Susan Knox

 

Susan Knox & Marie, 1998
Susan Knox & Marie, 1998

Susan Knox enrolled in writing classes after moving to Seattle and got an idea for her first book, which bridged the gap between her old career as a CPA and her new one as a writer. Financial Basics, A Money Management Guide for Students was published by The Ohio State University Press in 2004. Lately she has become interested in retirement and aging and is working a collection of essays on this subject. Her short stories, creative nonfictions, and personal essays have been published in CALYX, Forge, MacGuffin, Melusine, Monkey Puzzle, Pisgah Review, Rusty Nail, Signs of Life, Still Crazy, Sunday Ink: Works of the Uptown Writers, Wild Violet, and Zone 3.

 

Autumn Life

Twenty years ago my mother decided it was time to move into a facility where she would be cared for in her old age. When I was a child, they were called “old people’s homes,” but now they are “retirement homes” or “continuing care facilities” or “active retirement communities” and they have bucolic names like Tall Oaks, Willow Knolls, Primrose Manor; or hopeful names like Horizon House, Golden Age Center, Friendship Village; or corporate names like The Alliance Community, Emeritus at Regency Residence, Five Star Premier Residences of Plantation; and mottos like “Beautiful Vision,” “Whole Life Living,” or “Destination for the Ageless Generation.”

Mom was considering Copeland Oaks Retirement Home in Sebring, Ohio, a premier facility twenty miles from her home. She was seventy-seven, still driving, and in good health except for epilepsy that was usually, but not always, under control. She told me she was slowing down and she was worried if her epilepsy worsened, she wouldn’t be admitted to Copeland. “I need to be healthy enough to walk in the door, and if they accept me, I’ll be taken care of for life,” Mom said. Copeland Oaks is affiliated with the United Methodist Church and like so many retirement homes under church auspices, they guarantee lifetime care even if a resident exhausts her fiscal resources. It was a comforting thought for both of us.

I felt fortunate my mother was taking charge of her future. My aunt Rachel, the matriarch of our extended family, was unwilling to move from her Minerva, Ohio, home of more than sixty years. Her children, Liza and Leo, were beside themselves. They lived in Arizona and wanted their mother safely settled with caregivers. She refused to move and, for a while, hired people to stay with her, but her worsening heart congestion canceled her say in the matter. Aunt Rachel’s ambulance journey to a Kentucky nursing home near her granddaughter might as well have been a dead-of-night exit since her children did not offer Aunt Rachel time for farewells to neighbors and relatives in the town where she had lived for ninety-two years. I don’t know why Liza and Leo didn’t invite family and old friends over before they moved her, but they are the same cousins who, without consulting any of the other twenty cousins, sold the family Bible at public auction.

Copeland Oaks Retirement Community, built in 1967 on 250 acres of land with stands of alder, ash, oak, sycamore, Scotch pine, birch, and hickory, was situated in the Ohio countryside, a location inviting peacefulness and pleasing views but isolated, being five miles from the nearest town. A long lawn as verdant as my dad’s alfalfa field led to the main building constructed with bricks rosy in summer sun. Thick cream columns stretched two stories high and invited us into an atrium lobby reminiscent of a four-star hotel with its apricot and ivory walls, soft easy chairs, and taupe, low-pile carpeting. We viewed various-sized apartments and meeting areas on each floor where residents could gather to play cards, read, and entertain visitors. We surveyed the library, fitness and aquatic center where a water aerobics class was in progress, art studio where two women were working with watercolors, health services center, and chapel. Everything was clean. There was a fresh citrus scent in the air. The dining room, spacious with floor-to-ceiling windows and French doors, opened onto lush lawns and gravel-covered walking paths around a lake featuring two swans. We stopped for lunch and ordered tuna melt and tomato soup, and Mom pronounced the food good. We talked money. Copeland required $30,000 to secure a place and a monthly fee based on the apartment she chose. She’d had to pinch pennies when we kids were small, and it wasn’t until she went to work as a beautician that our family was pulled out of near-poverty. She was proud she could afford to live here.

For the next ten years, Mom lived in a series of apartments at Copeland—she enjoyed change. She played bridge almost every evening, she read, she did water aerobics, she went on day trips arranged by the staff. The only complaints I ever heard were that the swans were territorial, and no one walked near them for fear of being attacked and that all the residents were Republicans. “I just keep my mouth shut about politics,” she said.

Mom was bright, had a great sense of humor, a trim figure, and two boyfriends. Homer was genteel, tall, thin, soft-spoken, a retired county extension agent. Bud was a lively man, short, muscular, loud, a garage mechanic. Bud eventually won the competition and spent every day with her, took her out for dinner on Saturday, and phoned before he went to bed. Mom made it clear, she didn’t want marriage. She had no intention of cooking, cleaning, and caring for a man in her old age. Mom and Bud enjoyed eight years of companionship and love until he died in 2001.

My brother Tom and I visited Mom after Bud’s death and took her out for dinner as a pick-me-up. When I checked in with Bridgett, the head nurse, she told me Mom was missing appointments, showing up on the wrong day, often wearing the same food-spotted clothes. “We didn’t notice she was slipping,” Bridgett admitted. None of us had realized Bud had been keeping Mom on track. I opened her pillbox, which contained eight different medications segregated for each day of the week. Even though it was Friday, near the end of the week, there was an uneven number of pills in the preceding slots. It was clear she was confused and missing important drugs like Dilantin, which prevented epileptic seizures.

Looking back, I realize I missed a lot of signals. My mother couldn’t balance her checkbook anymore; Tom took over her bill-paying; she mentioned how hard it was to follow the story line of a book she was reading; a bridge partner complained that if she couldn’t count cards, she shouldn’t be playing. While I don’t think there is much I could have done to change her decline, if I had been more aware, I would have been less critical and more understanding of her needs.

Bridgett insisted she move to assisted living. I told Mom. “Assisted living? That’s like going to jail.”

“Have you ever visited assisted living?” I asked her.

“No, but I’ve heard stories. Friends drop away and the rooms aren’t nice, just small bedrooms. It’s like a dormitory.”

“Why don’t we take a look?”

We walked to the manager’s office. Bill said, “We have two single room vacancies.”

Mom looked at me with a raised eyebrow as if to say what did I tell you?

“And there’s one unit with a separate bedroom and a spacious living room, but it costs more money.” He named the figure. “Can you afford it?” I told him she could.

Bill led us to the assisted living wing. When we entered the light-filled living room, larger than her current apartment, Mom’s eyes lit up. She loved the space and was delighted to learn her laundry would be done for her, and she would continue to take her meals in the main dining room. She agreed to move.

A year later, in 2002, she began to wander at night, looking for my father who had died twenty-two years earlier. The staff insisted she wasn’t safe in assisted living. “But she’s so happy here,” I said to the floor nurse. “Isn’t there a way to monitor her movements?” I was told no. “Could I hire someone to stay with her at night?” I was told it had never been done. The staff wouldn’t budge so for the last year of her life, Mom lived in Crandall Nursing Home. She did not go happily. Sitting together on her new blue couch, Tom broke the news. “Must I?” she asked. He nodded yes. She looked at him, her lips compressed, and turned away.

After moving to a small room furnished with a hospital bed, recliner, and chest of drawers, Mom quit wearing hearing aids. Hershey chocolate bars, once irresistible, went uneaten. She lost weight. She didn’t answer her phone when I called, and I had to contact the nurses’ station to get her attention. My mother had tremendous will. I think she’d decided it was time to go. She died just short of her eighty-eighth birthday on July 28, 2003.

*****

Through all of this, I never thought about my older-age future. I was in my fifties, healthy, energetic, strong. Retirement home? Not for me. But today, in my seventies, still healthy, I am not as energetic, not as strong. I can no longer scramble on top of a desk to dust high shelves or paint a room or move heavy furniture. My hearing is not as sharp. I’m developing cataracts. Recently I tore cartilage in my shoulder doing a simple move in Pilates—a move I’ve been doing for fifteen years. “A common injury for older women,” said the physical therapist. Twice my optometrist has spotted a ruptured retinal artery and sent me to a specialist. The condition was uneventful, but frightened me and I wondered, is it starting—that downward slide to infirmity?

Then there’s my brain. My mother developed dementia in her eighties. My late father’s siblings, Mildred and Jack, have Alzheimer’s. That’s both sides of my family. Does that double my likelihood? According to the Alzheimer’s Association, one in eight Americans over sixty-five has Alzheimer’s or similar dementia, and nearly half the people over eighty-five have the disease. My mother lived to eighty-seven. I will probably live longer.

My husband, Weldon, and I were invited to visit our friends John and Beverly in their apartment at the newly opened Mirabella Retirement Community located in Seattle’s South Lake Union neighborhood. John had been an engineer at Boeing and is a community activist—vigorous and energetic. Bev is a pianist and one of the best-informed people I know. John and Bev met after having been widowed in their seventies and have been a couple for ten years. They delight in shocking people with their unmarried cohabitation status.

Mirabella Retirement Community, constructed of maize and burgundy brick eight stories high, covers a city block. The building seems uninviting, its design cold, and the location feels remote even though it’s only eight blocks from downtown. Across the street is the Seattle Times buildingwith its charcoal gray exterior. I saw no coffee shops, no retail, just a few fast food restaurants, and a dry cleaner. I would not want to walk in that desolate area.

After drinks in John and Bev’s Mirabella roomy apartment, they took us to the top-floor restaurant for dinner. As we waited for a table, most people arrived carrying a bottle of wine, already opened, so they wouldn’t have to buy the restaurant’s higher-priced wine. All the residents wore name-tags. They greeted one another effusively. Everyone was old. Weldon and I were quiet as we drove home. Returning to our building, we took the elevator with neighbors, Jack and Kathy, and I blurted out we’d had dinner at Mirabella. “Everyone looks the same and they act desperately happy,” I said, “and you have to pay for thirty meals a month in the restaurant. So much togetherness. I don’t think I could be with the same people day after day.” Kathy nodded her head and said, “I’ll never move to a retirement home.”

Shortly after the Mirabella visit, I received an invitation from Skyline at First Hill, “downtown Seattle’s only true life care retirement community,” to join residents for lunch. A colorful trifold brochure had a picture of a smiling woman seated at a table with a grouping of white-haired men and women standing behind her holding wine glasses in a celebratory fashion. I wondered, would I act older and feel older if I lived exclusively with people my age?

Every week I write with a group of women ranging in age from forty-two to sixty-two. I am the oldest. I learn from them about raising children in today’s world, about dating, changing social mores, current vernacular, their work world. This is an important connection I might lose if I were in a retirement home. Fourteen-year-old twins and their parents recently moved into a condo on my floor. I enjoy our brief elevator conversations, getting a glimpse into their young lives. My book editor introduced me to a thirty-something entrepreneur who lives in my building, and we went to the Virginia Inn for drinks and conversation. Would this happen if I were in a retirement home?

I’m entering unknown territory. My mother and I never discussed what it was like growing old. One time she mentioned being scared of dying and I was scared to have the conversation with her. In her last year I questioned Mom’s physician about why she was sleeping so much. He looked at me, a little exasperated, and said, “Old people don’t have much energy. Even the act of eating a meal can exhaust them.” In her essay “Why I Moved Into an Old People’s Home” the British writer Diana Athill, reflecting on an acquaintance who insisted on dying at home with the help of friends, wrote, “I had not realized until now that an old person can be reduced to helplessness—can reach the stage of having to be looked after—almost overnight.” As I write these words, I feel a frisson of apprehension move through my midsection. It’s visceral, my denial, my apprehension. I recall my mother’s words in her later years, “We come here to die. We all say that to one another. We come here to die.”

I watch the elders at Market Place North—a condominium building in downtown Seattle where my husband and I have lived for the past seventeen years. I observe them in elevators, converse with them in the lobby, query our doorman about their health. I’m curious about how older residents are managing while staying in their homes. One couple, Phyllis and Mike, installed an electric chair to trundle them up and down their unit’s stairs. My place has thirteen stair steps, and it’s reassuring to have this option. Mark, in his nineties, a former physician, shops Pike Place Market every day and finishes by walking the steep incline on Virginia Avenue that borders our building. I tease Weldon, who exercises six days a week, that I will be long gone and he will still be running up Seattle hills. Pat relocated her husband Brewster, ill with Parkinson’s disease, from a nursing home back to their unit at Market Place North and hired round-the-clock nurses. We often see him being wheeled around city streets and always say hello even though he can’t return our greeting. I was seated next to neighbor Gordy at a fundraising dinner for the Seattle Chamber Music Festival when he leaned over to whisper he was scheduled for radiation treatment for a brain tumor. Nine months later Gordy died in his bed tended by his wife and a nurse’s aide. Bob and his early-onset Alzheimer’s-afflicted wife shifted to assisted living until she died. He returned to his condo and remarried. Unable to shop the Pike Place Market anymore, Pia, a widow who kept her husband’s ashes in her living room until hers could join his and be buried in their native Italy, had groceries delivered from market vendors she had long frequented. Pia made her own Limoncello digestivo and drank it daily saying, “It’s good for my heart.”

Maybe I will be able to stay in my condo with its view of Elliot Bay and spectacular sunsets. I love living in downtown Seattle where the streets are alive with residents in low-income housing and young Amazon employees in recently built high-rise apartment buildings and empty nesters and retirees who’ve downsized to downtown condominiums. I hear Spanish, Chinese, Japanese, German, French, and Italian as I move through the Pike Place Market. And, yes, there are homeless people begging for money and drug dealers darting into alleys to conduct transactions and while I’m thoughtful about where I walk, I don’t feel threatened. The street life invigorates me. I value the diversity.

I’ll continue to walk to Benaroya Hall for symphony concerts and to ACT for plays. I’ll walk to the movies and the Seattle Art Museum and the public library. I’ll go to Caffé D’arte every morning for doppio espresso and chat with the regulars. I’ll shop in the Pike Place Market. I’ll converse with the fishmonger, the green grocer, the cheese purveyor, the grocer, the baker, the wine merchant. When I don’t feel like cooking, I’ll dine in a neighborhood restaurant.

Last summer I prepared a thick notebook for our children entitled “After We’re Gone…” In 2012, nine years after my mother died, we discovered a life insurance policy she’d taken out when she was nineteen. It had been fully paid by 1954. Prudential Insurance Company was ready to turn over the proceeds to the state of Ohio unless we made a claim. Her $500 life insurance yielded $5,000 to her heirs. I didn’t want our children wondering what we’d wished or if they’d missed an important paper. I made lists and copies of documents for them: financial advisors, attorney, insurance agent, real estate agent, Last Will and Testament, social security and Medicare cards, banker, bank accounts, safe deposit box location, key for box, condo deed, supplemental health insurance, doctors, passwords, artwork bequests, jewelry bequests, disposal of possessions, cremation wishes, spreading of ashes, celebratory dinner in lieu of funeral. I included articles on dying that reflect my own wishes for care at the end. Weldon and I have talked with our children about not letting us linger, but I wanted to reinforce our desires.

All that remains is finding a compatible retirement facility. While my intent is to follow the example of older neighbors at Market Place North and spend my remaining years at home, I know there may come a time when I can’t cope on my own. I’ve been declaring for five years that I will visit retirement homes in Seattle to collect information, assess their desirability, persuade Weldon to visit my short list, and inform the children of our preferences in case they have to move one of us quickly, like my Aunt Rachel. But the truth is I haven’t done the research; I’ve only talked about it. I’m resisting this project. I think, it’s too early. My mother was seventy-seven when she went to Copeland Oaks. I’m only seventy-two. I’m a lot like my mother. Will I know, as she did, when it’s time to get assistance, time to quit driving, time to move to a full-care facility? I’m going to trust that I will be as decisive and responsible as she was, that I will know when it’s time.

My mother’s final legacy.

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