Featured Prose | September 28, 2017

“At one time or another, I’ve been their daughters and granddaughters, their sisters and sons and fathers,” writes Jennifer Anderson in her essay about the experience of providing “diversional activities” for nursing-home patients.  The essay appeared in TMR 36:1.

It’s a Sin to Tell a Lie

By Jennifer Anderson

 

In the locked unit an old woman slumps on one of the mismatched sofas that line the walls, crocheted blanket draped over her head. Beatrice, I think. She snores softly, and I consider nudging her awake, leading her to the dining room. But I don’t. I need to hurry. Ada is yelling at one of the others to “Wake up! Wake up!” I grab the cassette player from the shelf near the door and head to the dining room—crowded with six tables, a wall of cupboards and a cart of bibs—to keep the residents busy while they wait for their eggs and toast.

I’m the activity girl.

Fran is asleep, forehead pressed against the table, white hair streaked pink from the lipstick she rubbed there a day ago. Ada sits across from her, slapping the table with both hands. “Wake up! Wake up!” Her voice is hoarse. I open the cupboard and rummage through the basket of rumpled clothes I sometimes give the women to fold. Near the bottom, I find a plastic baby doll.

“Ada, look what I found.”

“Give him here,” she says, “He’s mine.” She slaps the table with more urgency. “Here. Here. He’s mine. Here!”

I hand her the doll, and she wetly kisses its bald head. She hums and swaddles it in her terry cloth bib, fat fingers clumsy but deliberate, forgetting all about Fran, who does not lift her head from the table but sings, “I love you little, I love you big, I love you like a little pig.”

At another table, Art has taken his wallet from his shirt pocket and pulled out the photographs, business cards and flattened cough drop wrappers. He sighs.

I get a toolbox out of the cupboard and sit beside him.

“Miss,” he says, tipping his Mariners cap back on his head, “how will I pay?”

I help him gather the contents of his wallet. “Your wife has already paid for you.”

“No.” He puts his wallet in his pocket. “No, she hasn’t. I’d better find some money.”

He pushes back his chair and starts to get up, so I open the toolbox and pull out a screwdriver, a screw and a piece of wood.

“What’s this for?”

“Will you please fix this for me?” I ask.

He doesn’t question why he’s driving the screw into the piece of wood, and when he finishes I take the wood to a corner of the room where he can’t see me and remove the screw. Once more I hand him the screwdriver, screw and piece of wood. “What’s this for?” he asks. We can go on like this all morning.

Some of them forget they’re waiting for breakfast and try to leave as soon as the nurses’ aides bring them in, so I play an Andrews Sisters cassette. “Lift up your arms,” I tell them. “Now wave them from side to side.” I try to keep them—about twenty residents in all—seated until the breakfast cart arrives. In the locked unit, their diagnoses are all the same, their activity care plans similar: Diversional Activity Deficit r/t diagnosis of Alzheimer’s dementia. Activities staff will involve in structured programs daily, especially exercise groups and sing-a-longs. A few half-heartedly follow along, mouthing the words to the song—Don’t sit under the apple tree with anyone else but me—flapping their arms like broken wings. Ada rocks the baby doll, Art works on the wood, Fran sleeps, and Emily, whom an aide has just seated, takes off her bib and folds it on the table in front of her.

“Can you lift your arms over your head?” I ask her.

“You do it,” she says. Then she pushes back her chair and wanders away.

I follow her. Past the scuffed piano, past the television, which shows musicals most days—Oklahoma!, The Sound of Music, Carousel—because so many of them like to sing, past the nurses’ desk and the yellow cat hiding beneath it. She pauses at a vase of plastic pink carnations.

“Aren’t they pretty?” I say.

“Aren’t they pretty,” she says. Her hair is short, and her ears stick out. She wears green-checkered pants that hit above her ankles and a bright red sweater. She looks like a pixie.

I try to hold her hand, but she pulls away, so I step in front of her. “Time for breakfast,” I say, cheerfully. I have to be careful. When aggravated, Emily hits and scratches.

“Time for breakfast,” she says, but she continues walking the other way, down the corridor past the activity table—the stacks of puzzles, magazines and folded lap robes—past the rooms where nurses’ aides busily wake residents, help them with their socks and slippers, their glasses and false teeth.

***

This is what most of them do, the ones in the locked unit. They walk the halls looking for the way out: rattle the doors, circle the unit, ask for directions home, rattle the doors, circle. Fran usually sleeps all morning, but she packs her bags several times a week, right before dinner. She tucks her sweaters, still on their hangers, under her arms and waits. Dark paper covers the green exit signs hanging from the ceiling at both ends of the hall. The windows are locked. But she waits for the staff to punch the secret code that releases the door and then tries to slip away.

“Come on,” she’ll say after the door has closed, leaving her inside. “I have to get home to the babies.”

“Your babies are fine,” I’ll tell her. “Why don’t we sit at the piano and sing a song?”

I take hold of her arm to guide her from the exit. Sometimes she follows. Sometimes she curses and pinches. And sometimes she just stands there, sagging under the weight of all those sweaters. “Please,” she says. “Why are you doing this to me?”

***

A watercolor of white magnolias hangs on the wall at the end of the hallway. Emily stops in front of the painting and then looks at the fire door and the laminated sign taped at eye level: This is not an exit. She clasps her hands together and sways from side to side.

“Where are you going?” I ask.

“Where are you going?” She looks at me and laughs.

***

Most days, I leave all that I see at work behind. Beatrice, Ada, Fran, Art, Emily. When I clock out and push open the facility door, I don’t think about the residents inside. The ones who lie feverish in their beds, the ones who circle the halls, looking for their babies. Instead, I focus on relaxing at home, eating dinner with my husband, maybe sipping a glass of wine. I think about walking my dog or going to the Laundromat, about the book I’m reading or the movie I’ve just watched. I try hard to keep my life separate from theirs.

But other times, it’s not so easy. I still see them. The bedsore on Agnes’s shoulder, big as an orange, cutting clear to bone. Diversional Activities Deficit: Resident is bed-bound r/t ulcer and is at risk for social isolation. Activities staff will provide in room 1:1 visits 3x/week. The bandages on Rose’s leg, caked with dried urine, pus and shit, the skin beneath as fragile as onionskin. Resident has limited socialization r/t to depression. Activities staff will assist to structured activity programs 3x/week. The bed that Martha thrashes about in, writhing uncontrollably. Betty’s endless stare, bright eyes blue and unblinking, a paper doll’s. Resident demonstrates little response to external stimuli r/t cognitive decline. Activities staff will provide sensory stimulation 3x/week, encouraging resident to open eyes and change facial expression. Rita’s high-pitched howls, rising from deep inside, as if with all her strength she is pushing out the noise. Like a sick cat. Alice’s chants, Hail Mary mother of God pray for our sins, one, two, three, four, five, six, seven, eight. Hail Mary mother of God pray for our sins. . . .

I still see the room where Jack lay dying, head tipped back, mouth wide open, while his nephew filled cardboard boxes with the photos and toiletries from his shelf, the pearl-buttoned shirts from the closet, and carried box after box to his car. I see Jack gasping for air while his room was being emptied. Resident is on comfort measures. Activities staff will provide 1:1 visits as tolerated.

Nights can be difficult, so I get out of bed and straighten my house: clear junk mail from the counter, dust the antique mantel clock and sewing table, the porcelain hatpin holder with an R.S. Prussia stamp. I may even scrub the bathroom floor. Two in the morning, the clock ticks remarkably loud, sluggish. I keep moving so I don’t think about what’s in those rooms. Rooms crowded with dollar-store bric-a-brac—ceramic cats and horses, pretty young women with flowing hair, wooden plaques that say Home Sweet Home and World’s Best Grandma. Rooms with silk tulips in vases, tatted doilies and silver-plated pocket watches. Rooms that smell of urine and Aspercreme, of hoarded fruit rotting in black leather purses.

My job is to conduct what their care plans call “diversional activities.” Upon admission, every resident is given an assessment and assigned an “activity deficit” related to his or her diagnosis and placement in the nursing home, generic problems and approaches selected from a long list. This means that I sometimes help them remember they’re waiting for breakfast. Play an Andrews Sisters cassette, sing “Boogie Woogie Bugle Boy,” toss balloons and dance. Other times, when I visit the ones who live outside the locked unit, who know exactly where they are and what they’ve left behind, this means I help them forget.

“Will you teach me to crochet?” I ask to get them to stop thinking about their shortness of breath.

“Let’s take a stroll through the rose garden,” I say, so that even if only for a few minutes, they might stop missing home.

I push their wheelchairs to bingo, coffee social and church services. I conduct writing groups and craft projects. I take them out of the nursing home for a couple of hours, drive them around town. Paint their nails. Fix their hair and powder their cheeks with rouge. Smooth lotion over their stiff fingers. Play a game of cribbage, clean their fishbowls. I help them write letters to their children and thread embroidery needles. I read them stories from The Good Old Days magazine and show them the rhinestone necklace in my activity basket.

Isn’t this pretty? I say. Would you like to try it on?

But when there is nothing left to do, I sit on the edges of their beds. I hold their hands. I help them wait.

Slowing down is the hardest part.

That’s when it gets to me.

***

Jack isn’t ready. His eyes, once summer-blue, are clouded with cataracts, and he raises his torso off the bed in an effort to draw a deeper breath, then drops, exhausted. The charge nurse has called me into his room to calm him down until the morphine takes hold.

“Mother.” His voice cracks.

He was placed on “comfort measures” a week ago. Perspiration beads his forehead, but beneath his thin blanket he wears only a diaper. Through his skin I see the outline of his breastplate.

“Are you thirsty?”

He nods, so I work the straw of a fortified milkshake between his chapped lips. As he sips, I lean into him, smelling the odor of damp newspapers. He turns his head and coughs. There is a bottle of Old Spice near the sink. I dab some behind his ears and beneath his chin whiskers.

He complains of itching, so I roll him onto his side. When my fingers graze his ribs, it feels like the washboard I take to the reminisce groups I conduct with residents who aren’t yet in the end stages. “I bet all you ladies used one of these. Mondays, right?”

“Yes,” someone may say, “and on Tuesdays we ironed.”

Photographs line the shelf across from his bed—his wedding portrait, pictures of grandchildren. In one, he leans against a small-engine airplane, young, muscular and confident, smiling in chinos, leather jacket and aviator glasses.

I try to be gentle as I rub his back, brushing the tips of my fingers over his hot, dry skin.

“Do you remember flying?”

“Don’t leave me here.”

I imagine him in the air, gliding weightlessly over mountains, thin ribbons of river and cloud. Now he can barely lift his head from a pillow. I help him turn onto his back, and his spine pops and cracks. He grimaces.

“It’s okay.” I adjust his oxygen tubing. “You’ll be okay.”

He grips my hand. “Please, Mother.”

When he was first admitted, he was wheelchair bound but could still take himself to and from meals. Even then he passed most days in his room reading aviation books. I’d invite him to activity programs—reminisce groups, coffee social, bingo—but he refused them all. When I complimented his photographs, he glanced up from his book and said, “They’ll do until I go home.” Over the years, I’ve listened to many residents talk about going home, though they are here to stay. Jack was admitted with emphysema and dementia; his son had already sold his house.

Jack isn’t in that room anymore and hasn’t picked up a book in over a month. The nursing staff moved him because his cries upset his roommate. Jack’s new roommate, Roy, lies in the bed by the window. He’s in the end stage of Alzheimer’s, and I visit him three times a week, read him articles from Field and Stream, play Western cassettes or tickle his arm with a feather. Anything to get him to respond. Sometimes he looks at me and appears to be listening. Other times, he stares up at the ceiling. He no longer remembers how to speak.

“Mother?” Jack asks.

“Yes?” I smooth a damp washcloth over his forehead.

“Mother, don’t leave me. Not here.”

At one time or another, I’ve been their daughters and granddaughters, their sisters and sons and fathers. I’ve listened to them go on about our horse ride in the southern Idaho desert or Aunt Alma’s rice pudding. “Remember how we used to pick apples in the fall? Remember how Joe fell out of the tree and broke his arm?”

“Yes,” I’ve said. “Yes, of course I remember.”

Outside, the air is crisp, the sun bright, but here in Jack’s room the shades are drawn; the get-well chrysanthemums on his shelf are brittle. We listen to two nurses’ aides outside his door complain about being short-staffed. Then there is a rushed clip-clop of heels, a chair alarm buzzing and the clang of a lunch cart on its way back to the kitchen. I have care plans I should update, a manicure group I need to prepare for. I know of three women who are already waiting for me in the activity room, hovering over my place, drumming their fingernails on the tablecloth.

A woman rolls her walker down the hall, her voice raspy from shouting. “Daddy? Daddy? Why won’t you answer me?”

“Daddy’s in Nampa,” a nurses’ aide says.

“Oh, he is?”

Jack squeezes my hand. “Mother, don’t go.”

“Shhh. You’re going to be just fine.”

I smooth back his hair, and we listen to the drizzle and thrump of his oxygen machine, a delayed heartbeat. I know these noises inside and out, the same noises I’ve listened to for ten years, working activities in one nursing home or another. If I closed my eyes, I wouldn’t know the difference between any of the facilities I’ve worked in, any of the beds I’ve sat beside, as if time does not move forward but just keeps circling back on itself.

***

Beatrice, Ada, Fran, Art, Emily, Agnes, Rose, Martha, Betty, Rita, Alice, Jack, Roy. Sometimes I stand over their beds and watch them while they sleep: the flutter of their eyelids, the twitch of their faces, the way each exhalation parts their chapped lips as if they are on the verge of speaking. I lean so close that their sour breath warms my cheek and wonder what they think about, if memories of the past fill their minds, take them outside the nursing home to another place. And when there’s no one else around, I whisper secrets in their ears because, though I don’t remember when my great-grandmother died, I will always remember the long walk to her room, my first time in a nursing home. The halls smelled like pee, my grandmother like vinegar, and I stood on a chair and leaned over the bedrails to kiss her cheek as my mother instructed. I was just a child, and my grandmother slept on her side with her mouth open, long silver hair fanned on a pillow, thick fingernails curled into her palm. My breath caught in my throat, and my temples throbbed. I remember pulling the chair up to her bed and standing over her: lips drawn tight around her gums, long hairs on her chin. When she didn’t open her eyes, I looked to my mother for guidance, and she nudged me forward—“It’s okay,” she said. “She can hear you. Tell her anything, anything at all”—and my throat relaxed, my pulse calmed, when I began to speak, and I believed she was listening.

***

Brenda is awake when I visit her room. She lies on her back, an arm at each side, and stares at the ceiling—same as the last time I visited her and the time before that. I lean over her bed with a warm cloth to wash her forehead and temples, around her mouth, her chapped lips. Pale skin, faint laugh lines at the edges of her eyes.  She’s the same age as my mother.

It’s October, and the sun is warm, leaves just starting to turn. Brenda is not dying, but the plaques and tangles have damaged the neurons in her brain, and she has lost the ability to speak. Rumor is she was once a police dispatcher and has a daughter about my age. It’s been months, maybe years, since she’s been outside, so I tell her about the Salmon River and Skeleton Creek, how my family camps there for the fall steelhead run, tents pitched near the crumbling rock wall built by a man called Sourdough Jones in the early 1900s to urge his cattle across the river—the same place his entire herd once starved, leaving the canyon floor littered with bone. I tell her about the smell of dry canyon grass, sweet and chalky, about sinking my bare feet into warm sand, about the rapids and how in the dark they change pitch, a chorus that is faint and then strong, whipping down the canyon and back up again.

I didn’t go this year because I couldn’t get the time off, but my family did, and my mother called to tell me the canyon had burned—grasses charred, trees black, tang of ash in the air. The big pine—I knew which one she was talking about—gone. I wipe the crust from Brenda’s eyelashes, and she doesn’t blink.

I talk about the old cabin at the bottom of Eagle Creek Road, how my mother told me it was gone too—all except the river rock chimney—and I didn’t want to hear it. I talk about the photos I took of the cabin the last time I was there, of the wire bedstead, the early 1900s newspaper pasted to the walls. I talk about the house along Wapshilla Creek—how it leaned to one side, threatening to tip, and how as a girl, if I was alone, I went inside anyway. I ran my fingers along the brittle, blue-flowered wallpaper, the rusty screen of the pie safe nailed to the back porch. A breeze drifted through the open windows; star thistle and apple trees cast shadows on the floor, and the scent of watercress and damp leaves wafted up from the creek. I stepped carefully, testing each slanted board for rot, and tried to picture the life that had once filled the house. Apple pie cooling on the porch. A gleaming white sideboard filled with canned goods. A woman once glanced out the gingham-curtained window, then returned to the cook stove, to whatever she was doing, maybe canning beans, boiling them in mason jars, or roasting a chicken.

I tell Brenda how I once walked to the house, and it had disappeared, burned to the ground by government officials for safety. I’d felt sick, as if they’d burned the stories of those long-gone inhabitants with it. I wash along her jaw and throat. She stares at the ceiling. I lean in close and whisper, “I resent that I couldn’t go this year. Instead I wandered these halls.” I tell her things I would never tell anyone else, not even my own mother.

***

Beatrice, Ada, Fran, Art, Emily, Agnes, Rose, Martha, Betty, Rita, Alice, Jack, Roy, Brenda. And all the rest. Dozens of names and faces that meld together and overwhelm. Their true identities are trapped beneath the surface as if caught in an eddy swirling deep. I hope they feel the damp cloth I press to their faces, and when I blow on their cheeks, I hope they can imagine kneeling on shore, the sun warm on their shoulders. I run the faucet in their rooms, a gentle stream. “Listen,” I tell them, “what does it remind you of?” I hope they can hear me.

***

When someone dies, I try to clear the other residents out of the halls before the funeral home arrives with the gurney. If I am conducting a program in the activity room, I turn their faces away from the door. I lean over their tables and offer them another cookie, another cup of coffee. “Look out the window—aren’t the trees pretty? Over here—look at me,” I say when I see the black body bag heading our way. But I’m not there when Jack finally dies, and when I walk past his room the next day, I notice that his bedspread is smooth.

I take a busload of residents from the locked unit for a ride.

Beatrice sleeps, her head pressed against the window, crocheted blanket balled up in her arms. Across the aisle, Ada yells at her to “Wake up! Wake up!” so before we take off, I hand her a baby doll from the overhead compartment. Ada swaddles the doll in her lap robe and is quiet.

Emily stares at me in the rearview mirror with eyes as dark and wet as mud puddles. She grips the seat in front of her and laughs.

“What’s so funny?” I ask.

“What’s so funny,” she says.

She spent the morning standing in her room, laughing at her own reflection in the mirror over the sink.

Fran hums quietly to herself. She used to sing at weddings and funerals. She likes to wear bright pink lipstick, too, and today, instead of wiping it in her hair, she has traced it outside her lips. When I pull out of the parking lot, she stops humming and tugs the collar of her cardigan up to her ears. “Oh, no,” she says, “I’m catching pneumonia.”

“Just button your sweater,” I tell her. “You’ll be fine.”

“Oh, no,” she says, “What do I do?”

“Just button your sweater,” I say again.

Art, a World War II sergeant, worries that he’s AWOL, and today, I don’t have a piece of wood and a screwdriver to redirect his attention. “They’re not going to like this,” he says, minutes after we’ve started. “We better get going.” He sits directly behind me. “Miss?” He taps me on the shoulder. “Don’t you think we ought to get back?” He says this though he circled the unit all morning, tried all the doors.

“You’re fine,” I tell him, patting the front of my jacket. “I’ve got your leave papers in my pocket.”

This quiets him for a while.

There are others on the bus too. They stare out the windows or down at their laps. Three of them sleep. Every Thursday I pull their arms through the sleeves of their overcoats, move the sofa away from the door and firmly take their hands. The courtyard gate is open: seven feet of solid cedar and a latch that only unlocks from the outside—no one can see in or out. Beyond the gate, the bus idles. They shuffle forward in bedroom slippers, and I reassure them when they hesitate, afraid to step over the threshold onto the concrete. When the ground is wet and shiny, some think I am guiding them into a lake.

***

I take a country road that winds along the outskirts of the city—past farms, fields and ponds, barns, horses and cows—sights I hope they will recognize and enjoy. I slow the bus as we near a pasture. “See the cows?” Some look in the direction I point; others turn their heads the opposite way. Emily continues to stare at my reflection in the rearview mirror.

I’ve seen what’s coming. Eventually, my body will also give out. It will wrinkle and weaken, be overcome by the one of diseases I read about in their charts: COPD, CVA, myocardial infarction. Diabetes, Parkinson’s, Huntington’s, Alzheimer’s dementia. I may eventually have a care plan of my own: Resident is on comfort measures. Activities staff will provide 1:1 visits as tolerated. I may lie in a bed and a stranger may visit my room to reassure me. She may hold my hand and tell me it’s okay. Pull the sheet up around my shoulders though I am hot and no longer care if she sees my naked flesh. Watch me, skin flushed and tight with fluid, sores on my legs weeping. My body will decay, and the stranger sitting on the edge of my bed will spray perfume to cover the odor. I tell myself it doesn’t matter.

***

“I’m catching pneumonia,” Fran says, clamping her sweater tighter around her ears. “Oh, no. What do I do?”

It’s time to take them back.

“It’s okay,” I tell her. “We’re heading home now.” I steer toward the crossroad where I will turn left and circle back to the nursing home.

“Heading home,” Emily repeats. “Heading home. Heading home.”

I wonder if they ever worry where I am taking them, or if they even notice that I’ve driven into the desert, where we see nothing but flecks of washed-out sagebrush and wild rye, snow-capped mountains a hundred miles away. I wonder if Jack was still frightened as he took his last breath or if he had slipped into a coma by then and was already gone. I wonder if Brenda recognizes my voice, if sixty years from now, I will be on a similar bus steered by a girl young enough to be my granddaughter, if I will be glad to sit and ride or if I will fret about my husband, peering out the windows, calling his name. If I will ask the driver, “Where am I?” and to calm me she will tell me all the same lies.

 Just button your sweater, you’ll be fine.

You’re fine. I’ve got your leave papers in my pocket.

Shhh. You’re going to be just fine.

The desert sprawls on either side of us, all dirt and jagged rock. I put in a Billie Holiday cassette I’ve brought along and coast down the straight stretch of highway, gray pavement, no center line. In the distance, I notice a large body of water spilling across the road. The way it shimmers, I could almost believe it’s real.

Fran sings along, “Be sure it’s true when you say I love you, it’s a sin to tell a lie.”

When I glance in the rearview mirror, I see that she has let her sweater fall from her ears. For now, she’s not worried about catching a cold. For now, Emily quietly taps the seat in front of her, keeping time to the music.

Art clears his throat and leans forward in his seat. “Miss,” he tells me. “I hope you know where you’re going.”

I nod and let it go at that. For now, I simply turn up the volume and sing along to the songs I know by heart, guide us down the road toward nowhere in particular—just a drive, an outing, a journey that will take us back to where we began.

 

Jennifer Anderson is an English instructor at Lewis-Clark State College. Her work has appeared in the Missouri Review, the Colorado Review, Hayden’s Ferry Review, the Cimarron Review, and Open Spaces Quarterly, among other places. She also collaborates on documentary films with her husband, Vernon Lott; their latest project, “The Act of Becoming,” explores the recent international success behind John Williams’s 1965 novel Stoner.