​​

      How Many Points is Your Mom Worth?
     Four years ago we moved my step-dad and mom to Trevista, a leveled care facility in Antioch, CA. Up until last year it was a perfect fit. In the beginning, they were both on the level two care plan. I used all of their social security and Veteran’s benefits to pay their monthly bill. Then John, my step-dad, fell and broke his hip. He was sent to a MediCal facility in Concord. I tried to bring him back to be with his wife of forty years, but he had too many “points.” The point system is used by some private facilities to determine a resident’s level of care and monthly cost. The head nurse told me he would need to be in the Villa, the section deemed for memory care patients. The minimum cost for this is 10,000 a month, twice their income.
      On Monday I called Trevista. I decided to bite the bullet and ask about the email I received. The email explains the new point system and informs families that their loved ones are going to be evaluated in July to determine if their level of care will be changing. Originally I did not want to ask this question because I know my mom has been needing more care than she’s been getting for a long time. She  has been flying below the radar, so I didn’t want to call any attention to it.
      “How many times is she getting medications per day?” I asked.
     “Twice, once in the morning and once at night.” Ifrana, one of the head nurses,  answered.       “ Does she need to take them  twice a day?” I asked.
     “Yes because some of the medication she needs to take at night with her sleeping pills.”      Ifrana answered.
     “I’m asking because of that email we got with the new point system.” I said.
     “I know, I’m dreading July when I have to talk to families about this.”Ifrana commiserated.
     “So what’s my Mom’s level going to be?” I asked, accepting our fate.
     “Let’s see, your mom has 392 points so she’s currently at level 3. In July her care plan will be a level 4.” she answered.  My stomach dropped, recalling the graph of the prices from the email.
     “This would be an additional 800 dollars per month.” she explained. I felt the blood rush through my body as my heart sunk further into my belly.The photo of Ifrana’s eighteen month old baby on her desk flashed through my mind reminding me of her humanity. Still I had to say something.
     “Our health care system sucks!  We need to be more like Finland where they take care of their seniors for free,” I chuckled to lighten the sentiment. I felt numb. In the past I would feel the rage surging through my body when I brought the unjust system that affects my life so deeply to the surface. Today I was numb. I’m desensitized just as I am to the gun shots that pervade my neighborhood.
     “Some families are taking their relatives to the doctor to see if they can get some of the medications removed from their lists because each one is worth points. Other families consider a shared room to cut costs.” Ifrana explained.
​     Looking at the analog clock in my classroom, I thanked her and ended our conversation abruptly. I heard the sound of my fifth period students at my classroom door and panicked. I was overwhelmed by my  increased financial burden.  I felt like a ton of weight was on my shoulders and my voice was stuck in sludge in the deepest pit of my stomach. Only five minutes remained  until the bell rang. I sucked in as much air as I could, breathing deeply, reveling in my solitude until I had to heave my voice to the surface to teach again.

​     I was showered and ready to go pick up Mom from Trevista when the phone rang.  I was running late, so I knew it was her calling to ask when I was coming.  I let it go to voice mail, as I often do.  I listened to the message.  In a feigned sick voice she said,
“Mel-Knee, I don’t know if you’re on your way or not.  I know you said you were going to take me to see John today, but I’m not really feeling that well.  It’s cold outside and I can’t find a coat.  I have my sun glasses, but I can’t find a coat.  It’s cold out and I don’t want to get sick too.  My back’s been really bothering me. "  Then with an uptick in her voice, she continued, "There’s going to be a happy hour here with a singer.  So can we just go another day?  I thought if you were already on your way, we could just go to happy hour together.”
      My first impulse, I’m not gonna lie, was “oh good I’m off the hook.  I can just stay home.”  I was running late, trying to work up the energy for our new Saturday routine which I had put off until Sunday because of the holiday that some people care about.  After all, I had those big plastic eggs Blue bought at the dollar store with my parents in mind.  I planned to fill John’s with the dark chocolate Reese’s Thins he loves and Mom’s with quarters for her nightly UNO game.  Blue, who many times helps me be a better person, said,
“Just call your mom back. Give her a pass this time.  You and I can go visit John.  He’s all alone there.”
     Then she turned around and yelled in the direction of her almost fourteen year old’s room, “If I’m ever in a rehab center or senior home and you ditch me for a happy hour, you’re dead!  If you don’t at least bring me a piece of cake…” Jos laughed.
     “I’ll just go.” I said. Even though the thought of having her company, a buffer to help absorb some of the weight, felt comforting, I knew she needed to finish cooking the ham and mashed potatoes for her and the kids.  Besides, I had plans with my friend Patty who lives in Concord.  She has been the best part of my new Saturday routine.  She has been my rock, providing space for me to just be.
     Blue handed me a Tupperware packed with her pineapple upside down cake and headed over to the big plastic egg sitting on the table in the living room.  I watched her out of the corner of my eye as she arranged confetti, Hershey’s Easter kisses and Reese’s eggs along with his Dark Chocolate Thins.
      I headed to Concord, actually excited to spend time with just one parent with dementia for a change.  When I arrived, John sat in a wheelchair in the hallway by the nurses' station with his tray table over his lap.  They started putting him in the hallway because the first day he was there, he kept trying to get up.  He would yell, “I have a right to go home.”, try to walk out and end up falling.
      The stale smell of sickness and the constant drone of the beeping monitors washed over me.  I said, “Hi John.  Happy Easter.  Do you know who I am?”
“Yes Melanie.  Where’s your mother?” He replied.  His lifeless stare turned to a slight smile and added color to his cheeks.
“She’s not feeling too well.” I lied. “I brought you some treats and coffee, black, the way you like it.”
     A young caregiver walked by, speaking Spanish with a co-worker.
¿Puedo tener unos paquetes de azúcar para su café?” I asked.
“I speak English.” She snapped.
“I know you speak both.  I just asked you in Spanish because I just heard you speaking Spanish.” I explained.
“How many sugars?” She snapped again.
“Two please.” I said.
     She opened the closet, reached in and handed me three, frowning the whole time.
“Thanks.” I said.
Crickets.
     “Here John, I got you some sugar.”  I said as I sat down in the slightly broken swivel office chair next to him. I opened two packs and mixed them with the plastic spoon on the towel in front of him.
“So what’s up John?” I asked.
 “Nothing. I’m just working on this.” He answered.
     John had opened his plastic egg.  With his shaky hands, he meticulously placed the confetti one strand at a time onto the top part of the egg.  After all the confetti was in a pile, he began to sort the candies.  He pulled all the tiny eggs out of the big egg and organized the Reese’s Thins in a neat line.  He began to open the eggs and shove them in his mouth, placing each wrapper next to the pile of confetti as he went along.  Within a few minutes he had consumed almost all the eggs.  He dropped one of the eggs under his wheelchair and stretched his arm down to pick it up.  Unable to reach it, he let out a sigh of frustration like the beginnings of a toddler’s tantrum.
     “It’s okay John.  I’ll get it.” I said. 
      As I stood up, one of the patients who regularly sat with John by the circular nurses’ station in the hallway said, “Can I get some strawberries?”
“I don’t work here.”  I told her.
“Since I gave up my lunch and dinner, can I have some strawberries?” She persisted. 
     I placed the fallen egg onto John’s lap table and asked, “Can I throw this garbage away John?” I was still haunted by the memory of him chasing Leysa, the Care.Com helper, across the parking lot of their Florida apartment complex three years earlier.  Leysa was part of the team I hired to help me move my parents to California.  She held a pile of torn up bleached brown towels that had travelled with them since the 70s.  He flailed his arms around screaming, “Don’t take my towels.  I need those towels!” as she scrambled to stuff them in a garbage bag.
     I picked up the top of the plastic egg, careful not to wake the beast, but John was focused on tearing off the tinfoil wrappers and shoving the eggs in his mouth.  As I neared the garbage hanging on the side of the rolling monitor, I said, “She wants some strawberries.”  I pointed back to the woman in the pink sweats and a pink beanie sitting next to John.  The nurse turned to me for a second and swiped her hand in the air in the universal symbol of “that’s not important.” and turned back to her screen.
“We’ll get you some if the kitchen has any.” The attendant addressed the woman in pink while continuing to type.
“Oh they don’t give a shit!” John’s fuzzy pink neighbor exclaimed.
      I returned to my office chair and noticed that John had moved on to the cake.
“Let’s play our brain game now, John.  So you don’t become brain dead.” I said.
“What, brain dead?” He yelled. 
     His hearing has gotten progressively worse since the three brain surgeries he endured about eight years ago when his foot got caught in the sheet and he literally fell out of bed and bumped his head.
“No.  We’re going to play the game so you don’t become brain dead. Give me a letter” I proceeded.
“C” he said with slight hesitation.
“Name a beverage with a C.” I said.
“A what?  I don’t understand you?” He turned to read my lips but my N95 mask covered my mouth.
“A drink.  What’s a drink that begins with a C?” I asked.
“I don’t know.” He shook his head as he reached for the coffee I brought him from Starbucks.
“It’s your favorite drink.” I exclaimed.  There was a long pause.  I watched him devour his cake with the same intensity of the eggs.
What’s this called?”  I pointed to the cup in his hand.
“I don’t know.” He repeated.
“Coffee.” I finally said, feeling defeated.
“Oh yeah, coffee.” He shook his head, crumbs of cake circled his lips.
     I looked down at number two on the Scattergories for kids list I had saved on my phone.  I decided to change mammal to animal to cause less confusion.
“What’s an animal with a C,  John?”
“Cat” He responded quickly.
“Good.” I said.  I recalled the time John pulled Candy, our twenty-three year old Himalayan cat, out from the pool of their Florida house.  She had fallen in after taking her daily drink.  John gave her mouth to mouth resuscitation in a failed attempt to save her life.
     When we got to number eight, I asked, “What’s a sea creature that begins with a C?”
John looked at me confused.
“A sea what?” He said.
​“Something that lives in the sea.” I explained.
“A catamaran.” He said immediately.
“That’s a boat, but good.  What’s something that lives in the water?” I asked.
He shook his head. “I don’t know.”
“What about the animal that crawls on the ground with its legs like this? I stuck my arms out and moved my torso from side to side.
“I don’t know.” He repeated.
“You sometimes eat its legs at restaurants.  You know, you pick the meat out with a tiny fork and dip it in butter.” I paused. “This is something you can get if you sleep around a lot.”
    The fuzzy pink woman stopped talking to herself, looked at me and turned her head sideways.
“Be around?” John yelled. “I don’t understand you.” I resisted the urge to pull my mask down so he could read my lips, remembering the numerous robocalls regarding Covid cases in the facility.
“You know like if you go out with a lot of people, you could get this.” I laughed hearing the absurdity of my clue.  The woman in pink sat attentively waiting for my next word.
"What go around?" He asked.
“Crabs, John!” I said.
“Oh yeah.” He said as he watched his fork full of cake in his quivering hand.
“It’s five o’clock.  All visitors need to make their way to the front.” I heard the announcement over the drone of beeping monitors.
“I have to go now John.” I said.
“You have to go?” He repeated.
“Yeah they’re kicking me out.” I explained.
“They’re what? He asked.
“They’re asking all visitors to leave.” I clarified.
“So soon? I can’t come with you?” John pleaded.
“No, John.  You have to stay here and get better.”  I felt the weight of guilt in my stomach, knowing he would most likely be there until he dies.
“I will be back in a few days with your wife, my mom, Bette, okay.” I struggled to make it better.
“Why so long?” He moaned.
“I have to work.  Remember I’m a teacher?” The pangs of guilt landed in my stomach knowing I was on spring break this week.
“Yes I remember.” He replied.
“We’ll be back in a couple of days.  I’ll bring Mom.” I said.
“I have to stay here alone?” He whimpered, looking confused.
    I looked into the blackness of his eyes and saw the terror of a helpless child.  A wave of panic and sorrow consumed my body.
“Yes. I’m sorry, John.” I fought back the tears.
    I felt the bones of his back against my arm as I hugged him and said, “I love you.”
“Love you.” He replied.
    I started to walk away, “Bye John. I love you.” I repeated.
He waved his hand, “Ok see ya.” And went back to eating his pineapple upside down cake.





​