"Oh, this place again," my mother says, as if somewhere in her memory, where most things are forgotten, this building, with its enormous orange and yellow Senior Living sign, clicks a normal synaptic reaction.

"Yes," I say. "That's right. Let's go inside and have some lunch."

It all seems so innocent, a dutiful son taking his elderly mother out for a meal. She doesn't know how I've struggled with the decision I've made, how it tears me apart. She doesn't know that today isn't just lunch. And she doesn't know that my heart is broken again because I've done this before—struggled and ultimately removed another family member from a comfortable home without consent.

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Twelve years ago, I paid two men to come to my house in the early hours of the morning and take my eldest son to a therapeutic wilderness program in North Carolina. With my wife standing beside me, I grabbed his shoulder as he slept. "Wake up. These men are here for you. We love you," I said, before I calmly walked away.

It seemed so utterly heartless, but the truly difficult part—making the decision to send him away—was done. The wringing of hands and the endless debating was over. His situation, of course, was hugely different from my mother's, but the agonizing process of getting from what should we do? to actually doing it was eerily the same.

At 14, my son had remained impervious to all the help we'd given him. Medication didn't help. Therapy had little impact. Love was our best hope, but that, too, failed to stop his relentless opposition and violence. His brothers loved and feared him. During his worst episodes, it wasn't uncommon for him to brandish a large kitchen knife through the house. He was euphemistically diagnosed with oppositional defiant disorder, and the police were regular visitors to our home. But the last straw for us—a thankfully nonviolent act—was his refusal to attend school.

Just like my mother, he had no idea what was coming. The evening we sent him away, he was playful and even shoveled the few inches of snow that covered the driveway. It was weird; he was being so good. But I couldn't let a few hours of good behavior change my decision—he'd wreaked havoc for years and endangered the people who loved him most.

Before sending him to wilderness therapy, I'd spoken with the experts, the teachers and social workers and educational specialists, most of whom felt the wilderness would be a useful step toward altering his behavior. Still, my wife and I were tormented by the anguish of sending him away. Had we abrogated our responsibilities as parents? What if it didn't work? What if he hated us for it? And what about the expense? Would we resent him for putting us through this enormous financial burden, and would he sense our resentment? And now, with my mother, history was repeating itself, although with a different twist.





My mother, now 85, started showing the first signs of dementia about five years ago. She'd wake up in the morning, go to the local convenience store, and purchase three cardboard containers of soup. When she got home, she'd consume half of one container and put the rest in the refrigerator. A few hours later, forgetting that she'd been to the store, she'd purchase three more, and once again, consume half of one container. Once a month, during mostly quiet but sometimes loud and agitated battles, I'd throw out more than 50 containers of soup against her wishes.

In the winter, she'd wear a red sweater and black pants. In the spring and fall, she'd wear the same red sweater and black pants. In the summer, when she couldn't bear the heat, she shed the sweater and pants for a nightgown that looked as if it hadn't been washed in years, much the same as the red sweater and black pants. She said she bathed, but she also said she did the laundry.

On a warm day in June, my wife and I showed up at my mother's home and were horrified by the state she was in: clad in gray pajamas covered with dried spills and yellow stains, her hair stringy and unkempt. As always, a half-smoked cigarette hung between her fingers. Aghast, I said, "You look filthy!" To which she replied, nonplussed, "It's fine." Dementia had settled in, taking away the woman who'd taught me how to tie my shoes, how to swim, to spell, to be respectful and kind to others. The sophisticated woman who'd dressed to the nines for most of her adult life, who'd adorned herself with pearls, was indistinguishable from a person living on the street.

My son was gone for 15 months, attending a therapeutic boarding school after seven weeks in the wilderness. He was 16 when he came home, and at 17 we had him taken away again, this time to a lock-down therapeutic boarding school in Utah. The stealing, violence, and drug use had gone beyond what we could ever have imagined. The years after that were punctuated by many arrests and more than a few stints in jail. I can still feel the fear I lived with—that at any moment, we'd get a phone call notifying us that he was dead. Yet he survived, and today at 27, after spending four years in a sober living house, he has a good job, a loving girlfriend, and the possibility of a long and happy life. He exercises no less than two hours a day, looks amazing, and is proud of his transformation, as he should be. He loves his family, and often tells us that, but I wonder if he's ever really forgiven us for those two abductions. Do they still haunt him, as they haunt me, especially now, as I drive my mother to the senior living facility for our "lunch date"?

She's in a good mood and chatty as we get on the New Jersey Turnpike and drive past the New York City skyline. "That's my city," she says with pride, admiring the expanse of tall buildings that seems to evoke her childhood. There's an endless library of stories in her head, as fresh as if they'd happened yesterday. But ask her what day of the week it is, or what month, or year, and she blithely and honestly says, "I don't know." She also doesn't know that less than 24 hours earlier, she'd told me to go to hell when I suggested it was time to sell the house. Or that sometimes she calls me 15 times a day, often screaming at me to get garbage out of her house that isn't actually there.

At lunch my mother says, "This is a really nice place and the food is so good." She speaks as if she's been here before, but she thinks she's been to nearly every place we go, even if we haven't. It helps her feel comfortable.

There's a plan in place. I'm going to tell her that my wife and I are going on a trip and she's to stay at the facility until we return. I'm dubious about the plan, but this is what the experts at the facility are recommending since three times before, my mother agreed to enter an assisted-living facility, and each time she stubbornly reneged 48 hours before moving. I know my mother pretty well: she may have dementia, but she's not stupid.

During lunch, two of the residents join us. This is part of the plan. They're supposed to engage my mother in conversation to make her feel comfortable. Yet over the next 20 minutes, not many words are exchanged. I begin to lose confidence in the plan. My mother and I finish our meals and rise from the table. As we're leaving the dining room, I see an empty table and ask her to sit down. "I have to talk to you," I say.

"Okay," she replies.

"I'm going away for a while."

"Yeah, so what? You go away all the time."

"That's true," I say, "but you're going to stay here while I'm gone."

All of a sudden my mother is as quick as a cobra about to strike its prey. "No!" she screams, slamming her fist down on the table. "You bastard," she yells. Suddenly, she's a woman with purpose and storms out of the building.

To my amazement, the diners continue quietly eating. I suspect they've seen this before. I signal a couple of staff members. When we find her in the parking lot, we lie and say it's only a temporary stay until I return. We bring her inside and show her the beautiful suite that'll be her new home, fully furnished and decorated by my wife and me. And then I do the unthinkable. I've done it before. I turn and I leave.

Later that day, I ride my bicycle for a few hours. Normally, cycling clears my head, but this ride is different. I'm obsessed with what I've done. How could I betray my mother just as I betrayed my son? How could I leave her like that and not even say I love you? Was she really unable to care for herself? She'll hate me for the rest of her life.

The next day my mother calls me. "Can you come over?" she asks. "I don't feel well."

"What's wrong?" I reply.

"My stomach is bothering me. Can you come over?"

"No. Not today."

I'm terrified, despite assurances from the staff that my mother is adjusting nicely. If I see her, I know she'll immediately want to go home. "Is she asking to go home?" I ask one of her caregivers. "No, but she thinks someone is coming to take her home soon." I stay away.

Seven days pass and my youngest son takes it upon himself to visit his grandmother for lunch, knowing it's unlikely that she'll be angry with him. Although she introduces him as her favorite cousin from New York, she doesn't bring up her house. She doesn't ask him to take her home. In fact, my son reports, she's happy. The following day, I muster up the courage to follow in his footsteps. My wife joins me.

My mother is waiting for us when we arrive. She looks amazing: clean and nicely attired. She smiles and embraces us as we sit down in the dining room. "Let me tell you about this place," she says with confidence. "The people are so nice. They really know what they're doing. And the food is good, isn't it? When we're done eating, I'll show you my room. It's so big."

Whenever there's a moment, and there are plenty, when she's not paying attention, my wife and I look at each other in joyful astonishment. And then there's the most amazing transformation of all. On the day I'd dropped her off, she was being escorted along a walking path, chain-smoking in her desolation. Now the staff tell me she hasn't had a cigarette in five days—this from a woman who's been smoking since she was 15! That was my sign, the lightning bolt of affirmation I needed.

I'm never quite sure if I made the right decision with my son, though I often think he might be dead had I done nothing. I know that today he's kind and gracious and grateful to the people who made difficult choices for his survival. I hope the same is true for my mother, that she's better off after I made a difficult choice for her, too. She may not be able to tell me as much, but it certainly seems that way.

At one point, I convinced myself that my mother believed she was on vacation. But recently, I've come to think there's an unconscious recognition in her that for the first time in many years, she can simply relax with no worries. I can relax, too, a little bit at a time, breathing in and out, but also knowing deep inside that, as life carries us forward, I may have to make other wrenching decisions out of love, as best I can.

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