The Circle of Humanity

My Mom is a geriatric social worker who helps caregivers taking care of homebound elders. The caregivers are often the adult son or daughter of an elderly person and they provide daily hands-on care in the elder’s own home.

This morning my Mom was visiting an 91-year-old man and his adult son who serves as the primary caregiver. The father lives alone in the house he purchased for his family in the 1960s. He suffers from hypertension, rheumatoid arthritis, and diabetes and is diagnosed with dementia (type unknown). He is bladder and bowel incontinent so he wears adult diapers. He can’t support himself in the shower, so he gets sponge-baths every other day. He spends his days in a specialized recliner and spends his nights in a rented hospital bed, which is lined with special pads to absorb urine or feces in case his diaper leaks. He has an elevated bedside table where he keeps a glass of water, his pill box, the television remote, and a phone. His room has one window, which looks out on his street in a crime-ridden section of West Philadelphia. His wife died several years ago after a long battle with cancer. She died alone in a nursing home. His son promised that he’d never place his father in a home – not after everything his mother went through.

The elder’s son is a 63-year-old divorced male who is his father’s only remaining child. His siblings have all either died or lost contact with the family. He lives five minutes from his father in a rented studio apartment. Until recently, he worked full-time and would visit his father on the way to work, then again on the way home. In the mornings he helps his father out of bed and into his chair, dresses him, cooks him breakfast (Cream of Wheat), and takes his morning pills from the pillbox for his father to swallow. In the evenings, he cooks his father dinner (pureed food required), gives him a sponge bath, changes him into pajamas, lays fresh pads on the hospital bed, and helps his father transfer into it. Once his father is asleep, he has time to wash the dishes, do the laundry, take out the trash, and pay his father’s bills. Then he heads home to his empty studio apartment.

This routine changed a few months ago when the son was convicted of drunk driving (not the first offense) and sentenced to house arrest. He lost his job and had to forfeit his license. He now wears an ankle bracelet to track his whereabouts at all times. With Mom’s help, he got special permission to leave his house every day in order to take care of his father. He has to walk there and come straight back. He’s no longer allowed to do his father’s shopping, so he pays a neighbor to pick up Cream of Wheat, diapers, and other necessities for him.

This morning when Mom was visiting them at the father’s house, she watched the son as he spoon-fed his father Cream of Wheat, like he does every morning. This time the son was wearing an ankle bracelet, too. It stuck out from underneath his sweat pants. It was bigger than Mom expected. It wasn’t the first time she’d seen someone wearing an ankle bracelet, but it was the first time she knew the person wearing it. Maybe that made it more noticeable. She watched as the son – a convicted criminal – spoon-fed his father, just like he’d done every morning and night since his father became ill. A criminal, feeding Cream of Wheat to his elderly father to whom he promised to never place in a nursing home. Not after everything his mother went through.

At the end of her visit Mom told the son that she recently accepted a new job, so his case would be transitioned to new social worker. The son congratulated her, upset to see her go but happy for her new opportunities. He told her she’s lucky to find work in this economy. He didn’t mention how hard it was when you’re on house arrest, too. But his eyes said it for him. He asked where she’d be living and she told him New York State. He said he heard it’s beautiful up there and he’s always wanted to see it. He didn’t mention that he couldn’t because he’s on house arrest. Nor did he mention that he couldn’t travel anyway because his father needed him there. But his eyes said it for him.

Mom said goodbye and wished the son good luck and good health. She told him his father was very lucky to have him -- not everyone would make these sacrifices, even if it’s their own family. He said he’s just grateful the judge allowed him to serve his sentence at home. If he had not, his father would have suffered the same fate as his mother did several years ago – dying alone in a nursing home.

Before turning to leave, Mom caught one more glimpse at the son’s ankle bracelet.

What was once symbolic of a criminal act suddenly represented the son’s selfless commitment to his father as well. As long as that bracelet stayed on his ankle, he could honor his promise to his father. That round piece of plastic and metal symbolized both guilt and compassion.

As Mom drove away she thought of a quote from The Other Wes Moore: One Name, Two Fates: “Even the worst decisions we make don’t necessarily remove us from the circle of humanity.”