It has been almost a year since my mother Ginny turned 90 during the Covid lockdown. At the time, I remember telling her that as soon as restrictions lifted, we would celebrate this important birthday by taking her out to her favorite restaurant, ordering her favorite gin and tonic cocktail and digging into a birthday dessert together… instead of waving through a glass panel.

It is mind spinning what life is like a year later. Her body survived the long lockdown, but her mind did not. It was only a few months later when she would try and walk-out of the senior care facility at 3:00 o’clock in the morning. They promptly placed her into Memory Care – a type of senior living that provides specialized, secure care for people with Alzheimer’s and other forms of dementia.

Although we eventually moved mom to another community; every visit still gives me new insight as to real life inside a memory care unit; and it is eye-opening for the uninitiated.

The first change I needed to get used to was a large metal door, locked with a code, separating memory care residents from the rest of the assisted living community space. Exit-seeking is a common focus for someone with dementia. The resident believes that they need to “get home” or “get to work”, and they try to open the door. Many times, I have witnessed (or heard the loud metal banging) when someone is shaking the door in frustration. The staff is patient; re-directing the resident away, but too often. they return. The urge to meet some invisible obligation is overwhelming strong.

I also learned that the nurses try to keep the doors to the residents’ rooms locked during the day because residents will repeatedly wander in and out of other people’s rooms. Sometimes, they take items, not understanding that the items do not belong to them.

Our first experience with this was when we had barely moved Ginny in. We unpacked her belongings, hung her clothes in her closet, and then returned the next day to line the drawers in her dresser. We found every article of clothing we had hung folded neatly and placed in her laundry basket. At first, I thought she was telling us that she was ready to leave, and had prepared for that departure, but that was not the case.

We learned that there is a gentleman who “packs” his clothes nearly everyday and carries them outside where there is a gated courtyard. The staff will gently assist him in returning his belongings to his room. Based on something mom said, and well, the clear evidence of folded clothing, we figured out that he had visited and “helped” mom with her packing.

One significant change is simply being in contact with Ginny. Since I live three hours away, I am accustomed to checking in by phone. Now, I have to call the front desk, ask for memory care and ask for mom. If it is a good time for the staff, they will find her and put her on the phone. Why don’t residents have phones in their own rooms? We were told because too many of them were calling 911 requesting help in getting out of the facility.

When my husband and I do visit, my priority is to bring a small moment of joy for mom, whether that be a ride in the car, sitting in the nice courtyard (right now, it’s too hot) or taking her into the assisted living common areas for a change of scenery. I have used the opportunity to bring an old scrapbook to look at or call a relative or old friend of hers and pass the phone over so she can say hi. The assisted living section does have an ice cream parlor, so it’s fun to get ice cream together.

Ginny definitely needs to be in memory care, but she is a little higher-functioning than others. As we sat eating ice cream just a few days ago, we heard the metal banging down the hallway. My husband asked “Who do you think is trying to open the door Ginny?” and she replied “Well, it could be any one of us. You know, you have to try” and we couldn’t help but laugh. Her humor still peeks through.

I can’t overstate the adjustments to having a loved one in memory care. If I’m being honest, it’s an almost surreal experience. I arrived one day to find a man inside her living space (the door was unlocked) saying that he needed to find his wife. She had been kidnapped. Or, sitting in the dining area after lunch was over, I watched a resident walk over to one man’s meal (brought in by his wife) and open the dessert and start to eat it while the man was using the restroom. Or, finding my own mom barefoot in the lunchroom because she didn’t like her shoes.

I understand that these seniors once had vibrant lives, whether as mothers and fathers, serving in the military, owning their own businesses or maybe they were world travelers. I’m quite sure that at least some of them once served as caregivers for their own parents.

So, life comes full circle. But in memory care, I can only say that watching a diminished mind in motion is heartbreaking. It’s important to try and visualize who they once were.

In the overnight hours, the nursing team will check on each resident every 90 minutes (there are 16) to make sure they are safe. On a past visit, I had bought colored ribbons on rolls and children scissors so mom could have fun putting different ribbons on her beloved stuffed pet Button. But they told me she couldn’t keep the scissors. They weren’t safe. They even lock all toiletries in a closet, for safety and “theft” issues.

The staff is trained to try and determine what “obligations” the residents are trying to fill when they stand at that door as well as try and find the triggers for those obligations so they can be avoided. They are taught to walk in the shoes of the resident, and sense what solutions would make themselves feel better (or worse) and apply them to the situation.

I feel lucky in the sense that Ginny still recognizes me. That is not always the case in memory care. When I’m asked by family and friends how mom is doing, I find myself saying the same thing: “it’s just different now.” There are no more dinners out, no more grocery shopping, no more trips to the library, no more home visits and drastically reduced conversations on the phone. And Ginny, who has always been extremely independent and “in charge”, feels so passive to me now. It is unsettling to see her personality shifting away from what I have always known. We have entered a phase where we will never return to what once was. We can only move forward and think of new ways to make her smile. I hope to do that when we celebrate her 91^st together.