Excerpt: The Stemwinder: Stories of a Faithful Care Manager

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Very excited to share an excerpt from my upcoming book, The Stemwinder: Stories of a Faithful Care Manager.


Chapter 2: Dark Swells

Along this journey I’ve encountered situations where I unwittingly entered the orbit of some malevolence, like a moth navigating darkness that gets snagged in a hidden spider web. The occasions have been few but memorable and involved characters that were uniquely “creepy.” It doesn’t take a degree in social work to know that dysfunction and discord are common with most families. Then there are secrets. Whether buried, denied or protected, they do their damage. Some are so virulent they’re evident to an outsider.

Such was the case with Edward. I worked with him for a brief time. Though he was always respectful with me, I was never comfortable around him. I sensed something really foul behind his otherwise polite disposition.

Edward was a Pennsylvania Dutchman, an old school, hardworking laborer. He and his wife built the home they raised their children in. Modest house. Beautiful acreage. His wife barely knew who he was due to the severity of her dementia. In the time I worked with the family I only saw her twice. Edward had two daughters and three sons. When they came to see him at the care facility they recoiled from their father. Even the staff noticed the strained interaction.

There was never any touching or hugging. Their presence seemed to be out of obligation.

Later I learned he violated his eldest daughter from a young age. Everyone knew. They witnessed it but nobody said a word. His son and daughter-in-law confided in me. It was one of those situations where I had to both absorb and compartmentalize the information. As Edward’s Power of Attorney it was my responsibility to sell the house, take him to the doctor, and oversee financial matters. He was compliant. He thanked me. It physically made me uncomfortable to be in his presence. I saw the mission through and worked with his kids to place his wife of sixty years in a nursing home. At the time I suspected there was a timeworn wedge between them. Dementia widened the gap. She didn’t know who he was. A tragic blessing.


Blind Rescue

After an exhaustive two weeks of looking, I finally found a “no kill” facility in Delaware County. The manager told me for five cats they’d accept a donation (I offered them eight grand). I was so relieved that part of the rescue mission was taken care of. I had to make two return trips to Irene’s house to get all five cats. There was no circumventing the fact I needed Craig’s help. I made a point of notifying Beth so she knew where I was headed, at what time, and that he’d be with me in case something unexpected went down.

And so, once again, I was placed in his company where sure enough, I was thoroughly blindsided. When we picked up the cats on that first trip we loaded them into my car. Before we headed out, Craig, in a very matter of fact tone, announced he was carrying. He was so bizarrely casual about it I had to discern on the spot whether that was a veiled threat or his brand of small talk. I asked him where it was to which he replied, “my ankle.”

Never a dull moment.

I told him the only way he could ride in my car is if he kept his piece out of my sight. The seriousness of my tone didn’t leave any room for discussion. He respected my request.

Thankfully, the vet told us the cats would be fine after some much needed care. I was really hopeful they’d be adopted. They were beautiful animals. Show cats. The shelter administrators couldn’t have been more helpful (little did they know one of us was packing heat). On the ride back Craig talked about Irene’s attachment to her babies, how they were her world after she lost her husband.

Over the next several days I cried my eyes out. I was so distraught over how I was going to tell her what we did. I only knew I had to approach the situation with extreme care and hope for the best.

Neighbors speculated Irene started to go down hill after David’s death. A new septic system had to be put in because she had forgotten all of the maintenance that needed to be done. When it came to upkeep, she couldn’t put two and two together. Lucy pitched quite a fit when I briefed her on my visit.

“No furniture from that house can come in here. No clothes. No blankets. Nothing. There’s bed bugs, there’s mites…” As if she’d done the walk through herself.

“Listen, Irene can’t go back there. Out of the question. So what do you suggest?”

Lucy was short on immediate solutions. That was my department of course. She was wonderful with Irene and I really appreciated her for it. But Lucy also had a habit of imposing her opinion and asserting a know-it-all position even when she didn’t. I either had to find an apartment, buy a condo…some-blessed-thing that would smooth the transition.

My next visit with Irene was figuring out a way to soothe her patent expectations:

“When am I going home? I don’t want to stay here.” She was in one of those moods where the chances of talking her down were fifty-fifty.

“I know, but the doctor says it’s too soon for you to be moved.” Irene wasn’t on board with that answer. I followed that up with what I hoped would make her feel somewhat better:

“I’ve got the keys to your house and the car. I also have the checkbook so you don’t have to worry anymore.” I casually added, “Quite a bit of cleaning to do in there.”

“I don’t have that much. I’ve been in the hospital and things just got out of hand.”

“Irene, I had to climb over two mattresses to get to your closet.” It did neither of us any good to avoid the obvious.

“Craig did that.” I heard hostility in her voice. “He’s not a very nice man. You can’t trust him.”

“Everything’s fine, Irene.” I wanted to believe my own words.

“How are my cats?” My stomach tightened. “We’re taking good care of them.”

“I’d like to see them.” Whoops. Tripwire.


A momentary glitch as I tried to retrieve the right words. I replayed snippets of the fiasco, the dizzying task of getting the cats out of the house and into a shelter. Forced to drop the verbal dodge ball, I told Irene where they ended up.

“Why did you give them away?” My gut imploded a second time.

“Because they need special care and they miss you, Irene.”

She turned sullen. I felt for her as an animal lover, the weight of being separated from beloved pets handed off to strangers. At that time the aides told me Irene had bouts where she’d be very sad, very tearful. The fragility I saw from day one wound me up like a toy soldier set on going beyond the call. I wanted to be her lifesaver.

During that whole period I was falling in and out of favor with Irene. At times I kept my distance not out of preference but necessity. When she got herself worked-up there was a wall I couldn’t penetrate. Beth filled in. They had their own connection that allowed ongoing support of Irene’s psycho-emotional needs. She continued to have medical problems: trouble ambulating; lifting her feet; she became incontinent. All of these issues were an indication something was starting to become unhinged.


The ‘First’ Eruption

I suspected but didn’t know. I had a feeling but couldn’t verify. The feeling that became the gnawing that wouldn’t subside. Fragility. Vulnerability. Those were the things I saw in Irene when we first met. The more time I spent with her, the more I grew concerned there was some preexisting trauma separate from the car accident. A word that’s used in this field ad nauseam, trauma is at the core of most of the issues I’ve encountered in the psycho-emotional realm. How it reveals itself is as varied as the patterns of a kaleidoscope.

As a social worker I’m trained to recognize the signs but they’re just the siren call. Sometimes what you’re looking for is obscured by an overlay of normalcy. When I step back and review some of these situations, I liken it to a snow globe: from a distance it’s a picture of tranquility. When shaken, the environment is suddenly disturbed and takes time to settle again. It wasn’t long before I found myself standing in the middle of Irene’s snow globe, violently joggled.

It was late afternoon on a Friday. I was at the bank dealing with some Medicaid paperwork for another client. My wife and I made plans for an evening out and I was anxious to get the weekend started. It was quarter to four when my cell phone rang. One of the nurses from the care facility was calling.

As soon as she spoke I knew that something was wrong.

“Is Irene all right?” The default question contrary to the obvious.

“Not exactly…” The pit of my stomach contracted as her next words came through like molasses.

“We went to do our monthly body check and she got really agitated. We had to remind her about checking for sores being a diabetic. We finally got her to calm down… Denise, she’s covered in bruises.”



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