopefully how we can make life better for those around us, no matter what they're going through.
Here are a few quotes that I liked:
"I was going to force myself o confront what I'd been too scared to confront earlier, when the disease had been up close and personal. I was going to buckle down and learn all manner of important life lessons. I was going to make up for being a lousy daughter...So I spent time in the trenches observing other people's mothers, and I wrote about it. I peeled away maybe a layer or two, but I didn't feel much wiser....It was my detached position as observer and writer. If I was to come to terms with this disease that took my mother's life, if I was to learn whatever it was I needed to learn, I had to stop hiding behind my reporter's notebook and get inside the world of Alzheimer's...I decided to hire on at Maplewood. I would immerse myself fully and completely in the daily lives of those with this disease. I would take care of other people's mothers the way strangers had taken care of my mother (p. 2)."
"Like all mothers, I have done these jobs, all of these jobs. But caring for children who are cute and cuddly and smell good and get smarter every day is just not the same (p. 5)."
"Francis is not complaining, and she's not trying to discourage us. She's just getting a little weary of training new workers, some who don't make it past the three-day orientation, others who stay only long enough to pick up their first paycheck. Frances understands why others come and go. She accepts the reality. But it's not her reality. She loves this job, she tells us. She is one of those earnest, hardworking, egoless people you read about but don't quite believe exist (p. 14)."
"The myth is that families dump their relatives in institutions like Maplewood. The reality is that the decision is an agonizing one frequently made after extraordinary, often long-term, efforts to care for the person at home (p. 16)."
"Every child of a parent with Alzheimer's secretly fears that there is a bad gene at work, a gene that's been passed on and lies in wait, ready to switch on the machinery of dementia when the time is right (p. 27)."
"I'm sure I can learn something from this place and these people, but I'm not sure what. I hope I have the strength and the stamina--physical and emotional--to stick around and find out (p. 27)."
"For the next fifteen minutes I try to ease myself through the transition from Maplewood into the world I know, the world I am comfortable with. It is a world of thoughts and ideas, of talk, of concepts, of books to be read and discussed, films to be seen. Diapers go on babies in my world (p. 29)."
"If Jasmine and I didn't have each other today, one or both of us would be out the door (p. 31)."
"There's a way of looking at Alzheimer's that is not about decline and loss but is instead about movement from the worldly to the spiritual (p. 32)."
"He inches along behind his walker, asking us 'what's next, what's next?' with every step (p. 33)."
"Unresponsive and unreachable, Rose spends her days wandering from one resident's room to another, pushing a chair or walker in front of her, taking glasses or hearing aids, pillows, socks, knickknacks, whatever she an find, from one room and depositing them somewhere else. It's a joke around here, I've already discovered (p. 36)."
"It matters that I do this job well. The residents depend on me. Their world is very small now, the rooms and corridors of Maplewood, and I am in charge of it all (p. 43)."
"At Maplewood, as elsewhere, each resident has what's called a 'service plan,' a multipage document that details what help the person needs to accomplish the simple daily activities of life (p. 43)."
"The body is such a complicated machine, so many parts, so many systems, so many opportunities for errors and breakdowns. It's a wonder it all works, so I guess it's not surprising when ultimately, it doesn't (p. 45)."
"I started brushing her teeth. Then she took over and wouldn't stop. I couldn't get her to stop...So much for cueing to brush teeth. Maybe the difference between Frances M. on paper and Frances M. in the flesh is wishful thinking on her daughter's part, or perhaps denial (p. 45)."
"The idea of the game is to keep the ball in play, in the air, with the staffer batting it first to one resident, then another, each one returning the ball with a healthy whack. The activity combines physical exercise, hand-eye coordination, concentration, and a bit of socializing. From a life engagement perspective, it is a winner. But, from my vantage point in the kitchenette, I can't imagine how this is going to work, how, between the infirmities and slow reflexes of old age, and the disconnect of Alzheimer's, these men and women are going to keep the ball in the air. Or have fun (p. 55)."
"These women who no longer have the ability to regulate their own lies--they cannot dress themselves; they do not know when mealtime is or when to go to bed--somehow effortlessly keep their baby-dolls on a predictable daily schedule (p. 61)."
"Marianne, it is gradually dawning on me, believes she is an administrator here at Maplewood. What kind of a place she thinks Maplewood is, I have yet to discover. This woman goes against everything I thought I knew about Alzheimer's. I thought the disease stripped away the outer layers, the public layers, that over time if Alzheimer's left anything, it left the distilled essence of the person--Jack's sense that he is someone who helps people, Rose's restless soul. But Marianne's outer layers are very much intact. Or maybe I'm looking at it the wrong way. Perhaps this is Marianne's essence. After all, she spent a half century as a career woman, starting a job when most women, like my mother, were starting families in the new post-war suburbs. This is how she defined herself, and it's how she defines herself now. So maybe it makes sense that this part of Marianne remains untouched by brain plaques and never tangles (p. 86)."
"Suppose caregivers tuned in to the reality being lived by the person with Alzheimer's rather than trying to force another reality upon them (p. 88)?"
"When you're sure he doesn't understand, he says something so insightful it takes your breath away. Then, that neatly accomplished, he goes back to being a bossy, cranky, difficult old coot (p. 94)."
"With some of the residents this lack of modesty is part of a general lack of awareness, the brain-disease trance they're in. But with others, like Eloise, I think it comes from a different place. I think it's an almost saintly acknowledgement of their own vulnerability, a calm, open acceptance of their own needs and the fact that now others must be involved in helping them. It's Eloise's lack of vanity, her peaceful, artless humility that makes it possible for me to do what I do (p. 98)."
"I silently thank Jennie every day. I want to know her secret, her secret to not giving up (p. 105)."
"I take a week off after the funerals. I need time to accept that Rose and Hayes are both gone. When you work with the sick elderly, you know their days are numbered, but knowing that they will die and the fact of them dying are two different things. I am very slowly learning not to be unnerved by what is really, when I think about it, just the rhythm of life. In our culture, it's easy to shield yourself from that rhythm, to not hear it or feel it, to think you exist outside it. Your world is healthy and forever young. Death happens elsewhere, to invisible, anonymous people. But here at Maplewood, I am unshielded (p. 193)."
"I consider it a miracle that family members last as long as they do. I also think--and I've told wives and daughters and sons this--that, at a certain point, an Alzheimer's facility, a decent one like Maplewood, is the best, most humane, most loving place their mom can be (p. 202)."
"This is the most draining work I've ever done, but as I am drained, I am also filled, and I think the equation often works in my favor (p. 210)."
"Wisdom, it seems, exists outside of memory (p. 212)."
"The problem is understaffing. The problem is undertraining. The problem is high caregiver turnover. The problem is paying minimum wage. The problem is the eldercare industry. (I could go on, and so I will: The problem is undervaluing the elderly. The problem is fear of aging. The problem is fear of dying (p. 216))."
"'I am losing my mind...But the essence of a person is their heart, isn't it?' The documentarians let the question hang in the air. Is the essence of a person head or heart? It's not a warm-and-fuzzy New Age question. It's a real question that goes to the core of our sense of what it means to be human: When we lose our mind (our memories, our coherent thoughts) do we lose our humanity? If we keep our 'heart' (our emotions, our connectedness) do we remain, in essence, who we always were? When my mother got Alzheimer's, when I saw her and spent time with her, I would have answered that question, emphatically, one way. When you lose your mind, you lose your self, I would have said. Alzheimer's makes people into zombies, I would have said. The walking dead. Give me anything, but spare me this disease, I would have said. But the time I've spent with the residents of Maplewood has eroded my certainty about this (p. 223)."
"But part of me has come to think of Alzheimer's, despite its obvious horrors, as a disease of freedom. It's not just memory that one loses. It is inhibition. It is pretense. The thin layer of civility that forces us healthy people to operate with equanimity even when we are tired or crabby or don't like someone or just want to be left alone--that's gone too. What remains is some unvarnished, unprotected self, maybe the self a person would have been had culture and society, gender and class, manners and mores not overlaid it. The buried self, the unlived self (p. 224)."