I noticed pictures of Mabel sailing and others of her standing near small airplanes in some kind of flight hat. “I didn’t know you used to fly,” I said. “You must have been quite adventurous.” “Back then I guess I was,” she said. “That was a long time ago.”
She was sitting, leaning forward, looking down, looking defeated, appearing even smaller than her 5’ 2.” She couldn’t have weighed more than 100 pounds. She apparently had stopped doing housework. There were pastel-colored pajamas and bathrobes, empty plastic bags, towels and copies of People magazine scattered around the floor.
Because of the clutter, Mabel frequently fell. I asked her about hiring housecleaning and cooking help. “I can’t trust them,” she said. “There was one that I liked, but she moved away. It’s not that bad, I don’t think. Do you? I have my frozen dinners.” From the boxes in the garbage, it seemed like half a TV dinner a day had become her regular diet.
While Sylvia went upstairs to check the state of the bedrooms and bath, I asked Mabel, “Don’t you get bored here? It seems lonely.”
She thought about it. “I have Days of Our Lives,” she replied. “I don’t like the newer shows that much. Sometimes Sylvia calls. Or one of her children. But they’re getting big now. They have their own lives.” She brightened. “I have the birds.” She fed birds twice a day from feeders and sometimes from her hands. “Some of them have been coming for years. I feel like I know them. I don’t give them names, though. I’m not crazy.”
Every few weeks we’d have the same kind of conversation. I’d tell her about friends I knew who had moved into senior housing. She was usually dismissive. “That’s good for her,” she would say about an acquaintance who had moved. “She’s always been a social butterfly. It wouldn’t work for me.”
Because her sentences were becoming shorter and taking longer, Sylvia worried that Mabel might have Alzheimer’s. She took her mother for an evaluation. The doctor tested her and found no dementia. “I think Mabel just needs more conversation,” she told us. “She’s like someone who lives alone out in the country. What does she need words for?”
Sylvia and Mabel’s social worker agreed she would do better in an assisted living residence. In assisted living, she could have meals prepared and would meet new people. Sylvia found three that the family could afford, two of them in attractive, upscale Marin County settings.
Mabel wasn’t having any of it. Falls or no, loneliness or no, hunger or no, she was determined to stay in her beloved house. She brought up the high cost of assisted living. The places Sylvia had found ran around $3200 / month, which the family could afford, but would involve their dipping into their retirement savings. There were cheaper places (as low as $1500 / month) available, but they were much farther from Sylvia, smaller, and with fewer support services. Mabel said she wanted to save the family’s money for her grandchildren’s education.
What could we do at this impasse? Finally Sylvia threatened to go to the County and seek guardianship of her mother. This conflict was extremely hard on them, and for the next three months they hardly spoke to each other.