“A cat makes all the difference between coming home to an empty house and coming home.”
UNKNOWN
ONE AFTERNOON A FEW DAYS AFTER RUTH’S DEATH, I was seated at the nurse’s desk on the dementia unit, scribbling a note on one of my new patients, when I was interrupted by a commotion. Looking down the hallway, I noticed Maya chasing Oscar at full speed the way cats do when they are bored. Suddenly intrigued, I stood up and watched as they sped down the hallway past Louise Chambers, asleep in her chair. Then they were gone.
The scene of cat chasing cat in innocent play made me smile. As Mary said, this third floor really was their home. I looked past Louise in the direction of the departed cats. The afternoon sun had just started to make its impression, setting the walls aglow. Soon it would illuminate much of the hallway, then fade. It wasn’t a lasting impression after all. I found myself thinking about Ruth Rubenstein; her death was still fresh in my mind. An hour earlier I had stopped by her room. I lingered there alone. I studied the unoccupied bed, neatly made, and the barren walls. Gone were the pictures of her youth, her husband, her past. The room was no longer hers, save for the faint reminder of her perfume. That too would disappear in time.
The main doors to the unit clicked open, interrupting my thoughts. I turned toward the door and saw Mimi, the admissions coordinator, escorting an elderly gentleman and two younger women onto the unit. They looked like sisters. They were on a tour of the facility and Mimi was in the midst of describing the unit.
“This is our advanced dementia unit. It is forty-one beds and staffed by nurses twenty-four hours a day…”
Suddenly the door closed behind the family with a thud, locking them in with the residents. I could sense their discomfort, even from a distance. They listened politely to Mimi as she carried on with her explanation, but I could well imagine what they were really thinking: How in the hell do we put our mother in this place? The doors lock behind you! What did she do to deserve this? I’ve seen this before: the deer-in-the-headlights look of a new family.
Mimi led the tour down the hall toward Ruth’s room. She pointed out key locations on the unit—the kitchen area, the dining room, and the nurse’s offices. As they passed Louise, asleep in her chair, one of the daughters stopped briefly to consider her.
I could almost hear the questions in her head as she studied Louise: Is she clean? Is she happy? Do they take care of her?
She was looking for reassurances that they were making the right decision, that they were in the right place.
I didn’t envy them.
The lady moved over and studied the pictures on the corkboard next to Louise’s door. For the first time since she arrived on the unit, she smiled. Then she disappeared down the hallway, chasing after the rest of her family.
I returned to the note I was writing. Something brushed against my feet. I looked down.
“Hello, Oscar.”
He had finished his playtime with his sister cat and was looking up at me.
“I heard you were with Ruth when she died.”
Much to my surprise, he sprang up onto the desk and sat down, staring at me as if to say hello.
Our eyes met and he started to purr.
“What’s up, Oscar?” I asked, nervously reaching out my hand. “What’s going on?” What if he was like Lassie, as I joked with Mary all those months ago, trying to say someone had fallen down the well? What if Oscar was trying to tell me something?
He considered my hand and then moved his face in toward it as if to say, Scratch, stupid!
I relaxed and began to scratch under his chin. I pulled him closer and he continued to purr more loudly. We sat together, sharing a moment, before we were interrupted.
“Hello, Dr. Dosa. I want to introduce you to the Carey family.”
I looked up to see Mimi returning with the family. Oscar saw them too and began to take his leave. He leaped out of my grasp onto the floor before sprinting down the hallway.
“Cats,” I said, by way of introduction, and leaned over to offer my hand.
Both daughters smiled.
“Do you have any questions about the unit?” I asked, trying to be helpful.
“Do you always have cats here?” one of the daughters asked incredulously.
“Absolutely. We have two cats on this floor and four more downstairs, along with a rabbit and several birds,” Mimi answered.
“That’s so nice,” her sister responded. She was the one who had been studying Louise earlier. She turned to the father.
“Dad, Mom really loved cats.”
Past tense.
“You mean, your mother loves cats,” I said.
She gave me an odd look, perhaps slightly embarrassed. I realized how many of the families I worked with spoke of their loved ones with dementia as if they were already gone.
“Actually,” I said, letting the poor woman off the hook, “we’ve found that the presence of animals really helps residents in the latter stages of dementia. Your mother will know that they’re here.”
“Really?” the woman asked.
“Yes, I didn’t really think so myself at first, but I’ve spent enough time up here to realize that the animals really do make a difference for the residents and the families.”
The woman gave me a questioning glance that I immediately recognized. It was probably the same look I had given Mary the first time she had shared her musings about Oscar.
“I suppose there is just something about animals that still gets through.” I paused for a second. “I’d like to think they have something to teach us, too.”
The woman nodded and looked around, “So, what do you think, Dad?”
“I think this is the place.” He attempted a smile—an effort, given the circumstances and turned to Mimi. “If it’s still available and you’re willing to take care of my Lucy, we’ll take the bed.”
Mimi nodded and escorted the family out of the unit, deep in conversation about the various forms and paperwork that would need to be filled out.
As they left, Mary appeared from down the opposite hallway, pushing a resident in a wheelchair. She parked the patient by the desk and then reached over to give the woman a hug.
The woman smiled and returned the embrace.
“What was that all about?” she asked me as she rounded the desk to sit down.
“Mimi was here with a family. It looks like we’ll have a new resident in Ruth’s bed.”
“We always do, David. They never stay empty for long.”
The afternoon sun had faded now, like words written in water. Halfway down the hall I saw Oscar appear out of one of the rooms where he had taken refuge from the visitors. He looked at both of us and paused for a moment. Then he turned and trotted purposefully down the hall in the opposite direction. When he came to the last room on the right he stopped and appeared to sniff the air. Then with a flicker of his tail, he disappeared into the room. I looked at Mary with the hint of a smile. Was Oscar trying to tell us something?
I was listening.