What Are We Going To Do With Dad?

"Dad, I was just here yesterday."

"Why are you calling me that? You're not my son."

"Of course I'm your son. That's your wife, my mother, sitting over there." (My mother, shouting at my father: "What are you saying! Of course he's your son!")

"I like you and all, but you're not my son."

"Well, I love you anyway."

"You're older than I am. How could you be my son?"

"I love you, Dad."

"You ought to come around more."

Once in a while, though, he will surprise me: "Remember those big rockfish we used to catch off Thomas Point Light?" he might say. And then nothing.

Between my brother and me, one of us is there almost every day. We have been fortunate to find two dedicated women to help my mother in attending to my father's daily needs. My brother and I help with the cost -- $1,500 a month, but still only one-third of the expense of custodial nursing home care. I often wonder: Why isn't this kind of care covered by Medicare or Medicaid? After all, when my parents use up their meager savings (which they will, just like most families with a demented elder), they will become eligible for Medicaid, and the state of Texas will then pay the entire cost of custodial nursing home care. But the longer we can keep my father at home attended by aides, the cheaper his long-term care cost will be to society as a whole.

Drinking the nutritional supplements my brother brings to the house by the case (another non-covered cost of several hundred dollars a month), my father has actually put on a few pounds. But every week he gets worse, harder to deal with, more bizarre. Recently, he has begun to holler at my mother every time she tries to help him change his clothes, which is often because he wets himself. "You're my sister! You're not supposed to see me naked!" he screams at her.

At first, my mother didn't believe that my father was demented. Most of us do not recognize the reduction in the mental capacities of our spouses or parents unless something unexpected happens. My mother continued to see his stubbornness and withdrawal as purposeful acts of belligerence against her -- until the day she realized he could no longer figure out how to unlock the front door by himself.