distant and largely unconcerned. He had taken the news of his mother’s stroke with a disgruntled moan and characterized Gerda as “difficult.” He said he’d tried on two or three occasions to get her to see that the only real way he could take care of her in her old age was if she moved to Detroit where he and his family lived. Gerda had flatly refused. She was even unwilling to consider selling the house, he said, even though she could get a good price for that property, because it was a desirable location for rural development. He’d pointed that fact out to her several times. Why did she want to keep it? It was far more space than one person needed and starting to get very run-down because she couldn’t afford the upkeep and was simply past being able to do any of it herself. But his mother was difficult. She would never compromise to make it easier for anyone to help her. He was a self-made man, he explained. He’d pulled himself up from nothing. Got a good education, married into a good family, started a successful business, and really had made something of himself, but it hadn’t been easy. It was still hard work. He couldn’t just drop things to be at his mother’s beck and call.
The daughter was even less involved. When social workers had entered Gerda’s house after the stroke, they found photographs of the daughter, her Spanish husband, and their two children, but there was no way to tell when the photos had been taken. They couldn’t even find reference to the daughter’s name in the house. This was possibly not due to any purposeful removal but simply because Gerda did not seem to be a “keeper.” Her house was immaculately clean, in spite of all the cats, but also spartan. Joy had obtained the daughter’s name – Anna – from Edward, but this was clearly not a close family. He and his sister, who had returned to the States only twice since her marriage twenty-three years earlier, had no more contact than Christmas cards.
So that was the situation, Joy said. Social Services were now dealing with Gerda’s immediate future. She could only remain in the rehabilitation unit as long as it was apparent she was actually in the active stages of rehabilitation. For most stroke patients this lasted three to six weeks. In the doctors’ opinion, Gerda seemed to have made this initial recovery. Now decisions on her future placement had to be made, such as how much longer would she need full nursing care and would she be able to resume an independent life eventually? Could she care for herself in an isolated location such as her own home? At the moment, assisted care seemed more appropriate, or, indeed, full-time nursing home placement. Of course, all of this required money. A decision needed to be made, which would most likely entail selling her house to finance assisted-living arrangements.
Joy sighed. As the social worker, she had spent time trying to explore these various scenarios with Gerda, and Joy’s overall impression of the old woman was not one of a stroke victim so much as a very depressed individual. Depression, Joy said, is common among elderly patients who lose their independence and suddenly find themselves sleeping in strange beds, eating strange food, and having to live according to strangers’ rules. Joy was accustomed to dealing with that, but in this instance, it was grossly complicated by Gerda’s lack of speech. Joy had consulted the gerontologist supervising Gerda’s case and told him that she felt Gerda’s mutism might be largely psychological, due most likely to depression. The gerontologist put Gerda on Zoloft, which, if anything, had made Gerda even more subdued.
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