Suddenly, They’re All Gone

Suddenly They're All Gone

Lauri Rotko/Getty Images

Suddenly, They’re All Gone

By Carol Mithers

Caring for the old is just like parenting an infant, only on really bad acid. It’s all there: the head-spinning exhaustion, the fractured brain, the demands and smells. Only this time with the knowledge that it won’t get better.

That was my life for five years. First came my mother-in-law, then my father-in-law, then my childless aunt, then my mother — all needing different kinds of help as they weakened and started going downhill, all the care overlapping, and almost all of the work to be done despite distance.

You’re so good, friends would murmur, but I wasn’t — there were plenty of days I muttered, “Can’t do this anymore,” and nights when I threw back too many drinks, feeling how badly I needed for it to be over.

Now, though, it is done for real, everyone is dead, and the surprise is that instead of being relieved, I feel worse.

More than a year after the last funeral, I still have all the numbers on speed dial: my in-laws’ neighbors in Texas and my aunt’s in upstate New York; the security guard at my mother’s gated San Diego community; doctors, hospitals and emergency rooms in three states; two home health agencies; the 24-hour hospice nurse. I still sleep with the phone on and stashed on my night table, where I can grab it fast. It’s over, but I can’t let go. No, it’s worse than that: I don’t want to.

Maybe there is nothing new to say about the nightmare of shepherding the old through the time that is the prelude to death but not active dying. I knew it would be bad, but you don’t really understand until you’re there, any more than the childless can grasp why a new mother goes three months without shaving her legs.

“Drowning” was the word that came to my mind as the endless crises unspooled. My terminal mother-in-law, abandoning the 50-year pretense that she could stand her husband to demand: “Put him in a nursing home! Get him out of here!” My father-in-law, newly widowed and alone in an early Alzheimer’s haze, barricading himself in the house against caregivers. My aunt, her lungs destroyed by a three-pack-a-day cigarette habit and reeling from one hospitalization after another, begging me to send morphine so she could end it all.

Alerts peppered every hour. Do something! Your father-in-law’s behind the wheel again. Your aunt’s in the hospital with pneumonia; she’s recovering; no, she’s failing, come quickly; no, she’s been yanked back from death into a life of oxygen concentrators and cognitive crash; find a nursing home — wait, are you in New York? Because your mother’s in the hospital in San Diego and it could be serious, can you get on a plane?

Frantic was my new normal and normal the new never, because when someone is old, especially if dementia is involved, nothing is routine. Even the answer to a straightforward question, like “What day is it?,” vanishes on the wind; every patched-together arrangement works only until it doesn’t.

“Drowning” — also buried, shredded, torn apart. Helping my daughter prep for the SAT, cooking family dinners and maintaining a professional life, while also paying three sets of bills, running three houses in three cities, either planning a trip to see how things were going or recovering from that trip, and never living in just one place.

I started keeping my cellphone on my desk, then leaving it on all night, and finally didn’t even risk putting it down because the one time I did, to watch my child in a high school soccer game, there were five frantic caregiver messages by halftime: Where are you, what should I do, she can’t breathe!

And yet: Parenting on bad acid is still parenting. I wasn’t one of those women who went all dewy-eyed the second she gave birth. “I don’t feel anything,” I remember thinking in dull panic as I looked at my squash-faced, just-born daughter. “How can I love her? She’s a stranger.” Within two weeks, though, I was transformed, flattened by a passion I had never even dreamed existed, and it was the grunt work of motherhood that did it to me, the holding, touching, watching, feeding, smelling — the getting to know the specifics of this little creature in a way that went down to my bones.

I had always imagined that you put up with the job of caring for a baby because you loved her, but for me it was the unfathomable, slightly terrifying intimacy of caregiving that brought the love.

And with my old people, it was the same. The fried-brain resentment that gets you drinking at night fades when you are with someone in the living room or kitchen. Just as it is with a baby, your job is tending, and the comfort you bring is simple and physical. You sit for hours, the heat always cranked up high, doling out pills and pouring water, changing the nitro patch, combing hair. You fix lunch, rub in skin cream.

You come to know the precise texture of thin, dry skin, the kind of touch that pleases, the small things that bring a smile. My father-in-law had to have vanilla ice cream every day, but only Blue Bell brand and in a waffle cone. Even with her thinking garbled, my aunt needed the New York Times crossword puzzle and endless games of gin rummy. My techno-challenged mother wanted written computer instructions to consult the next time the infernal machine swallowed her text.

More than anything else, when you’re with the old, you listen. My Greatest Generation/Army veteran father-in-law, whose interest in the world essentially ended in the late 1950s, talked in endless circles about his small-town childhood and the World War II campaigns of Italy and North Africa. My aunt, obese and isolated for years in a small upstate town, had spent her 30s and 40s single, teaching history in New York City public schools for nine months a year, then buying elegant clothes and setting out for Europe and Africa.

The giraffes came down to the water hole every night, right in front of where I stayed…. One night, in Turkey, in a cafe next to the sea, we danced in the moonlight….

When the present is unbearable and there is no future, the past comes rushing back: family history, secrets and buried memories rising out of the ether. My relentlessly forward-thinking mother never dwelled on sorrow or regret, but she told me one night as we sat among the empty cups and crumbs at the dinner table: My Aunt Belle committed suicide by jumping in front of a subway train.

I was home alone when someone called. I had to tell my father that his sister was dead. I’d never seen him cry before.

I could see it all: my father-in-law’s bungalow in Kaufman, Tex., whose open front door proved irresistible to a contrary billy goat one day in the 1920s. The 10-cents-an-hour wage my aunt earned tending a booth on the Coney Island boardwalk during the Depression — I was saving to buy myself a new pair of shoes, but my mother took the money and I still can’t forgive her for it. My mother’s quiet, wild joy during her first winter in Ithaca, N.Y., when a Cornell scholarship let her escape the dirt and smudge of Queens to a snowfall that stayed white.

All the years I was young, the center of life’s drama, I barely saw these people. Now they were simultaneously disappearing and becoming unbearably real to me, heartbreakingly diminished and yet still powerful, deeply rooted trees that against all reason would not let go.

There was my 98-pound mother, befriending the immigrant podiatrist who tried to relieve her painful, bunion-crippled feet; limping to her desk and squinting her one good eye at that maddening computer, so she could finish an article for her community newspaper. There was my wheezing, demented aunt, frowning at the sign “Don’t Toutch” that her caregiver had placed above a complicated new hallway thermostat, and pushing her walker to it so she could correct the spelling.

Their singularity dazzled me. Their selves, revealed in all their layered complexity, could never be replaced. I came to know them — and I fell in love.

When you care for the old, life can go on unchanged for years. Then suddenly, without much warning, everything shifts. Six months after her cancer diagnosis, my mother-in-law died; 18 months later, my father-in-law fell, had a small stroke, fell again and lasted only two months in the Alzheimer’s unit of a nursing home.

Two years after she survived near-death by respiratory failure, my aunt’s breathing got so bad she couldn’t even make it to the bathroom; she wanted only to sleep, to talk to her long-dead sister, who she insisted she heard on the stairs. You’d better come quick. Minutes after my plane landed at Kennedy Airport I got the call saying she was gone.

Not long after my mother, radiant in a sun-colored jacket and pearls, celebrated her 90th birthday with a huge party, she said her stomach hurt. A week later, I was in a hospital room sobbing against her cold, still shoulder.

I have my life back now, but that fact is less simple than it was before. When I look at the mementos I’ve inherited, the crumbling photo albums, cookbooks that smell of cigarette smoke, ’50s furniture and cut glass, I also see where they used to sit, in other places and rooms. I miss the quiet afternoons, the houses that eventually came to feel like home, in cities I’ll never again have reason to visit. I miss it all. I miss them.

Sometimes, when I’m out, I catch a glimpse of a short, gray-haired man in a baseball cap or a skinny old woman in a tailored bright jacket and my heart stops. I see my old people everywhere, which only reminds me that I’ll never see them again.

When you have a baby, it’s as if your whole self shifts, reshaping itself around a presence that later you can’t even remember living without. You reach down and take a small hand, and joined, you hurtle toward the future. Death just offers stasis, absence, dissolving shadows.

None of that was a surprise, but it’s still a shock. While you’re caring for the old, you can’t believe what you’re called on to do and where you find yourself, can’t believe that your time with them will ever end. Then one day, it just does.

I cared for my dying parents. How is caring for my dying dog just as bad?

 

 

I thought it would be easier to care for an old dog than an old human — or maybe harder. But almost a decade after my husband and I cared for and lost three parents and an aunt, tragedy has repeated itself as farce in the form of our aging dog.

Casey, the handsome, thickly furred red dog we brought home as a puppy, is 15 — in canine years, what gerontologists would call “the old-old.” Suddenly, we’re back in the place we named Elder World, as managers of his decline.

The bulging disc in Casey’s back has outpaced the medication we’ve given him since he was 12, and he struggles to sit and lie down. His tail won’t wag; his gait stutters. His hearing is shot, and cataracts have left him nearly blind. The past six months brought “canine cognitive dysfunction,” a.k.a. doggy dementia. He gets stuck behind furniture, paces at night, has forgotten there’s a backyard and will only pee in front.

 
 

I never imagined that senior dog care would prove a weird resurrection of something I already knew. Instead of the shower chair, water bowls set atop risers, to make drinking easy; instead of the walker, a sling. A trail of absorbent puppy pads leading to the front door to catch the inevitable accidents takes the place of adult diapers. The mental changes hold echoes, too. Casey, part chow, ornery and snappish, has forgotten that he hates the dog down the street and strangers who presume to pat his head.

The newly agreeable Casey evokes my once sharply critical aunt transformed into a matron who marveled, “Look at the size of it!” in reference to a ShopRite. When Casey starts his evening shuffle, to the door, outside, back in again, his endless search for something that eludes him, I hear my father-in-law’s voice: “What day is it? Where’s my checkbook?”

As we did then, we ask ourselves the same questions: “What does he want?” Who knows? “Does he suffer?” We don’t think so. “Is he happy?” We don’t think that, either. “Does he want to die?” Our old people held fiercely to life, and to their habits of living — endless cups of weak coffee, coupon-cutting, a daily vanilla ice cream cone. In August, Casey fought his way back from a facial abscess we thought would kill him. Every single day, around sunset, his old walk time, he staggers to his feet and demands to go out.

 
 

We move through the weeks, trapped at home because we’re afraid to leave Casey alone; sleep-deprived from listening for the sound of him trying to get up in the night. We are driven to rage by the click-clicking of his nails as he turns in endless circles. In Elder World, we told each other, “If they were dogs, we could be merciful and end this.” Now it is a dog, and we can’t pull the plug. Which makes me think of the old people again, and how insistently the will to hang on demands respect. And another thing they taught me: that although caregiving feels endless, it always ends, though the empty space after doesn’t.

When Casey disappeared a few nights ago, I searched the house, then the yards with a flashlight, increasingly panicked, calling his name, though I knew he couldn’t hear me. Finally, after 20 minutes, I found him hidden behind a plant, frozen in place at the very edge of our back deck. He sensed the drop before him but couldn’t figure out what to do next.

“This can’t go on,” we tell each other; it goes on. When Casey doesn’t make it outside, we wipe up the mess. We help him to his feet in the morning, feed him by hand. We walk him, coax him to the end of the block — 30 minutes for what used to take five. We watch him sleep, looking for movement to signal he’s still alive. Think “how much longer will he last?” — and “It would be better if it wasn’t too long.”

Then we carefully turn away from those thoughts and get out his dinner, because the old man will probably be hungry when he wakes.

 

 

 

 

 

 

 

Opinion: U.S. cities are overrun with feral cats, and magical thinking isn’t the solution

Los Angeles Times

 

The alleys, parks and vacant lots of this country are alive with so many stray and feral cats that we don’t even know the precise number. Thirty-two million, says one estimate; triple that, another. The felines are the offspring of pets we didn’t bother to “fix,” the animals we adopted then dumped or left behind.

In the past, we called them pests and tried — brutally, unsuccessfully — to wipe them out. Today, the accepted strategy is to catch and sterilize them, then send them back outside, where they were. “Trap-neuter-release,” as the approach is called, has been hailed by the no-kill movement, which opposes routine euthanasia by animal shelters. And it has been adopted by animal control departments in more than 400 cities and counties. (Los Angeles has its own plan in the works.)

In theory, the tactic seems like an easy solution that lets us all sleep well: We don’t want these animals, but we also don’t want their blood on our hands. In reality, and as emphasized by a recent flare-up over the practices of Orange County’s public animal shelter system, it’s not that simple.

Originally, the promise of trap-neuter-release was to reduce stray and feral populations by curbing their prolific breeding — cats are fertile by six months of age and can give birth multiple times a year. But for cat populations to fall, more than 50% of the females in a given “colony,” or living group, need to be sterilized. That’s not easy, given cats’ ability to hide — and the fact that known colonies become dumping grounds for more unwanted, often unfixed, pets. As a result, herd sterilization hasn’t ever been achieved on a mass scale.

The approach has skeptics for other reasons, too. Many scientists, birders and wildlife managers oppose trap-neuter-release programs in general, noting that free-ranging cats are destructive predators, annually killing billions of birds and mammals, while also spreading diseases like toxoplasmosis.

The programs have been successful in one way, however. They have enabled shelters to sharply reduce the number of feral cats they impound, then euthanize, at a time when public shelters face immense pressure to reach a no-kill ideal, usually defined as not euthanizing any healthy or adoptable animals. An added bonus is reduced taxpayer cost: sterilizing and releasing cats costs less than housing, feeding and then killing them.

How well the cats themselves fare is less clear than you might imagine. Contrary to popular belief, cats are not self-sustaining. That means colonies under the watchful eye of caretakers willing to devote considerable time and money to their welfare may thrive. Those without human guardians may suffer from malnutrition, infection and parasites. Some of the cats get hit by cars or eaten by coyotes. Even the authors of a paper lauding trap-neuter-release programs acknowledged that “the welfare outcome for cats returned to location of origin were not tracked … [and] little research on this topic could be found.”

Some shelters run neuter-and-return programs in which individual strays that are brought in by concerned residents aren’t put up for adoption, but rather are neutered and returned to where they were initially found. In October, a lawyer representing a group of animal rescues and individuals sent Orange County Animal Care, the county’s government-run shelter network, a demand that it stop its practice of “abandoning” these cats.

According to signatory Sharon Logan, some of the more than 1,000 cats Orange County released between September 2018 and June 2019 weren’t feral, but roaming, lost or abandoned pets, or kittens still young enough to be socialized and made adoptable. Some were sick, she said, and in many cases, communities where the cats were returned weren’t told the felines were coming. There was often “no obvious presence of a feeder or caretaker.” As a result, she said, the animals suffered. Carol Barnes, another signatory to the letter, shared photos of one cat she said was released by Orange County and later found malnourished, with broken ribs, an upper respiratory infection and an injured eye crawling with maggots.

An Orange County Animal Care representative declined to comment, but a research and policy analyst for Best Friends Animal Society, which runs similar programs, has called some of the critics’ claims “misinformation and scaremongering.”

The answer? No one who’s ever loved a house cat or felt moved to feed a hungry feral (that includes me) wants to return to mass killing. And well-run trap-neuter-release programs may be an important part of dealing with our national cat problem. But increased and organized efforts to educate humans about their responsibilities to their animals are also crucial. So is more rigorous enforcement of existing spay/neuter laws and far more access to affordable services.

Maybe most of all, we need to abandon what one cat lover described to me as “magical thinking” — pretending that the only thing that matters is keeping stray cats alive; believing that any one effort holds a simple, painless solution. These fictions serve mostly to comfort those responsible for our cat problem in the first place. That is, us.