More than just an epitaph
Looking back at loving and losing the last of her generation
The last time Aunt Ruth spoke to me was on May 12. We were in the dining room at Country Cottage, the memory care wing of the Chelsea, an assisted living community in Washington Township. My dog Jessie was with me. The director saw me pulling into the parking lot and allowed me to bring Jessie inside if I promised to stay for just a few minutes. Before he changed his mind, I swiftly led Jessie down the bright hallway, past the mailroom and beauty salon, and pressed the four-digit code on the security pad.
The memory care unit housed a number of residents, like Ruth, who were confined to wheelchairs. It was almost 4:30, and the aides were busy moving people from the television viewing area to their dining tables. My eyes were drawn to the rolling end credits of an “I Love Lucy” episode; I can still hum its memorable theme song.
Residents sat four to a table — some talking to no one, some chatting to someone who may or may not have been listening, some tapping their hands on the table to the Lucy music, and some with their chins on their chests, fast asleep. Jessie was instantly overstimulated by the scene, pulling me toward the person she was most familiar with — Aunt Ruth.
Scanning the room, I noted the looks on the residents’ faces. I wanted to be sure that no one was afraid of Jessie. A few asked if she was a girl or a boy. Some showed no interest in her, too focused on the aide who was cutting up their food. The residents who were interested didn’t ask Jessie’s name. Instead, they called their own beloved pets — pets from the past, pets that had died long ago, pets that their owners may not have thought of in years. “Here, Misty!” “Here, Duke!” “Here, Lucky!”
Unfazed by her mistaken identity, Jessie was eager to please, pulling me from one table to the next, letting each person embrace her as though she were his or her own. She willingly complied with each request — giving her paw, sitting for cuddles, nestling her face on laps. She was thrilled by all the attention. After she made the rounds, I brought her to Aunt Ruth, who had a big smile on her face, likely feeling something like a celebrity. “This is my niece, Debbie,” she said to the others at her table. “And her dog,” she paused. “What’s the dog’s name again?”
“Jessie,” I told her. “Jessie,” she said.
As the residents’ meals were served, and the excitement at Jessie’s visit dwindled, Aunt Ruth asked me the questions she asked each time I visited. As I’m sure her other nieces and nephews and great-nieces and -nephews were also able to do, I knew what the questions would be: “What’s doin’?” “Did you go to work today?” “How are the boys?” “Did you pick them up from school?” “Don’t you need to feed them dinner?” “How is your mother?” “Your father?” “Gloria?” “Paul?” Then, looking around for the husband who wasn’t there, she’d apologize for his absence. “I don’t know what’s keeping Uncle Howard,” she’d say. “He should be here soon, but he’s late for dinner.”
Ruth’s devoted sister, Fran, who visited Ruth regularly at Country Cottage, also knew the questions Ruth would ask about the health, well-being, and goings-on of their mother, Jean, who’d died in 2007.
Having served as medical advocate for five elderly family members, three of whom had suffered from dementia long before their deaths, I’d learned the value of going with the flow of nonsensical conversation. The professionals had taught me: no corrections, no clarifications, no accusations, no commentary. And after arguing with my late mother-in-law in 2022 that it was Queen Elizabeth II, not her mother, who was lying in state for eight days at Westminster Hall, I’d given up and kept my mouth shut.
So on that Monday in May, I replied to Aunt Ruth’s inquiries cheerfully, pretending that my 30-something kids were still small, that my late parents and in-laws were still alive, and that her late husband, Howard, was just delayed and would be there soon to join her for dinner.
That’s how I communicate with someone with dementia. Keep it simple. It’s a skill I learned from years of life experience.
It was a short visit. Jessie had become more interested in the food on Aunt Ruth’s plate than Aunt Ruth was, the aides were eager to move everyone through dinner, and I needed to go. After taking the requisite photo to mark the moment, I gave Aunt Ruth a hug and waved to the other residents, wondering what each of them must’ve been thinking, hoping their memories of their beloved pets were happy ones, and feeling a knot in my stomach for just how seemingly fragile each of their lives had become.
Three days later, Fran and I got the dreaded call, telling us that Ruth had fallen out of bed and was being transported by ambulance to Valley Hospital. There, they’d do an X-ray to determine if she’d broken her hip. We feared the worst, knowing how common it was for someone at her age and stage to suffer a break. When Dr. Hammock, the emergency room physician tending to Ruth, called, first to confirm I was in fact her daughter — I wasn’t — then confirming I was in fact her medical power of attorney — I was — he told me that her hip was broken. But we knew that a hip replacement wouldn’t be possible. At her age, she might not survive the anesthesia and would never be able to manage a rehabilitation program.
Everyone who had cared for Ruth or cared about her knew the limits of her ability to be an active participant in her healing. We couldn’t take the chance of her experiencing hospital-based psychosis while at Valley or the confusion that might follow once she was transferred to an inpatient rehabilitation center. Moving too far from the familiarity and warmth of her daily routine in Country Cottage might put her over the edge.
Instead, we engaged the Grace Hospital team at the Chelsea.
Next, Fran, my husband, Jay, the hospice team, and I decided that Ruth would return to Country Cottage for pain management and care provided by a team whose names she might not know but whose faces she certainly would recognize. The staff adored her, would cater to her, and undoubtedly would keep her as comfortable as possible.
It was the best we could hope for.
The ER physician, who continued to refer to Ruth as my mother, concurred with our decision to send her back to the Chelsea. He felt there was a chance the bone might heal on its own with round-the-clock monitoring, pain control, and bed rest.
Ruth and Howard had not had children, but they were blessed with nieces and nephews who provided them with endless joy and purpose. Ruth’s posse of friends, some from as far back as grade school, also had children whom Ruth loved. And when two of her closest friends died way too soon, Ruth unofficially adopted their daughters, treating them as lovingly as a mother would.
When I married into the family and gave birth to our three sons, Ruth and Howard became Rob, Kenny, and Danny’s third set of Fair Lawn grandparents. Our friends marveled at our unique opportunity to spend time with and depend on not two, not four, but six elders who could babysit, provide a ride to practice or Hebrew school, help out in an emergency, cheer on the sidelines of a baseball game or applaud at a musical performance. From bris to bar mitzvah, orientation to graduation, Aunt Ruth and Uncle Howard participated right alongside my parents and in-laws in the everyday moments and special occasions of our kids’ lives.
The cherry on the sundae was that they were just as involved in Fran and her husband Stuart’s kids’ lives and the lives of the children of many friends, neighbors, and business associates.
So many times, I’d look at our three boys, surrounded by the six Fair Lawn elders, and think, “Who’s got it better than us?”
In 2020, the covid pandemic coincided with a significant decline in both Ruth and Howard’s cognitive status. I was honored to be asked to serve as their medical power of attorney. Just as I’d supported my parents and in-laws throughout their later years until they died, I was prepared to bring the same knowledge to my decision-making, resourcefulness to their care, and meaning to their lives.
It doesn’t surprise me how quickly I fell into step once Aunt Ruth returned from the emergency room on May 14. From that moment on, I knew that whatever was on my calendar could be canceled or postponed, that I’d be in regular communication at all hours with both Grace Hospice and the clinical staff at the Chelsea, and that Fran, my partner in Ruth’s care, would grow accustomed to hearing from me at least a dozen times a day.
The vigils were long, emotional and wearing for everyone who knew what had happened to Aunt Ruth. We watched her light diminish by the day. Sitting by her bedside just after Memorial Day, Fran and I recalled Ruth’s independent spirit, her quick wit, her boundless generosity, and her flair for fashion. She never wavered from her Saturday beauty routine, which consisted of hair and nails, a shopping spree, often at Lord & Taylor, and the requisite stop at the Market Basket in Franklin Lakes for “something special.”
She had a style all her own and insisted on keeping up appearances. Younger than my parents and my husband’s parents, 11 years younger than her husband, Ruth regularly looked like she walked out of a Neiman Marcus catalog.
The hospice nurses worked hard to stay ahead of her pain, but as tough a gal as Aunt Ruth was, the agony of lying on a fractured hip was more than she could bear. As hard as it was to see her suffer, it was a blessing when just two weeks after her fall, I got the call I’d been on high alert to receive.
Thankfully, God saw fit to bring Ruth home to Howard, the husband who’d no longer be late for dinner.
Time is something that doesn’t mean as much when you think you’ll always have time to spend with those you love. With the death of each of the elders whose care I oversaw, I’ve found that time is passing more quickly, leaving me no choice but to say the things I’m meant to say and do the things I’m meant to do before it’s too late.
Choosing a healthcare proxy is serious business. Serving as a healthcare proxy is even more serious. Each time I’ve been summoned to support a relative, I questioned where my strength might come from. But with each family member who needed me, the energy, the effort, the experience, the resolve came to me intuitively. There is no greater honor than to give freely to those who gave freely to us.
Writing Ruth’s obituary came naturally to me — likely because I was paying tribute to someone who’d affected my life so meaningfully.
With so many in attendance from all corners of her life, Ruth’s graveside service was a testament to her 82 years of living fully and giving unconditionally.
When she cleaned out Ruth’s apartment, Fran came across a wallet insert that held a few photos of our three boys when they were little and a tiny newspaper clipping tucked into the plastic pocket. It read: “Nieces and nephews are the children you have when you can’t have children of your own.” I believe Ruth’s life was as full as it was because she believed that wholeheartedly.
For me, her death marks the end of a generation. The loss hits hard. How different will life be without all of them? How lucky were we to have had six guiding angels we couldn’t bear to lose.
May her memory, like the memory of my mother, father, father-in-law, mother-in-law, and dear Uncle Howard, be for blessing.
Deb Breslow of Wyckoff is a freelance writer and college essay coach whose published work highlights topics specific to home, family, medical advocacy and Jewish causes. For the last three years, she has been contributing personal essays and reporting to the Jewish Standard and the New Jersey Jewish News.
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