My Life as a CNA #2: Strokes and Insights

 

This photo, from the mid-1960's, shows my maternal grandmother, Mary Urban Endrich, standing strong as ever in the magical flower and vegetable garden she kept between her house and ours -- the pink ranch in the background.

I know this is the mid-60's because Mary is already somewhat diminished here. A giant of a woman in both personality and form, she began to have a series of small strokes -- today we would call them TIA's (transient ischemic attack) -- when I was four and five years old. The big ones that finally took her from us were in 1970-72; she was only 74 when she died, and I, whom she had taught to read and write and garden and work a farm stand, only 11. 

Mary in 1961 at her full, pre-
stroke size, greeting my
arrival.

The big strokes caused her daughters, my mother and godmother, to move her in with us. Fifty percent of the time she was in NJ with my godmother and her family, 50% of the time with us. She and I shared a bedroom, so at an early age I got a good look at the damage strokes can cause to our beloved people. Her inability to speak, her permanently contracted hands, her rapid weight loss, her shuffling gait.

The majority of residents in today's nursing homes are those with some form of dementia or stroke victims. And the majority are women. Many of these can no longer independently perform their ADL's (activities of daily living) and require nursing assistants to feed, dress, toilet, and bathe them. A good many are confined to beds, unable to stand or walk on their own.

As a family, we cared for Mary until her body quit. The body is a tenacious thing and, 50 years later as we have extended life spans, even more so now than then. We were also there full time to tell her we loved her, and to remind her of the good life she had lived. 

In this way, we were also there to help her to die.

As CNA's, we're here to care for every resident just like family. In the absence of family members, we toilet, feed, dress and exercise people in the last portions of their lives. Yet it is different today. There are nearly six million patients with Alzheimer's in this country, and within 20 years this number is estimated to rise to 55 million. Alzheimer's and dementia break the connection between a body and its memories.

Can we know how to die when we cannot remember that we have lived?

As a culture, as we've become increasingly disconnected from the natural world around us, the cycles of living and dying can feel removed from us. Watching a flower bloom and die, we are reminded of how temporary life really is. We all die so that others can be born.

I still miss Mary every day. She is a huge part of who I am. Until her last breath she would point to me and say "the girl is good" no matter what I did or how impatient I was. Her love for and belief in me was no small thing to have. While I would have loved for her to live to see me go to high school and college as she wanted, I'm really glad we could all be there to help her die in love and dignity. And I hope that by caring lovingly for our many elderly residents who can no longer speak, or walk, or eat on their own that we are doing the same for them.

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