The number of seniors in Ontario will increase by 30 percent in ten years. This information was phlegmatically attached to recent news reports of allegations of abuse at a long-term care facility in Peterborough, Ontario. Camille Parent’s 85-year-old mother, Hellen MacDonald, suffers from dementia and resides at St. Joseph’s at Fleming, a non-profit seniors’ residence affiliated with Fleming College. When Parent found her covered in scratches and bruises earlier this year (having previously suffered broken bones after an attack by another resident), he installed a hidden video camera in his mother’s room for three weeks. The camera captured horrible images of abuse, contempt and neglect: a “caregiver” roughly handling the clearly docile patient while changing her (door to the room wide open) and then shoving a feces-smeared cloth in her face. An attendant blowing his nose on her clean sheets. Two employees apparently making out at the foot of the patient’s bed. A male resident entering the room (the door again wide open) and rifling through Mrs. MacDonald’s belongings.
The employees of St. Joseph’s were suspended, with pay, and later fired. “We have a zero tolerance for abuse in our long-term care homes,” said Deb Matthews, the Ontario Minister of Health.
This is the nightmare of my generation. Because we all may get to be characters in this drama, not just once, or twice, with power of attorney over our aging parents suffering from disease or dementia, but a third time, when we too become residents in a long-term care facility. (It does not matter what it is called—“home” for the aged, nursing “home” or care facility—it is the place where no one ever wants to go.)
Janet Hepburn’s mother, Anna Mary Greenslade, lived with Alzheimer’s for ten years before her death in 2011. In her mother’s memory, Hepburn has written a short first novel, Flee, Fly, Flown, in which she imagines precisely how her mother’s mind might have worked, and, I imagine, what she might have wanted more than anything else—to get out of the nursing home. Hepburn’s protagonists, Lillian and Audrey, two elderly, spirited women suffering from dementia, figure out how to escape from their nursing home, get a banker to release money from an account for which adult children have power of attorney, borrow a car that used to belong to one of them and set out on a road trip across Canada.
In fact, Audrey and Lillian get not much further than the bank when it becomes apparent even to them that driving is harder than it used to be and that they may have difficulty finding the way west. Fortuitously, a sweet-tempered, broke young man named Rayne is loitering in a state of indecision on the sidewalk outside the bank, and he agrees to drive their car. Implausible as this seems, it makes perfect sense to the reader that these women with slippery memories and a kid a long way from home might make a confederation; their desires and capacity for judgement inhabit common ground, that of wanting freedom, escape from adult supervision and deadly routine. Everybody wants to run away from home at some point in their lives.
Home in this case is the (fictional) Tranquil Meadows Nursing Home in Ottawa. Hepburn nails the infantilizing routine and artificial, pastel cheer of such places: “During breakfast, the woman in charge of keeping us busy with silly games and repetitive singsongs—I’ve forgotten her name— zigzags between the tables, inviting each person to come to the recreation room to make ‘late summer bouquets from fabric and pipe cleaners and seed pods’.” Plastic sippy cups for watery coffee, Jell-O and alarm bracelets. Bingo and TV. Clothing with name tags, like camp: “Every article of clothing has a big white tag stitched on it with my name—even socks and bras. I can’t figure out how it is that my clothes are always getting stolen right out of my closet when they’re marked so clearly. No one believes me. They say the missing clothes are in the laundry, or that I’ve never had red pajamas. But I’ve seen other people wearing my clothes. I have.”
Home, briefly, for my own mother 20 years ago was the Cardinal Care Nursing Home in North Carolina. My mother’s mind was quite sound, but after a series of small strokes she was unable to speak or dress herself. She too lost control of her wardrobe; one day I went to visit her and she was wearing what would have been in her own eyes, and mine, a costume—an ill matched skirt and blouse with a fluffy bow unlike anything she had ever worn or owned. There is a continuum from such apparently trifling indignities and outright abuse; how much will a “resident” tolerate? How much will adult children pretend not to see, because they are convinced that there is no alternative? How much do adult children choose to leave unaddressed because it seems their parent has not noticed his or her own disarray, dishevelment and incompetence?
Hepburn’s story is told by Lillian, who maintains some order in her own mind by writing down anything she considers important. Vacation. Address of the bank. Shoes. Knapsack. And one day, after she and Audrey have managed, in a crafts session, to cut off the blue and white bracelets that make them trackable, “wristbands gone.” In the nursing home, Lillian slides between clarity and confusion, cheerfulness and depression: “Days blur together. I suffocate beneath a heavy woolen canopy suspended too close to my face. The invisible shroud makes it hard to breathe. I stay in bed. People come and go … My mother is here and my granny … Albert sits on my bed and stays for a long time … I tell him I love him, then I hit him and tell him to leave. It’s his fault that I’m in this awful place … I get up to use the bathroom, but when I do, the lady in the next bed pounds on the door … After that, I just pee the bed.”
But through a combination of luck and surprisingly resilient residual strategic thinking, Lillian and Audrey walk out of Tranquil Meadows. With Rayne (whom Lillian often thinks is her son, Tom) at the wheel, the road trip is underway— Mattawa, Cochrane, Thunder Bay. Rayne slowly realizes that he is ferrying fugitives from a nursing home but chooses to make the trip work; they abandon what is in fact a stolen car, rent a van, keep moving. Kenora, Moosomin, Swift Current…
There is comedy, poignancy and an unnerving mix of compassion and dispassion in how Hepburn imagines the challenges of conversations, pain, unreliable bodily functions, confusion and encounters with strangers both kind and vicious. There are simple joys—finding a dog, sleeping on a beach, scoring big at a casino, remembering longforgotten lyrics and singing in unison, while making a kaleidoscope out of the faces in the front seat. There are moments of terror and despair, but also acceptance, when the chasm of memory suddenly opens and swallows up something as small as the ability to read a clock.
Hepburn’s tone is light, nothing tragic happens, but the book is upsetting. Its unblinkered, matter-of-fact portrayal of a truly demented road trip is more literal than literary, its prosaicness a too sharp rendering of what many among us fear more than anything else, the loss of our minds and freedoms as we too age.