January 2012

Mickey is my mother-in-law.  When I first met her, over thirty-two years ago, I was more focused on what she would think of me than on what I thought of her.  She met Barry and me at LAX and drove us to the house that Barry grew up in, in Altadena, just north of Pasadena. As she drove, she talked.  I don’t remember anything she said; I just remember that she filled up any potentially empty spaces in the conversation with jovial chatter, sometimes interspersed with little ditties that must have popped into her head.  She seemed positively bubbly, and compared to my own mother, who was chronically depressed, that was sort of refreshing.

There were many car rides in the Los Angeles area over the many visits we made to California, and all of them, when Mickey was in the car, were filled with chatter.  I’m sure at first I paid attention, wanting to feel part of the family, not wanting to be caught off guard, in case somewhere in all that chatter a response was required from me.  But such times rarely arose, and I usually relaxed and watched the palm trees go by, assured in the knowledge that my input would not be needed.

Perhaps because Barry’s father Arnold was so taciturn, Mickey seemed to me to be the center of the family – the one who made sure things ran smoothly; the one who organized the big family get-togethers with all the siblings and cousins and aunts and uncles. She seemed very much in control, although not controlling.  She seemed at ease with who she was and thus not in need of anything much from other people. Unfortunately, that extended to conversations.  Mickey was a talker, not a listener. We quickly fell into a pattern in which she talked and I listened. I noticed that was the pattern she had developed with Barry too. When he called her from our home in Maryland to say hello, he was mostly silent as he listened.

Still, there seemed to be a genuine warmth between mother and son.  If there were no “heart to heart” talks, there were many nice times spent together, times, we were told (by Barry’s sister), that Mickey greatly looked forward to, as did Barry.  They played scrabble; they chit chatted; they visited with relatives – both in Los Angeles, when we flew out there, and in Maryland, when Mickey visited us “back East.”  She was an easy guest, the kind who doesn’t make you worry you haven’t provided something absolutely necessary to her happiness and comfort.  And she was good with our children too.  As our kids got old enough to join the scrabble games, they happily did so.  I think they quite liked their Grandma Mickey.

Over the three decades that followed our first meeting, Mickey seemed amazingly constant.  The traits I noticed that first day remained – the light chatter, the spontaneous ditties, the cheeriness sometimes verging into silliness, the sense that she was comfortable with who she was and not in need of input from others. In fact, she seemed much more comfortable giving input than receiving it. She exuded a confidence that seemed to preclude introspection or self-doubt – at least as far as I could tell.

When the house Mickey and Arnold had lived in for 40 years became too much for them to deal with, they moved into an apartment near where Barry’s sister Cheryl had her medical practice in Beverly Hills. When Barry’s father died, a few years later, Mickey decided to move to a house nearby that Cheryl had found for her.

By this time, Mickey was in her mid-eighties and slowing down.  We began to notice some memory lapses that are typical of people in their later years, and even Mickey complained about her lousy memory (much as my own mother had when it began happening to her). But in typical fashion, Mickey was upbeat, as she seemed to be about everything.

By what seemed to be an incredible stroke of luck, just as it was becoming apparent that Mickey shouldn’t be living alone in her house, Sarah, the daughter of a friend, and her husband Robert – a couple in their forties – needed a place to stay in Beverly Hills. Robert offered to be Mickey’s caregiver, and Robert and Sarah moved into the upstairs, which Mickey couldn’t use because the stairs were too much for her.

Robert was wonderful with Mickey. He watched the football games with her, he did the grocery shopping and the gardening, and he generally attended to her needs.  But most of all he encouraged her to do things, to not just sit at the dining room table all day. Mickey seemed to thrive under Robert’s care; it seemed too good to be true.

The first hint of trouble came when Cheryl noticed some large checks Mickey had written and asked what they were for. Mickey had given Cheryl a Power of Attorney, and Cheryl was doing what such an agent is supposed to do – ask questions when it seems that something might be amiss. There were a number of large checks being written, and yet Mickey didn’t seem on top of them when asked. There apparently were no records or contracts that kept everything clear and above board. Being asked about them was, of course, touchy.  Mickey assured Cheryl everything was okay, but she was less than satisfying when asked for any specifics.

Then it became known that Mickey had decided to invest in an antique furniture business Sarah was trying to make a go of; she also decided to invest in a side business of Robert’s. These decisions were solely her own, she insisted, but of course they made us nervous.  Situations in which elderly women decide to invest thousands of dollars in the side businesses of their beloved caregivers are the stuff of textbooks on the pitfalls of eldercare. They reek of “conflict of interest” and “elder abuse.”

For all Mickey’s assurances that she knew what she was doing, just saying so didn’t reassure any of us. New business ventures are known to be risky; opening a new antique store during bad economic times can be assumed to be especially risky. But Mickey exuded confidence, if not specifics. When Barry asked her if she knew how much money she had, she didn’t, but she was sure her stocks were going up, because they always did. When he asked her how much money she’d spent in the last year, she didn’t know that either, but once again she was sure everything was fine.  She had plenty of money, and it would never run out.

Barry was not reassured.  His mother’s confidence seemed based on nothing, since she didn’t seem to know how much she had nor how much she’d spent in the last year.  He asked her to get a financial advisor to help her manage her money. He worried that the big checks would get ever bigger, and that she would eventually start spending beyond her means, since she betrayed no understanding of what she was doing. But Mickey wasn’t interested in a financial advisor, simply assuring Barry that everything was fine.

Things went from bad to worse.  Cheryl had been given a key to Mickey’s house so she could stop by and check in on her mom most days before or after work. Then one day she found that the lock on the door had been changed. Mickey said she was angry at Cheryl, but she wouldn’t talk to Cheryl about it. When Barry tried to defend his sister, Mickey’s anger at Cheryl turned to Barry as well.  Questions about the large checks Mickey was writing were taken as questioning Mickey’s competence and, perhaps, as accusations of Robert and Sarah, who lashed out at both Cheryl and Barry. Mickey had a mental evaluation done, and told Cheryl that she did fine, but when Cheryl asked to see the test results, Mickey refused to show her, and Sarah told Cheryl it was none of her business.

Barry and Cheryl’s concern about how Mickey was handling her money was also taken as self-interest – Mickey told relatives that both of them “have their hands in the till.”  Her previous open attitude (“my checkbook is an open book”) morphed into suspicion and mistrust. – unfounded, I might add; but once it’s lost, trust is hard to get back.

In April 2011, Barry flew out to Los Angeles to see his mother. By this time, things were extremely tense. Mickey had told Barry that it would be best to come in June, but that was a bad time for Barry, and there wasn’t really any reason that June was better, so he told Mickey he was coming in April. He had lunch with his mother the first day he was there, a Friday.  It was a cordial lunch, if not warm.  He called her the next day and suggested that he come over. There was a pause; then he heard Mickey say [presumably to Robert], “He wants to come over.”  When she returned to the phone, she said he couldn’t come over; she was busy.  What about Sunday, then, Barry said.  No, Mickey replied; I’m busy Sunday too. It was the same story with Monday. After flying over 3000 miles to see his mother, she would see him only that one time. She later admitted that she was “trying to teach him a lesson” since he hadn’t come to Los Angeles in June when she’d told him to come, but instead came in April.

Thinking that he could talk things over with Robert, Barry asked to talk to him on the phone. But when he suggested they get together over beer and pizza to talk things out, Robert refused.  He told Barry he wanted nothing to do with him.

It’s hard to describe how all this made Barry feel.  In the past, Mickey had always been delighted to see him. His visits to Los Angeles had been much looked forward to.  But now she seemed to want nothing to do with him.  When he asked her why she was angry at him, she couldn’t say. It was if she had turned into another person.

This “new Mickey” angrily delivered a hand-written notice to Cheryl revoking her Power of Attorney. She angrily told her doctor (who was in a group practice with Cheryl) that she was no longer her doctor. She suddenly seemed to delight in telling Cheryl’s son Brian about his mother’s online “bad ratings” as a doctor. Come Mother’s Day, she told Cheryl’s teenage daughter Kristin that she wouldn’t be spending Mother’s Day with Cheryl and her family (as she had always done in past years). “I’ve spent the last 60 Mother’s Days with my family; now it’s time to spend it with someone else,” she told Kristin. She spent that Mother’s Day with Robert’s family.  It was as if she was simply trading her original family in for a new one – Robert’s family.  And that seemed to be just how she wanted it.

Through all of this, we figured that this “personality change” was related to dementia.  There were many indications of memory loss, as is common at Mickey’s age.  And then there was the general vagueness whenever Barry tried to discuss financial matters with his mother.  But most striking (to me) were the behavior changes, the childishness and vindictiveness that none of us had ever before seen in Mickey.  It was the sort of behavior I associate with Alzheimer’s Disease.

But not everyone saw Mickey that way. People who stopped by and chatted on a superficial level – people with whom Mickey wasn’t angry and who didn’t try to probe too deeply – saw “the old Mickey,” who chit chatted amiably about this and that, nothing too probing or specific.  Many people said she seemed basically “okay.” Even Barry, on a subsequent trip to Los Angeles, said that she seemed to be able to follow the conversation and that her conversation was “appropriate.”

This discrepancy between the “two Mickeys” – one seemingly basically “okay,” if superficial, and the other profoundly not okay – became an enduring puzzle for many months.  If she was basically mentally competent, if this wasn’t dementia we were seeing, then what was behind this striking change in behavior? If she was so angry at Cheryl, why did she consistently refuse to talk things out with her? Or with Barry? At one time, she told Barry she was just too angry to talk to him; at another time, she couldn’t remember why she had been angry at him.

Mickey recently had a stroke that affected her left side. Barry flew out to see her.  Some days she looked awful; others, she seemed to have made progress in rehabilitation.  She may never walk again; it’s unclear how far she’ll “come back.” But in one important way, it seems she’ll never come back. There is no sign that her children mean anything much to her at this point; no sign that she’s all that interested in them or in reconciling with them.  And with this latest stroke, it’s likely that even if she wanted to renew bonds that were once strong, she isn’t able to.  Not that it seemed she ever really wanted to.

And this is particularly strange. Up until all this happened, any of us would have described Mickey as “very family-oriented.” When her kids were little, she used to take them across the country by train to visit not only her own parents in Milwaukee but also Arnold’s mother in New York (Arnold wouldn’t go).  She always seemed delighted when Barry came to Los Angeles with his new family to visit; and she made a point of visiting us about once a year “back East.”  She was always the one who arranged the “cousins clubs” when we came, when all the cousins, aunts, uncles, etc. in the Los Angeles area would come to her house.  Family, in fact, had always seemed the most important thing to Mickey – which makes it all the more strange that she so blithely let go of it, seemingly happy to trade the old one in for a new one. It’s not as if she had always been aloof from her children.  Quite the contrary.  Or so it seemed.  Did we misread her all those years?

I don’t think we’ll ever really know.  Amidst all the anger, unfortunately stoked, I suspect, by Robert and Sarah, some fears were acknowledged.  At one point Mickey said she was afraid her children wanted to “put her away” in a nursing home.  Nothing could have been further from the truth; Cheryl went to great pains to find a lovely house for her mother in Beverly Hills, and we were all delighted to see how much Mickey enjoyed being there.  We were also all delighted to see how good Robert was with her, making it quite feasible for her to stay in her home – until the other side of that coin became clear.  And while we did see signs of dementia, none of us inferred the need for Mickey to leave the home she obviously loved (although we did infer the need for her to have a competent financial advisor).

What has happened is heartbreaking. I suspect it’s due in part to real paranoia that probably was associated with some level of dementia. I suspect too that “just talking things over” was never a modus operandi for Mickey or for her family.  Even when Cheryl wrote a letter to her mom telling her she still loved her and trying to clear things up, Mickey didn’t respond, as she never responded to a mild letter Barry wrote her early on advising her to get a financial advisor.

Somewhere in all of this, Barry’s mom, the Mickey he had known for over five decades, “went away” and never came back. In her place was a “new Mickey” who was cordial but distant, who treated Barry more like a second cousin twice removed than the son she had loved all his life – up until recently. There was never any attempt to talk things over; never any effort to explain the anger, the hanging up of phones, the childish refusal to see him when he flew out to Los Angeles; never any apologies. Occasionally she would say that things would “get back to normal,” but things don’t just get back to normal unless people make an effort, and Mickey didn’t, or couldn’t do that. Instead, she essentially just “left.”  It doesn’t look likely she’ll ever come back.


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