When it came our turn to care for my elderly parents, the experience was anything but routine. Fred and Gertrude was what I always called them. After over 50 plus years of marriage, they were well familiar with each other’s idiosyncrasies. They adapted to each other far better than we, as their hosts, were able to adapt to the shenanigans we observed. As snowbirds they had only recently returned to their summer cabin in the mountains in Colorado in 1987. This episode is about one of their shenanigans.
Fred had a stroke five years earlier, and was unable to walk without a walker. His stroke left him paralyzed on the left side, his dominant side, but his speech survived intact. As such he remained a companion with an ability to irritate Gertrude from any place in the house. He was also modestly overweight, creating a serious problem for Gertrude, who was his sole assistant for getting up and down from chairs, couches, bed, potty, and bathtub. The potty was the only serious problem, mostly because of the frequency. As tradition might suggest, each urge to urinate required arising from wherever he was sitting, and going to the bathroom to relieve the urge. Gertrude’s urge was to tell Fred “Pick up your bed, and walk”, but she knew he was safely incapable of such on his own. So they adapted, appropriately, to the needs of the day. The frequent trips to the bathroom were becoming unmanageable.
The solution, suggested by their friendly pharmacist, was a urinal. Most any male can use a urinal from any position in a house. And so, a see-through plastic urinal solved the problem of moving Fred’s body parts to and from the bathroom half a dozen times each day. What’s more, the marks along the side of the urinal could be used to determine how much the urinal was needed after each use, and exactly when the urinal was full. Initially Gertrude decided it was not necessary to empty it after each use, preferring to wait to empty it until it was absolutely necessary. Exercising some caution, Fred was able to use the urinal until it was about half full. They discovered that spilling half a urinal on the couch, or carpet, and of course, on Fred was more work than the urinal was worth. They settled upon emptying it after each use, to avoid fertilizing the furniture, and to avoid the need to change all Fred’s clothes several times a day. Simply changing Fred into dry clothes was a substantial undertaking.
Actually, the days were only minor irritations to Gertrude, who had adapted to the new urinal as a miracle of modern technology. She became the bearer of the urinal, responding to each call as needed. Following each use, she would run to the bathroom, empty, wash, and return the urinal to an end table within Fred’s reach. The urinal became an integral part of the many things Fred needed to be within reach, thereby saving Gertrude many trips every day. If all of Fred’s needs were not within reach, Gertrude discovered she was always close enough to fetch whatever he needed.
After several years of perfecting these routines, the absolute worst happened. Gertrude acquired a serious disorder that would deliver her to the pearly gates within a few months. As her closest offspring, it was decided that Fred and Gertrude should move in with us in Georgia. The necessary resources were gathered to move their bodies and their furnishings from their two vacation homes to our place in Athens. The day of their arrival was their first visit to our place in about ten years. We set about establishing who was to sleep in Gertrude’s bed, who was to sleep in Fred’s bed, and setting the ground rules for their extended stay in their new accommodations.
My first speech to the folks went something like this:
Fred and Gertrude, we want you folks to know that is it our pleasure to have you staying with us. Now we know that Gertrude has been cooking meals, and washing clothes, helping you, Fred, get dressed and undressed, carrying urinals and getting you up and down like a yoyo from every place you go. She has completely run out of steam for continuing these many activities any longer. From now on, Gertrude will no longer be responsible for your daily care. You are to remain friends, but when you need something, Fred, you are not to ask Gertrude to get it for you. That is no longer her responsibility. We have elevated the couch up on blocks so you can get up and down by yourself, and you may need to start running your own errands around the house when Lois and I are not here. You have your own TV remote control, which you can share. Before we leave for work, we will make sure that you have everything you need for the day within easy reach.” After that I took a deep breath.
“Do you mean that I don’t have to run all of Fred’s errands any more?” Gertrude asked.
“That’s right, Gertrude. You are not responsible for Fred’s stuff any more. He will have to learn to take care of himself. This is also true at night. You will be sleeping in separate bedrooms, so you will both sleep better, and wont disturb each others sleep. Gertrude, you are not responsible at night, either. If Fred needs something after he goes to bed, you are not to take care of it. You just take care of yourself, and Fred will need to depend on us, or himself for his needs, both day and night. I wasn’t exactly sure what all this might mean at the time, but it was the least we could do in view of Gertrude’s fragile state. It was not long before we would find out.”
And so, with this understanding, when it came time for bed, we all retired to our respective bedrooms. As Gertrude was fully capable of getting herself around as needed, she could take care of herself. Next to Fred’s bed was a small nightstand with the things he needed; a box of kleenex, a wastebasket, a glass and a pitcher of water, his walker, and, of course, the urinal. We left the doors to the bedrooms open to facilitate emergencies, and we all went to bed around 10:00pm. It had been a very long and tiring day, particularly for Fred and Gertrude. We anticipated a long and restful nights sleep.
Shortly after retiring, we were all fast asleep.
Around 11:30pm a horrible racket echoed throughout the house.
Thump, thump, thump, thump, thump, thump, thump, it went. It sounded like a small drum piercing our ears, and awakened us all from a sound sleep. Thump, thump, thump, thump, thump, it continued. I jumped out of bed to find out what was thumping. The noise was coming from Fred’s room. I turned on the light, went into Fred’s room, and asked:
“What is all this racket? Just what is going on here?” I asked.
“I just finished going to the bathroom in the urinal” Fred said, “I always thump on the side of the urinal to let Gertrude know that she needs to take care of it. I would like you to empty it out, wash it, and return it to the table next to the bed, if you don’t mind.”
“We were all sound asleep” I said, “and the thumping was particularly irritating, as we didn’t know what was going on. Let me take care of the urinal, and you go back to sleep, I said. I emptied, washed, and returned the urinal to Fred’s bedside, and returned to bed, just like Gertrude would have done.”
In ten minutes we were all fast asleep again. Then around 1:30am, it erupted again. Thump, thump, thump, thump, thump, thump, thump went the noise. This time we were all awake again, but we thought we knew what was happening.
I jumped out of bed, and went into Fred’s room. “What is it now?” I asked..
“I had to go to the bathroom again. The urinal is right here. Could you take care of it, please?” he said.
“That’s two!” I replied, and proceeded to empty the urinal a second time, and returned to bed.
After returning to bed, I said to Lois that I was beginning to understand some of Gertrude’s irritation as a caregiver. Once again we all returned to our fitful sleep.
About 3:30am the noxious noise recurred, awakening all in the household for the third time. Thump, thump, thump, thump, thump, thump, thump went the noise. By this time, there was little need to inquire about what was going on. There was no need to say anything to Fred, as the see-through urinal explained it all. I emptied it in silence, washed it out, returned it to Fred’s vicinity, and returned to bed for the third time without a word. Fred had urinated for the third time, but I was pissed, to use the vernacular. I was irritated that the thumping on the side of the urinal managed to wake up everybody in the house. I was pissed that we had been awakened, so far, three times for Fred to urinate. I was pissed at being deprived of my sleep, as well as that of the others in the house. I was beginning to understand why Gertrude had acquired a fatal disease. It was the only way she could figure out how to get a good nights sleep.
We were not awakened again during Fred’s first night at our house. It was enough, however, for me to take a vow that it would never happen again. Analyzing the situation, it occurred to me that there was a simple solution.
Gertrude had advised us that while Fred was able to talk quite normally, he was not playing with a full deck. The stroke’s damage to the brain, she said, produced the paralysis, and a lot of other problems. We had very little evidence of this, so far, but accepted that she knew what she was talking about. He certainly didn’t have a problem with his bladder, which was working overtime. At the same time, for the whole family to be awakened several times each night was simply not acceptable, regardless of any collateral brain damage.
The following day I visited my friendly pharmacist, and purchased three additional urinals. I had hard evidence that three would be needed, but figured that a fourth urinal for insurance was a small price to pay for the ability to sleep through the night. Then I retired to my shop, where I fashioned a rack for hanging four urinals, side by side. I mounted the rack just above the head of Fred’s bed, and hung the four urinals on the rack, neat and orderly.
At bedtime, I advised Fred that I had added an essential bathroom appliance to his bedroom, and that we needed to have a meeting of the minds. I asked him to focus his attention on the rack with four urinals beside his bed. Then I delivered the longest speech I ever gave my father. It went as follows:
“Fred, I want to call your attention to the rack on the wall next to your bed. You will notice there are four urinals on the rack, fresh, clean, and orderly. After last night, it occurred to me that you suffer from overactive bladder. Now I consider this to be your personal problem, yet last night three other people were awakened three times, a total of nine awakenings, just because you had to pee. Tonight I want you to know that there are enough urinals on the rack to last you all night. I want you to take the nearest urinal, use it, and then hang it back up on the rack like it was nobody’s business that you took a pee. Then you can go back to sleep. When the urge strikes you again, you are to take the next urinal, use it, and then hang it back up on the rack. You are to do this as often as needed. Be sure that you start with an empty urinal each time. If for any strange reason, you should need to pee five times, then, and only then, can you go thump, thump, thump on a urinal, and wake up everybody else in the house. On the fifth urge, I will respond to your personal need.”
“What’s more,” I said, “You need to be extremely careful each time you pee. Be sure that you use an empty urinal each time, because if you get a urinal that has already been used, and you dump it all over yourself, that is still your personal problem, and I don’t want to know about it till after the sun comes up. That way we can all get the sleep we need every night. Do you understand?” I said.
I’m not sure which one I should use first, he said.
“If you use the closest urinal first,” I said, “Then hang it back on the rack as far away from you as possible, then the closest urinal should always be empty. In any event, you better figure out your own system, because we will not be bothered with your waking-up the whole family to pee any more.”
The following night was the acid test, a trial run with the new system of four urinals. In spite of Gertrude’s warnings, Fred never awakened the family again through several months of visiting in our home. On rare occasions he would use all four urinals, and on only one occasion did he have a minor accident. We all slept throughout each night, thanks to this marvel of modern technology. Never again from that time forward did we hear the piercing thump, thump, thump in the middle of the night that greeted us during Fred’s first night.