INVISIBLE BARS

“Albert”, eighty-six, has suffered from Alzheimer’s Disease for over ten years. He is widowed and lives in a Residential Care Facility where someone is available twenty-four hours a day to attend to his needs. Albert is able to walk slowly with some assistance. He has cataracts and can barely see. He is very hard of hearing and one must speak into his one good ear in order to communicate with him. Albert understands simple instructions.

Albert has been in a recent decline to where he is weaker, sleeping more and eating less. He is getting more confused and has started to resist staff when they are trying to assist him. Albert has four daughters, although only his youngest, “Betsy” ever routinely visits.

The hospice nurse and I went out to meet with Albert and Betsy this morning to admit him to our hospice program. Albert was sitting about fifty feet away from us in a recliner chair. Every so often, he would start a conversation with no one there. Betsy said her dad talks to John F. Kennedy quite often. Albert would laugh, then sit back in his chair with a contented look on his face.

Betsy lives about thirty minutes away and visits weekly. She said her other sisters rarely visit. Betsy’s eldest sister lives two states away and suffers from Multiple Sclerosis which limits her activity level. She does fly down occasionally to visit her dad and help her sister as much as she can.

Betsy said another sister lives nearby but only visits every three to four months. Betsy said her sister is in strong denial and wants things done to keep her dad alive. Fortunately, Albert assigned Betsy as his agent on his Advanced Directive so only she, legally, can express his medical wishes.

Betsy’s third sister, who had been a big help to Betsy, was recently incarcerated. Betsy added that they don’t know how long she will be in prison. It is a huge loss for Betsy as she was the only sibling who helped out.

It made me think that bars can be visible and invisible. Prison bars are strong and impassable. In addition, one can feel just as trapped with limitations due to poor health. Also, the invisible bars we place ourselves, are just as powerful and impenetrable.


INVISIBLE BARS
　

He seems happy and pretty content,
although his memory is all but gone.
He talks when no one is about.
His vision and hearing have faded away.

He’s trapped inside his body
by invisible bars hidden from view.
There is no way out for him;
no magical key.

He has four grown daughters,
but only one ever comes around.
The eldest lives in another state.
Multiple Sclerosis keeps her away.

Another is in strong denial.
Her visits are many months between.
She cannot face her father’s prognosis.
Staying away makes everything okay.

A third daughter was recently arrested.
She will be incarcerated for a long time.
Her bars are real and holding her inside,
leaving her one sister to carry the burden alone.

Invisible or not, both bars are equally strong.
Even though few ever escape from a prison cell, 
the invisible bars of poor health; of denial
are the most compelling bars of all.