Stage Six

by Dawn Corrigan

Global Deterioration Scale, Stage 6:

People in Stage 6 require extensive assistance to carry out daily activities.

They start to forget names of close family members and have little memory of recent events. Many people can remember only some details of earlier life. They also have difficulty counting down from 10 and finishing tasks.

Incontinence is a problem in this stage. Ability to speak declines. Personality changes, such as delusions, compulsions, or anxiety and agitation may occur.

Average duration: 2.5 years

6/14/09

It’s often said that old age is a second childhood, but at eighty-nine, my Nan more resembles a cat. Specifically, a cat washing her face. All day long, every day, she rubs and rubs her face. Sometimes with a tissue, sometimes just with her fingers. And just like a cat, she periodically licks those fingers, or the tissue, then resumes rubbing again.

But unlike the experience of watching a cat giving itself a bath, watching her rub her face all day doesn’t fill me with a sense of well-being.

I try not to let it get to me. I try to look away and just listen as she tells me—again—how she earned her retirement because she worked as a senior tax compliance agent at the World Trade Center for forty years.

At first, Grandpa and I used to remind her that the Towers only stood for twenty-eight years, not forty, and that her career with the New York State tax division lasted eighteen; but our facts can’t compete with the cadences of her imagination. The phrase “senior tax compliance agent” in particular seems to give satisfaction.

6/23/09

Over the weekend my uncle calls to say she’s complaining of abdominal pains, so on Tuesday after work I run in to check on her.

“How are you feeling? Is your tummy any better?”

“Yes, I’m feeling a little better today. My stomach was so rumbly, and I kept having to run to the bathroom. I thought I was pregnant.”

When I burst out laughing, she rolls her eyes upward. “God forbid!”

8/13/09

In August she’s still rubbing. She’s also begun to complain that she has something in her eye, which she surely does, a result of the constant rubbing. She puts makeup on, then rubs it off. She covers her face in Vaseline, she rubs it off. Finally, my aunt makes an appointment for her to see a psychiatrist.

I take her to the appointment. On the drive over, she tells me her father came to visit the other day.

“He drives the car and comes to see me,” she explains.

In the office I tell the doctor about these hallucinations, and about the rubbing. I try to do so furtively, so she won’t know we’re talking about her. But of course she does know.

“What are you saying?”

“I was telling him you have these sores by your eye,” I say, brushing her temple.

“Oh, that’s where my husband punched me,” she says, looking straight at the doctor with a deadpan expression. “It’s all right, it will heal.”

Other things may be deteriorating, but her sense of humor—tough, outrageous, of another era—is still intact.

8/25/2009

Less than two weeks later, she falls and breaks her hip. I wait with her in pre-op.

“I’m glad you’re here,” she says. “I would be very lonesome if you weren’t here.”

The surgical nurse stops by to remove her dentures and jewelry.

A minute later, she asks, “Where are my teeth?”

I explain where her teeth are.

“I bet they’re talking about me.”

She says she’s cold, so I ask for some of those warm blankets from the little blanket ovens that are the nicest thing about a hospital. The nurse brings two, tucking one over her and draping a second around her head, forming a kind of halo.

“I look like an angel now. Where are my teeth?”

I tell her.

“They don’t want me to swallow them during the surgery?”

“Right!” I say, happy she remembers something.

“But where are my teeth?”

I tell her.

“They were afraid I’d bite them,” she says.

9/13/2009

After the surgery, she’s moved to a nursing home for four weeks of physical therapy. When I visit a couple weeks later, she’s out in the hall by the nurses’ station. She gets excited when she sees me, and throws her arm around me and gives me a big kiss. Then she says, “People are going to think I’m a lesbian!”

9/20/2009

The four weeks she spends in the nursing home are by far the longest interlude she and Grandpa Dom have been apart since they married in 1966. And because Dom isn’t around and she doesn’t understand why, she imagines the worst, like any jealous lover.

After the first week she starts telling me about all the fun Dom’s been having. “He’s been playing cards—and dancing! I had no idea he could dance so well! You should have seen him doing the Charleston! He was great.”

Part of the problem is she doesn’t know she’s not at the assisted living facility anymore. The corridors, the staff wearing scrubs, the wheelchairs parked in corners—the details of the nursing home are just too similar to the ALF where she and Dom have lived for the past two years. Her fading memory can’t parse the difference The only possible explanation she can fathom for why she doesn’t see Dom is that he’s staying away on purpose—because of his wild new social life.

However, it’s also still important to her that she should appear as a sophisticated, worldly person in my eyes—as she has for my whole life. Therefore, she makes an effort to mitigate her jealousy: “That woman he was dancing with, she was great too.”

When Dom and I visit her together on Sunday, though, the gloves come off.

At first she keeps it fairly good-natured. Ignoring Dom, she addresses me. “He has a girlfriend, you know.”

“No, I didn’t know that.”

“It’s okay. He can have a girlfriend. In fact, he can have three girlfriends.”

“No one could argue with that, Nan. That’s very generous.”

My grandfather, however, is not amused by this largess. “I don’t know what you’re talking about,” he tells her nervously.

“What’s your girlfriend’s name? You know, the tall one.”

“My only girlfriend is Frances.”

Frances is her name. She isn’t fooled by this trick.

“No! You know who I mean.”

“Dawn,” he says.

“Hey!” I say. “Leave me out of it.”

“The tall one,” she says again.

All of a sudden I have a terrible feeling I know who she means. Her friend Sara at the ALF is quite tall, a fact she’s commented on frequently.

“The tall one,” she says again, looking at me impatiently.

I shrug. “I don’t know, Nan.”

10/1/2009

On her last night in the nursing home, I arrive to find her telling one of the staff members, a young woman who’s been extremely nice to her, to “Shut up!”

“Nan! I don’t want you to tell people to shut up.”

I sit next to her. After a few minutes, she says, “I guess I’m getting older. I get scared. But I’ll try to do better.”

I take her for a walk outside. Back in her room, she starts going through her drawers in preparation for the next day’s departure, about which she’s very excited.

In one drawer there are several boxes of tissues. I notice one is covered with her handwriting, in a narrow column that runs the length of the box.

Frances was playing

all by herself

Dom was downstairs

or upstairs

and I was

all alone

From

now

on

I am

playing

by

myself

The

hell

with

Dom

To the best of my knowledge, it’s her first poem.

12/28/2009

A month after returning to the ALF, she breaks her other hip. She’s back from the second surgery by Christmas, but she can no longer walk. This time she refuses to participate in physical therapy. And there isn’t much you can do to make a person with dementia do something she doesn’t want to do.

Even before the dementia, there wasn’t much you could do to make her do something she didn’t want to do.

When she returns to the little apartment she and Dom share, it doesn’t go well. She immediately begins falling a lot. When I stop in a few nights after Christmas, he’s agitated.

“Thank goodness you’re here! She’s trying to get out of the bed.”

Dom and I start the lecture: You have to be a good patient, etc.

“You fell TEN TIMES,” I tell her, holding up my ten fingers.

“Oh, my.”

“You have to do what they say,” I continue. “Otherwise you’re going to wind up crippled for life, and you’ll never get out of that bed.”

She nods in agreement with me. “They have to do what,” she begins. Then I see she knows she has it wrong.

“They have to ...” she shakes her head. She’s trying, she really is, but dementia and a lifetime of her true temperament are fighting against her.

She tries again. Slowly.

“I … have to do ... what they say.”

1/10/2010

By the new year it’s clear she isn’t capable of independent living anymore. She’s moved to the ALF’s specialty unit, up on the third floor. Dom remains in the apartment downstairs.

Tonight when I arrive she’s just been served dinner, a hot dog and fries. There isn’t a lot of extra room in the specialty unit dining room, so I tell her I’ll go see Dom and then come back once she’s finished eating.

When I return upstairs, I’m happy to see she’s made a good job of her hot dog, finished the fries, and is working on a serving of pudding.

“Did you see Dom?”

I admit I did.

“I played a trick on him. I pretended I was mad when I wasn’t. That was mean.”

I agree it was mean.

“Mean, but funny.”

5/7/2010

In May, she turns ninety. When I arrive on the big day, she’s dressed up in a new outfit, hair freshly permed, a corsage on her wrist, and clutching the strings to some balloons in one hand. Dom holds her other hand. She’s very excited. While we wait for the other guests, she wraps the string from the balloon around her neck like a noose, pretending to hang herself. Then she looks for my reaction.

My aunt and uncle arrive. We sing and pass out cake.

In her room afterward, she rubs her belly and mumbles. We look at her with concern. Is she complaining about wearing a diaper again? Does she have a tummy ache? She rummages around for a moment, then suddenly produces a package of cookies she snuck out of the goodie basket downstairs and stuffed down her pants.

When I crack up she smiles, pleased she still has an audience for her comedy bits.

10/26/2010

In October, she falls again. The ALF staff takes her to the hospital to be checked out. By the time I get off work, she’s already back on the specialty unit.

When I arrive, there she is, sitting in the middle of the hall in her wheelchair, in lavender from head to toe. There’s a scratch on her nose, but aside from that she looks fine.

In my hand I hold a notepad, which she regards with great interest.

While I chat with staff, she takes off her left sock and tries to hide my notepad in it.

The staff member excuses herself. “She’s hot shit,” Nan says, after she leaves.

6/13/2011

Shopping in a secondhand store, I find a pink jacket I think she’ll like. Her clothes are always going missing. I think she sneaks into the other residents’ rooms and hides them in the drawers.

The jacket looks like something she would have worn years ago, when she was, yes, a senior tax compliance agent, and she looked the way Dom described her to me last night:

I used to drive her around, you know, when she had to go see

some of her clients. The ones who were likely to give her trouble.

But I’d just hang back and let her work. Sometimes I’d look up

and see her on the street in front of me, wearing her suit just so,

and the sun gleaming on her blonde hair.

So I buy the pink jacket, and take it to her, and bundle her into it. She buttons all the buttons, and we play with the sleeves for a while.

“I’ve loved you since the day you were born,” she says.

Dawn Corrigan has published poems and prose in a number of print and online journals. Her debut novel, Mitigating Circumstances, an environmental mystery, was published by Five Star/Cengage in January 2014. Currently, she's working on a family saga set in southern Italy, Hell's Kitchen, and South Jersey. She lives in Gulf Breeze, FL. Learn more about her work at www.dawncorrigan.com.