Mary Graham says good-bye to Mildred Allen after one of her hour-long visits to the 81-year-old's home. A home health care aide, Mary tends to mostly older people, changing their linens, bathing them and helping with their grooming. Photo: Hugh Grannum/Detroit Free Press
DETROIT (Detroit Free Press), January 6, 2008:
It's a little before 8 a.m. when Mary Graham pulls her 1988 silver Buick Regal onto a west side street and rolls to a stop in front of a still-sleepy bungalow that is home to nine people ranging in age from just over a year to 81, and a dog she doesn't trust.
Mary is here to see Mildred Allen, the woman who raised children and grandchildren in this little house, who watched her fortunes rise and fall here, and who has become so ill from diabetes and Alzheimer's that she will probably never leave -- at least not alive.
"How are you today?" Mary asks, cheerfully, hopefully even, as she leans over the bed and tries to wake up Mrs. Allen.
Mary likes to think Mrs. Allen knows her, if not by name, at least by sight. She likes to think that Mrs. Allen looks forward to her twice-weekly, hour-long visits. That Mrs. Allen, who appears lost in a fog of sleep and confusion, knows more than she lets on.
"I don't want to lay there like that. That's no quality of life," Mrs. Allen's granddaughter said one day, as she and Mary were fixing the elderly woman's bed. Mary changed the subject, just in case Mrs. Allen understood.
Mary has lifted Mrs. Allen -- she would never dream of calling her by her first name -- out of the bed and into a wheelchair, and is rolling her toward the shower."Mom, mommy," Mrs. Allen moans.
"It's all right," Mary says.
A tough job
It is difficult to know when or how or where a person will find his or her life's purpose, the thing that makes being alive about more than just getting out of bed in the morning.
But this is where 51-year-old Mary Graham found hers: bathing people who are too ill to take care of themselves and are too much for their families to handle, washing away the sour stink of sickness, leaving them feeling refreshed and renewed even though their flesh may be rotting from bedsores.
There is a great demand for people who do what Mary does, though it's not a job many people want -- the intimacy can be as off-putting as the pay, $11.45 an hour. Which makes experts wonder and worry about who will care for our aging population, our grandparents, parents, even our sons and daughters. Nationwide, about 3 million people work as home health care aides, nursing assistants or personal care aides. By 2017, we'll need a million more. And by 2030, when all surviving baby boomers will be at least 65, we'll need an additional 3 million.
It is not a job many people do especially well, though Mary's agency, the Visiting Nurse Association of Southeast Michigan, gave her an award -- a plaque, a luncheon, a bonus check that went toward car repairs -- for being its best home health care aide, and she was thrilled.
She attended the ceremony in her office's boardroom with her son, Brandon, a part-time college student who works at Home Depot. Mary raised him on her own, never married. Together they live in a neat and tidy two-story house on the east side of Detroit across the street from an abandoned home she says she'd buy and turn into an adult day care -- a place that would be so popular there'd be a waiting list -- if she ever comes into money.
In the meantime, she is in and out of sick people's houses for as long as their doctors and nurses think is necessary and as long as their insurance companies are willing to pay.
Her patients live in the city and the suburbs. She sees some of them -- the 90-year-old man who hurt his leg -- through to recovery. She sees others through to death. But the majority of her patients, including Mrs. Allen, linger somewhere in between, somewhere in the twilight -- that vague time of day between sunset and nightfall when the moon and the sun both occupy the sky. They are alive, but not really living. Dying, but not ready to go.
They rely on Mary to give them back a little bit of the dignity they lost a long time ago. She relies on them, too. They are her ties to her own mother.
'Something's wrong'
Mary wants to take a nap, but the phone is ringing.
It's a sweltering hot afternoon in July 1979 and she is feeling ill.
Darn that phone ....
It's Vanessa, a girl from her mother's neighborhood, calling from a pay phone -- which is odd because the neighbors always use Mary's mother's phone. Vanessa says she and her grandmother are worried because they haven't seen Mary's mother, Glaydean Oliphant, all day.
Mary figures that her mother, who lives alone -- she and Mary's father split ages earlier -- has gone somewhere and will be back home in time for supper, which she'll cook and Mary and her two younger brothers will come over and eat together as they always do.
Mary is especially close to Glaydean, more so than a lot of daughters and mothers. As a young child, she was sickly and spent a lot of time indoors with her mother.
Sometimes, her mother would make her an apron -- she didn't need a pattern, it was just off the top of her head, or, as Mary would say years later, from her heart. And then she'd assign the young girl to stir cornbread batter and Mary would feel proud and safe and, most of all, loved.
As long as she was with her mother, nothing bad could happen.
After graduating from Northeastern High School in Detroit, Mary wanted to be a flight attendant. Her mother, terrified of airplanes, begged her to choose another career. Mary thought about being a kindergarten teacher. She always liked kids and had enjoyed dressing her younger cousin and walking him to school. She took some courses at community college.
To pay the bills, she took a job reading meters for the electric company.
She'd just gotten home from work when the phone rang. Now she is back in her car, driving the four or so miles to her mother's place to make sure everything is OK.
Mary opens the front door and is hit by a blast of stagnant air that makes her feel as if she is suffocating.
"Mama, Mama!" she yells.
Glaydean Oliphant is sitting on the couch with her orange cat at her side. Saliva is dripping from her mouth. She is wet with sweat. Her eyes are open, but she seems to be asleep.
Mary screams for a neighbor. "Call 9-1-1! There's something wrong with Mama!"
Home is the best place
Sickness tests people.
Being close to it breaks some, causes them to walk away.
But it also makes some people stronger. It helps them see what's important, what they can't live without, who they can't live without. And, during the summer of 1979, that's what is happening to Mary.
Mrs. Oliphant, 61, has had a series of strokes that have left her unable to walk, struggling to talk and generally confused.
Doctors suggest a nursing home, but that makes Mary uncomfortable. The strokes have changed her mother, but sending her to live somewhere else would mean losing her altogether. And Mary isn't ready to do that.
She knows the best place for her mother is at home with her.
Her siblings agree.
She leaves her meter-reading job and becomes her mother's full-time caregiver. "I thought she was going to get better," Mary would say years later. "She didn't get better. She didn't get any worse. She was at a standstill."
The transition is difficult, both for Mary, who is used to being able to come and go as she pleases, and for her mother, who is used to running her own household. Mrs. Oliphant had always been a modest, private person and now she can't eat on her own, can't go to the bathroom alone, can't wash herself.
Mary can't do it either -- take off her mother's clothes and cleanse her. She doesn't want to embarrass her.
But she knows she'll have to force herself to do it -- to cross the threshold that will forever transform her mother into a child and Mary into a parent.
As she is bathing her in the tub one day, Mary looks at her mother and sees tears rolling down her face. She is sure they are tears of embarrassment, though her mother doesn't say anything, and Mary wants to cry, too.
One morning in November 1986, Mary's mother grabs her daughter's nightgown and won't let go.
"What is it?" Mary asks.
Her mother looks her straight in the eyes and says, "Thank you for everything."
A few minutes later, she dies.
'I love coming here'
One of Mrs. Oliphant's visiting nurses, impressed with the way Mary cared for her mother, suggests she pursue a career as a nursing aide.
And that is the job Mary has had for the past 20 years.
She likes old people, she likes to know how couples met, and she is always impressed when she meets a husband taking care of his wife, a husband who didn't run when things went bad. It is a commitment she never had from a man. And as for who might take care of her if anything happens, she says she hasn't thought about that. She says she doesn't expect anything bad to ever happen to her.
"Mary is the best!" says 90-year-old Henry Washington, who needed help after spraining his ankle. Many of her patients consider her part of their families."Mary is my girl! Mary is the best!" says Henry Washington, who is 90, lives in Detroit and has sprained his ankle. He is happy to see Mary.
"Bless his heart," Mary says. "You know I love coming here. ... What have you been doing?"
He tells her he's been walking with his walker.
"I'm proud of you," she says and she means it.
Her patients show her pictures of themselves when they were young and full of promise. They -- or their family members -- show her pictures of children and grandchildren.
"I truly, truly believed that she loved my mother and my mother loved her," says Marsha Fischer, who hired Mary to look after her mother, Rose Diem, on Mary's days off from the visiting nurse agency.
Diem died two years ago and toward the end, Fischer says, "even though my mother wasn't talking, Mary would talk to my mom. ... Sometimes if my mom was sleeping, say if she had a seizure or was sick or something, Mary would be sitting in her room next to her, talking to her or watching her. She didn't just leave her there."
Stephanie Cox, the daughter of one of Mary's patients, a woman who has been bedridden since a brain aneurysm 31 years ago, sees Mary approaching her parents' Detroit home and runs down the front steps. She wants to show Mary her diamond and tell her how her boyfriend proposed during a ride in a hot-air balloon.
Mary makes a fuss and Cox is delighted. Her mother's short-term memory -- everything since the aneurysm -- is shot, so that no matter how many times Cox tells her about the engagement, she doesn't remember.
The woman doesn't even know how long she has been married, though Mary got an invitation to a family party when she and her husband marked their 50th wedding anniversary in June.
"Mary is part of the family," says Cox.
And Mary would have attended, if the party hadn't fallen on the same day as her son's birthday. He is 21 now. For as long as he can remember, his mother has been taking care of other people. "She has a big heart," he says.
He has seen her mourn the death of some of her patients. Seen her put sympathy cards in the mailbox. Seen her get dressed to attend their funerals. Seen her become teary with grief.
Patients tell Mary they want to die and she tells them she's pretty sure God has every single person here for a reason. If they start questioning that reason, or start questioning God, Mary will say, "I can't help you on that because I got to stand in front of him too, one day."
Mary's boss asks her to check on a hospice patient whose regular aide is away.
His hair is dirty. He is lying in his own waste. His caretaker swears he'd just cleaned up the sick man, but Mary can tell the mess isn't fresh. As she cleans him, she thinks about what little regard some people have for the dying. It still surprises her, after all these years. When she finishes her work, the man, unable to speak because of a tracheotomy, holds her hand.
She gets word a couple of days later that he has died, and she feels relieved.
She believes in Heaven, which she hopes is like Hawaii. But even if it's not, she knows the hospice patient is better off now. He isn't suffering anymore.
Sometimes, she says, "I look at my patients and I say them a prayer. I say, 'I hope they see my mom.' "
Knowledge and understanding
It is just before Thanksgiving and Mary has just wheeled Mrs. Allen back from the shower and is combing her hair.
Mrs. Allen has grown more frail. But every time her family thinks the end is coming, she rallies and pulls herself away from death. She and her granddaughter, Cindy Boyd, were good friends. Maybe they are still, depending on how much Mrs. Allen knows and whom she recognizes.
Mary, Boyd says, understands everything because she knows what it's like to stay home with a sick relative. "Everything she did with her mom, she does with her patients."
Mary sees her mother in some of her patients. She sees her mother's neediness and her pride and her struggle for dignity.
She misses her mother.
She thinks about her every day.
Mary has gotten Mrs. Allen back in bed now and the elderly woman appears to be sleeping. But suddenly, she opens her eyes and stares down everyone in the room.
You wonder what Mrs. Allen is seeing, whom she is seeing.
You wonder whom Mary is seeing, too.
By Georgea Kovanis
Copyright © 2008 the Detroit Free Press.
