November 5, 2017
These visits didn't happen often enough and she knew it. When her grandmother had first been moved into a memory care unit, Nora had promised herself that she would visit once a week. And at first, she had killed herself trying to fulfill that promise. No matter how late she had been stuck at work or how tired she was, she made sure that she was there to spend at least an hour of quality time with her grandmother. But as the weeks went by and she got busier and busier, it felt easier to justify skipping a week here and there. After all, she had other visitors, right? And as her memory had already declined quite a bit, the older woman didn't appear to have the best grasp of time, and a missed visit was almost never acknowledged unless Nora mentioned it first. And she made sure to, because she knew that despite her grandmother's marked cognitive decline, she still had many good days left in her, even if it was hard to tell if and when those would happen. She had no intention of getting caught trying to cover up a skipped visit when, for all she knew, her grandmother might have been having a good day.
When her health and cognition continued to decline and she needed to be moved into a long term care facility (known more commonly, and depressingly, as a nursing home), that promise had been renewed. One visit, once a week, at least one hour long. No exceptions. She visited when she could fit the time into her schedule, even if it meant coming straight from the hospital when she still smelled vaguely of antiseptic. If she was able to get on the road early enough, Nora would make sure to stop at a local bakery on her way over to pick up some tea or ginger ale and a few not-too-healthy pastries that they could share over a visit. Even though it didn't seem like much, her grandmother seemed to appreciate the gesture and Nora was always greeted with a big smile whenever she appeared.
Belmont Manor was considered to be one of the nicer facilities, and it had been the luck of the draw that they had had an opening when the time came for her to be transitioned to long term care. It had been a process that had been jumpstarted by a scary trip to the emergency room from the memory care facility, and after lengthy, involved, and emotional discussions with several members of their family, the geriatrician had gently suggested that the time for long term care, palliative care, in fact, had come. And of course, none of it had been new to Nora. She knew the trajectory for this disease. What it looked like for the patient, what their families would have to endure. She had seen it several times over, and she knew the toll that it could take on people. But no amount of preparation or education or experience could have prepared her for the day that her own grandmother had to make the big move. And as nice as Belmont Manor may have been, no amount of crown molding or Victorian furniture could mask the truth.
These days, her grandmother was bedbound and at the mercy of anyone and everyone who was able to help. Her mental faculties seemed to surpass her physical abilities on most days, but the two systems didn't connect or communicate very well in her mind and so extra care was needed to ensure her safety and mobility. She could manage short, supervised walks as long as someone could guide her walker and another person could follow close by with a wheelchair. She could enjoy meals with other residents in the shared dining rooms and seemed to enjoy the company, though more often than not, she would quietly complain that everyone around her was crazy. Whichever family member was visiting her at the time would shake their heads and offer her a sad smile, assuring her that the other residents weren't crazy and neither was she. Sometimes they just had to speak loudly in order to be heard, and there was nothing wrong with that.
According to Nora's calendar app, she had skipped several visits in a row. And while none of this was a surprise, the guilt was something she carried around constantly. It wasn't something that she actively thought about until her day was starting to wind down and she wondered if she could squeeze a visit in, or if she was trying to plan out her week and wanted to scope out a free hour or so where she could swing by. It was heavy, and it could be all-consuming if she let it—so she shut it out. Was it the best coping method? Certainly not. Did it fix anything? No, of course not. But it let her breathe a little bit easier, and it let her feel like she was doing herself a kindness by not beating herself up over skipping a visit. It was something that some family members encouraged, even: yes, she should see her grandmother more often, but no, it shouldn't have come at the expense of her mental health.
She pulled into the familiar drive and easily found a parking spot. She made sure that she had everything she needed and grabbed the tray that held two paper cups filled with hot water for the accompanying tea bags. There was a small white box resting on the passenger's seat and she fought for a moment as she figured out how to juggle everything. Once she was convinced that she wouldn't drop anything, she shut the car door and locked up, ready to head inside. She made small talk with the kind receptionist at the front desk despite that she felt as if she was being secretly judged for not having come around for so long, though she knew it was a ridiculous thought. Did she even recognize Nora? And if she didn't, was that only confirming the worst of her fears?
Nora quietly walked down the winding halls and veered left towards the corridor that would lead to her grandmother's room. The small lounge nearby was empty, and she smiled to herself; they could have their own little tea party there. As she approached the room, she craned her neck to make sure that the lights were still on and that she hadn't arrived too late. It was barely seven o'clock, but Belmont residents often had early starts that subsequently meant earlier bed times. She took a deep breath to clear her head and mustered up a smile before she walked in.
"Hi, Grandma. Ready for some tea?"