My Mother’s Keeper

It is a mitzvah to take care of your parents: “Honor thy father and thy mother.” And caring for people comes naturally to me. I’m a physician; this is what I do.

But when my father looked to me to cure my eighty-five-year-old mother’s dementia, saying, “You’re the doctor! Help her!” I knew he was asking too much.

And yet. How could I stand idly by while my mother’s mental acuity slowly drained away?

For over ten years, my mother had been drifting deeper into the murky waters of Alzheimer’s. At first, she had trouble recalling words and phrases: “Thermostat.” “Smoke detector.” Then one day she called to say that she couldn’t operate her sewing machine. Several years later, her ability to drive a car faded away. When we went to a hotel for Passover, my normally outgoing mother refused to sit next to anyone but family, confiding that she was afraid she couldn’t follow a conversation.

On Sundays, when I visited my folks, I’d find her lying diagonally across the bed, eyes closed or staring into space. She spoke very little, using only single words. And her eating became painfully slow.

Over the years, I tried various treatments with her, but none of them worked. First, I went through a range of nutritional supplements, but Mom resisted swallowing pills. Next, I ordered plant-derived drugs available only in Europe. Then I brought her to a memory-training center, and after that to a program for frail adults that met five days a week. Still, she deteriorated.

With each new therapy, my expectations would rise. And with each failure to help her–let alone cure her–my hopes would plummet. 

In the early stages of her illness, my mother knew she was going downhill. She sometimes seemed sad, even mildly depressed. Later, as her disease progressed, she appeared obliviously content, while my father, my brother and I were the ones grieving.

Serving as your mother’s physician is not included in the commandment to honor your parents, nor is it well-regarded in medical circles. “Never treat friends and family” is an apt mantra.

That said, it’s often ignored—as in my case. I simply could not give up.

Even after my mother had lost the ability to read, to speak or even to eat, and resided in a nursing home, I was still looking for treatments.

A case in point: Along came the new “miracle” drug, low-dose naltrexone. At regular strength, it blocks opiate receptors and serves as a kind of “Antabuse” for heroin addicts. When compounded in tiny doses, it blocks the receptors only partially, causing the brain to compensate by pouring out opiates at levels enjoyed by a healthy young adult.

Perhaps, just perhaps, this chemical sleight-of-hand might help my mother, I thought. After all, higher opiate levels reduce brain inflammation and improve focus and energy. It was a long shot, but I had to try.

My mother hated swallowing pills, but that hurdle was easily surmounted. I had the naltrexone compounded in a cream. Then my father told me that the nursing home wouldn’t allow this non-formulary drug. Okay, that wasn’t surprising.

I’m a doctor, I reasoned. I’ll speak to the medical director.

Dr. Kaplan was very kind. He was even interested in the new drug. But, ultimately, he couldn’t authorize it. He told me that I would have to bring it myself. But, alas, it had to be given every night at bedtime. What should I do?

“Give it to the night aide,” suggested my mother’s personal physician. “Pay her a little extra and have her rub it on.”

A fine idea. But what if the aide got into trouble and lost her job? I decided to ask my father to rub the cream on my mother—maybe not at night, but at least during the day, before her afternoon nap. True, he didn’t visit her every day, but four to five days a week was better than nothing.

Then one day, I walked into the home to find the head nurse waiting for me.

“Don’t you try to smuggle in medications anymore!” she fumed. “Do you realize we could lose our certification?”

Turns out my father had been leaving the prescription cream in my mother’s night table.

Okay, so he’ll carry it back and forth every day, I thought.

Problem solved—except, of course, that the drug made no difference to my mother’s medical condition. She remained mute and childlike.

I usually visited my mother during the home’s regular daytime visiting hours. But one summer evening, while on my way to an engagement party, I stopped by the home just as the patients were being put to bed.

I walked into my mother’s room. She was dressed in her soft pink sleep outfit. Her aide, Delores, was helping her to bed.

My mother didn’t see me. She gazed up at Delores as if at her own mother. As Delores leaned over the bed to fix the covers, her long hair fell across the sheets. My mother stroked it, and the aide smiled.

“You like my hair, darling?”

My mother smiled back. Tears formed in my eyes as I recalled my beautiful, competent and loving mother.

I didn’t want to break this moment—but if I wanted to speak to her, now was the time.

I walked to the bedside.

“Good night, Mom,” I said through my tears.

She looked up at me. Her face was calm. I put my hand on the covers. She stroked it as she’d stroked the aide’s hair.

“I love you, Mommy,” I said.

I kissed the soft, wrinkled skin of her forehead.

I wished I could know such peace. Or does this serenity come only when you can no longer ponder the vagaries of life’s twists and turns? 

Clinging to my sadness and grief, I left to wish the young engaged couple mazel tov.