by Robert Lanz LCSW
She was one of those older women like my mom or my aunt- women who were small children during the first world war. Women, who, when reaching what should have been the security of adulthood were thrashed again by the ravages of the great depression, wondering for years what could be worse, what next- And then she, like all the women in her generation found out what next was the second world war, the war that brought an end to the depression but rained down a whole new hell on already battered and insecure Americans.
Americans who watched as their friends and brothers and husbands and fathers marched off to a distant war, a war that killed hundreds of thousands of men and even some women.
When all that was finally over and those that were coming home, did come home, there seemed to be a rhythm that satisfied a daily life. Not a hot danceable rhythm, just the rhythm of routine and people liked that. After two long wars and the Great Depression, people just wanted to feel safe, to hunker down behind a white picket fence with a loved one and not have anymore changes or adventures in life. Changes and adventures were too scary with bad consequences. What they longed for was sameness, security and predictability. They wanted to wake up to the same stuff every day, safe stuff. And they wanted to have a solid mate to hunker down with. In a life of frightening changes the forever of marriage offered a great comfort.
Of course, changes happen anyway in even the seemingly perfect marriages when couples grow old together. That’s what happened to Mildred, the last few years of her life turning into a nightmare. A nightmare some people would have thought of as punishment for some evil deed, although it is hard to imagine a deed so bad and pathological as to cause such profound torture.
Mildred never brought it up when she came to the ER with her husband, a once successful attorney who slipped into dementia and probably Alzheimer’s at the end of the contract they had married into about sixty years before. Alzheimer’s sufferers fall and get sick and have chronic medical problems like any other person in their age group but their ability to cope with those things and respond appropriately and accept help from a loved one are all compromised. A guy who used to be smart and powerful in the court room was now getting lost on the way to the bathroom, his power and sense of self ebbing away, replaced by depression and angry outbursts.
On their second visit to the ER I noticed some bruising on Mildred’s upper arm, the kind that show up on kids and old people when they have been vigorously grabbed and held tight. I tried to edge into the private space of their lives to assess the danger level Mildred may have been in. She probably knew I knew she wasn’t being totally truthful about the injuries. A little late in the party to change partners, she had picked the one she wanted and they planned on having the last dance together.
“Oh, I was in the garden with Harold and lost my footing. He grabbed my arm so I wouldn’t fall.”
A possible explanation but in my experience, not the most probable one.
“Mildred, you know I’m the social worker. My job is to look out for people, young people, old people, frail people, people who might not be totally able to look out for themselves. Sometimes I wonder about you. Your husband’s a big guy and I’ve seem how confused he is. I’ve also seen a couple of his outbursts down here on other visits. I just want to be sure you’re safe.”
“I’m safe. My husband would never hurt me.”
“If he lost control of himself who would you call for help?”
Mildred sort of stared off for a moment. Enough time to consider a couple of wars and a depression followed by forty years of safety and security. She had weathered the storm and seen the sun shine again. Going back to the storm wasn’t an option.
“We’ll be fine young man. Thank you for your concern.”
Maybe a younger social worker would have called the police or Adult Protective Services. Maybe a social worker who hadn’t been a long time observer of that greatest generation himself would have just considered the mandated reporter rules. Those are the rules that say you should err on the side of caution and report any suspicions. But I know what happens when the cops or protective services get involved in these cases. Nothing good would come of it, nothing good for the contract they had signed with their wedding vows. So I just let it go.
Mildred and Harold made a few more visits to the ER in the next year and I always made it a point to check in with them. Harold followed a fairly predictable path of deterioration but I never saw any more marks on Mildred and I assumed things were stable or at least tolerable per their contract and I was relieved I hadn’t disrupted the flow they had chosen to live their lives with.
But when they didn’t show up for almost a year I began to get anxious and the downside of my failure to report began to chip away at me. On a couple of occasions I thought about calling their house but I didn’t, trying to balance my fear of knowing against my fear of not knowing. Maybe a younger social worker would have handled that differently too.
Time passed and the life and death craziness of the ER night shift covered my fears and I had all but forgotten the aging couple until the paramedics brought Mildred in. She had taken a fall and couldn’t get up. Harold wasn’t there to help her anymore.
Mildred told me that Harold’s doctor finally insisted he go to a facility specializing in Alzheimer’s care. The separation had been hard on Mildred, being alone after all those years together. But she was a dutiful wife, visiting Harold every day, watching the man she knew slip away until one afternoon he no longer recognized her and all the emotional connection between them was severed. At least for Harold anyway. Mildred , however, of sound mind, was still up for that last dance, her own emotional ties intact and her daily visits continued.
One day, as if talking to a stranger, Harold told her, with the glee of an infatuated adolescent, he had fallen in love- fallen in love with another patient who was equally demented.
Mildred told me she tried to endure but eventually she saw how happy he was with his new love and hers alone was no longer enough to sustain her. She said she still loved him and liked to see him happy but that the heartbreak couldn’t be endured forever. She accepted he would have the last dance with someone else and she would be going home without her partner. She thanked me for all the concern I had shown over the years.
Her life was ending the way it had begun, cold, insecure and frightening and she chose to endure it alone.
I never saw her again but thought of her often like I do of the older generation in my own aging family. My generation had its own wars and financial crashes and job insecurities. We won’t know about the last dance either until the time comes. I just hope we can live up to the fine example set by Harold and Mildred….