Life follows a curve. If you are lucky, you rise up to reach a peak of freedom and empowerment, and then begins the time of loss. Bob and Helen Arehart together had such a journey.
Robert Franklin Arehart and Helen Willamina Kohr had similar Philadelphia childhoods to this extent: they were raised in loving families by parents who fought hard to make a living, keep a roof over-head and food on the table. Bob’s father Frank had been career-Navy, married and started a family later in life, and his pension was a lifeline that saw them through the Great Depression without losing their home. Helen’s father John, had no such safety net. He dreamed of being a teacher and had completed two years of college when he met gentle Myrtle Creep, fell in love and left school to marry her. Always a hardworking man devoted to the welfare and education of his children, he mostly found work managing restaurants. The Kohr family did lose their home to the Depression, and like so many families of that time, was always one stroke of bad luck away from homelessness. In fact, John could not find work during the worst of the Depression, and the whole family was supported by Myrtle’s sister, Helen Creep, who kept her job as a bank clerk. Despite these hardships, perhaps because of them, for both families empathy and aid for those with less was the rule. And so Bob and Helen each learned thrift and kindness and the value of family by clear example. And they each inherited the wiring to value these ways and be guided by them.
Bob and Helen were a handsome but unlikely couple. Bob was a deep, quiet, introvert, elegantly handsome. He took Bing Crosby as his model and excelled at Frankford High School but did not immerse himself in extracurriculars. His father Frank was a Navy Chief and a ship’s electrician. Bob also had electricity in his bones, but set his sights higher. Helen was a tom-boy who went by ‘Bill’ as a child, her middle name being Willamina, and John having yearned for a son. She was a full-on extravert who saw Frankford High School as her shining time, her university, and she threw herself into her studies and every extracurricular she could pack in. She was a devoted acolyte of Dr. Sterner, a gifted english teacher, and was at her best working on Frankford High’s weekly newspaper. Every Wednesday evening Helen and her team would be at the local print shop putting the paper to bed. Often she was called upon to create a few column inches of content to balance a page, be it prose or poetry. She was prolific at this time but none of this output survived for my review.
They found one another late in their time at Frankford High and were deeply committed when Bob answered the call and entered the Navy upon graduation, part of the great generation that put life on hold to settle World War II. Then came the romance by post, victory over tyranny and the social miracle of the GI Bill, allowing Bob to set his sights high and pursue an electrical engineering degree at Drexel. Knowing he had in Helen a true love and life partner brought relentless energy to his quest for a bright family future. He swept self doubt aside and became the first of his family to achieve a college degree aided by Helen first as a devoted fiancee, then a wife. They lived their early marriage in a tiny, hot apartment in Mrs. Mann’s house, with Bob sweating in his underwear as he studied on and Helen typing his papers after coming home from her full time job that paid the rent and provided their meager fare. Theirs was a team effort to make a life together. They did not feel their grinding poverty. They were in love and with purpose.
A few of Helen’s poems from this time tell the tale. A little before they married:
Confession - Helen W. Arehart
Don’t close the door But say Goodnight Before you shut Me from your sight. I cannot hint To have a kiss But I’d reply If you’d insist. Perhaps you think It wrong somehow For me to be Here with you now. Your work kept you From going tonight. Now homeward bound I saw you light. And could not pass Your house and so Found an excuse To say “Hello!” But now the seconds Speed till I Now see it’s time To say “Goodbye”. And through your door I nobly step. Though you have failed To catch on yet. The story can Not end like this. And that is why I stole a kiss. your girl.
And in roughly this same time:
In Love - Helen W. Arehart
I find I like your shade of hair. I like your build. I like your walk. I like your eyes. I like your smile. I like to hear you laugh and talk. And though I find that this is true. That’s not just why I’m loving you. It’s not the flimsy outer shell That draws my soul so close to you. It’s cause you’re brave and strong and fine. It’s cause you’re good and kind and true. Because you are yourself, I know That’s why I find I love you so.
Bob hired on with Philadelphia Electric, the utility, in 1950, when such professional employment was regarded as a lifetime career. With this stability Bob and Helen started their family as soon as they had a reasonable financial toe-hold. Robert in 1952, Kurt in 1955 and Dawn in 1960. This was a family squarely in the new and growing middle class and moving up. But Bob and Helen rarely heeded the marketer’s call. They remained frugal and saved well, intent on financial security and freedom from the precariousness their parents suffered their lives long.
With steady care they rose, never in ostentation. They parented with gentle, quiet strength, avoided prideful displays, delayed material gratification and built professional and social standing. They sacrificed much for their children and made clear to us that a college education was ours for the taking. This made it tougher to save for retirement, but they tightened their belts and pushed on. They continued to live frugally, but were rich in spirit.
In middle age Helen was inspired by a grainy old photo Bob had taken of their sons while on vacation long before, at ages 10 and 7, arm in arm on a hilltop, with a grand view in the distance. She penned:
Snapshot - by Helen W. Arehart
Little lads who stand so tall Were you really there at all? Do your shadows linger still On that high and windy hill? If I travel to the place Could I find of you a trace? No, - I never can again But I thought not of it then.
Another of Helen’s Poems captures a moment in middle age, describing a traditional candlelight service at Saint James Lutheran Church, their beloved community of faith:
Light - Helen W. Arehart
A memory, - a memory But one that lives on down through time. And through the years that come and go These thoughts will forever be mine. ‘Twas Sunday eve the seventeenth, The stars were seen bright in the sky. Days were busy for everyone And Christmas was breathed in each sigh. There at the place on the corner The lights of the St. James Church shone. Many stood there in the quietness Closed in by those walls as though one. The silence made each heart tremble And hope as it never had done. Seeking to see through the darkness The light which the candles begun. The light to carry the story Of God and His love for all time. ‘Til not a soul would breathe the air That didn’t have God’s name in mind. Then one by one every candle Touched the one beside ‘til the flame Was there upon you candle too And you passed it to me, - just the same. And then the silence was broken But the words that broke it were grand. The Pastor asked in a prayer That this light go on through the land. A memory, - a memory But one that lives on down through time. And through the years that come and go These thoughts will forever be mine.
Helen played professional assistant to Bob’s dignified and accomplished senior engineer and together they launched into a phase of life marked by national and global travels as Bob attended to duties for several professional engineering societies.
With children raised, educated and off on their own, this should have been a time of harvest, of riding comfortably on attainments hard won. And might have been, if not for the cosmic joke that places elder care squarely in the road. It turns out that if you’ve lived a beautiful life with a perfect life partner, unmarred by ill health, alcohol, divorce or other tragic setbacks, you are a rarity, and on much stronger ground than most. And when family elders fall ill and destitute, no one else in the extended family is as well positioned to serve. So it was for Bob and Helen. With Bob still working, Helen took on care for her aunts and then her father and then her mother while none of her siblings could help. Sequentially, she cared for three elderly women as each descended into deep dementia, the last being her mother Myrtle, who she cared for in an upstairs bedroom for ten long years.
In Memory OF John Edwin R. Kohr, “Dad” (a man who lived in his garden)
Helen W. Arehart
I saw them there this year - That wave of bloom. The Columbines - Yellow bonnets nodding. And there, among their Long and slender stems My mind’s eye saw Your hands in loving care. A tear of memory dropped Into their midst. I should have stooped And pulled the choking weeds. For you have left This earth and all its tasks. But that is one I could not bear to do. Bill
Caring for elders deep into Alzheimer’s is demanding, seemingly endless and heartbreaking work. Helen would sometimes seek respite by placing Myrtle, now far gone into dementia, in a nursing home for a week so she could travel with Bob to some far away place. But the price was steep: her mother came back home filthy, poorly cared for, and once in a state of fear, indicating rough treatment had been experienced. So Helen tightened her belt further and knew that respite care was no longer possible. It nearly broke her, but she got through. The concept of long term care insurance was becoming available, and Bob and Helen quickly purchased policies. They wanted no part of placing such a burden on their children.
In this same time Helen lost the first of her siblings, an older sister, to cancer.
Memory Of Ruth
1921 - 1982
Helen W. Arehart
What matters now --- that dust lay white There in her world by day and night? For as she ran with cares of man, No time was there for earthly plan. What matters most of all to me Is that she always tried to see The greatness that each person had And said the words to make them glad. She read and talked for those in need. She had no use for formal creed. Her praise of God was quiet and sure. She taught and helped all friends endure. Must be, that in her current state She guides the lost ones to relate. As souls pour in from every place, She welcomes them with heaven’s grace.
This poem Helen wrote and left taped to an inside wall of an empty house, Bob’s mother’s, on the day of sale. Myrtle Arehart Fritz had moved into the Philadelphia Protestant Home.
Looking Through These Rooms - Helen W. Arehart
I’m looking through these rooms Where laughter rang And sorrow knew, and Also people sang. Where more of joy was there Not hurt or need. Where fifty years folks dwelt With Christian creed. May you who come to Settle in the space Absorb the warmth and love That’s in this place.
The time of elder care lifted before Bob retired from his long, steady, successful career with Philadelphia Electric. With their tidy little Cape Cod house paid off and some help from the stock market, Bob and Helen realized they could afford to retire at the relatively early age of 62, in 1988.
Were I to draw a curve representing their life journey, here they approached their summit. They were healthy, unencumbered and financially secure. They had a cadre of old friends dispersed around the nation who were also retiring. The world was their apple and they took some pretty good bites. Mostly it was domestic travel with a love of river boat cruises and visits with friends and family. For many years they opted out of Philadelphia winters and would spend several months in Florida, again making plenty of time to visit friends and family.
Retirement Plus - Helen W. Arehart
They say that we have reached that age, That will affect our lives. Not only that! - It’s going to touch Our husbands and our wives. That we must start to turn our thoughts Around the edge of time. Look in the mirror and admit, That we are past our prime. That people, places and our work, Will not go on forever, Now we must start to reason, cope And channel our endeavor. They tell that the dreamed of space To lazy out our days, May come to be a prison, in So many little ways. Could be the very stresses that We long to do without, Were once the the little probes and pokes That kept us going about. Now, like it was back in that phase That saw us off to schools, ‘Tis time to learn for life again, With brand new set of rules. The one thing that we’ve going for us That was not true before, The wisdom of our life thus far Can open wide the door. The skills, the strengths and knowledge that Are ours, but are not shown, Can be the new foundation for The best we’ve ever known. So lift your cup and laugh a bit And eat your bread with honey. We wouldn’t be seventeen again For any sum of money.
This was a truly golden time. And the years went by. But age is like gravity. It will not be denied for long. After ten or so years fully at the top of their game, the journey back down picked up speed.
I recently had occasion to go flipping through a stack of month-at-glance calendar books that Bob and Helen used to organize and coordinate their retired lives together. This collection ranged from 2001 to 2014, covering their aging from 75 to 88. We do not do advanced aging and declining health well in the U.S.A. We throw plenty of money at it, and the pharmaceutical industry catches most of it. And our elders do not fare well.
2001-2002 - Bob and Helen are age 75-76
The good times are still rolling, with both Bob and Helen busily engaged in extensive domestic travel, including river boat cruises, winter holidays in Florida, visits with family and friends, weeks spent at timeshare units, and the traditional family reunion week in Ocean City, New Jersey. At home in Philadelphia Bob and Helen remain active and engaged at Saint James, with Bob doing building and grounds work and Helen leading christian education. Bob is loving his barbershop singing and studying hard to master the many songs he performs in the chorus.
There are plenty of medical appointments, and aches and pains along with troublesome lab metrics lead to an increasing array of medications. Some medications very likely are introduced to address side-effects of other medications. Down the drug rabbit-hole we go, with “Big Pharma” the clear winner.
Through it all both Bob’s and Helen’s handwritings remain clear and distinctive and they joyfully note the arrival of grandchild Olivia in May of 2001.
2003 - Bob and Helen are age 77
The year starts well and busy, with plenty of concerts, church work and barbershop singing. The arrival of Alessandra, the first great-grandchild is joyfully noted in red ink, in June. Also lots of medical appointments, raising the likelihood that various physicians are writing too many scripts and without regard to the array of medications already in use.
And now the medical troubles hit. In June Bob fails a cardio stress test, is rushed directly to the hospital and has quadruple bypass surgery. His father died at age 77 of a heart attack, and Bob’s procedure allows far more oxygen to feed his heart muscle and undoubtedly extends his life well beyond his genetic potential. Yet when an age 77 man has his chest cracked, the way back is slow and full recovery elusive.
In late August Helen falls and cracks her pelvis and is hospitalized for three days. This will be the first of many falls and it takes us years to suspect that her medications leave her dizzy and prone to falling.
Through all this both Bob’s and Helen’s handwriting remains crisp and distinctive, though there are many scratch-outs and cancellations of normal activity replaced by rehab and medical appointments.
2004 and 2005 calendar books are missing
2006 - Bob and Helen are age 80
Far more medical appointments crowd out much else. Church and barbershop singing activities continue. The arrival in February of Aronne, the first great-grandson is another red letter event.
This is when Bob notices that Helen is always tired, tends to sleep in and take more naps than normal, sometimes verging on spending nearly all day in bed. And she cries a lot. He calls his children about it and worries both about her, and his ability to keep up their home of 43 years. After many weeks and conversations, Bob agrees to sell the house in favor of a senior independent living apartment that will be far less work to keep up and eliminate the need of using staircases. Helen is too tired and depressed to really care or have meaningful input, and the enormity of moving out of their home with its lifetime of accumulated contents is overwhelming to her.
Surprisingly, both Bob’s and Helen’s handwriting remains crisp and distinctive.
We should have seen that Helen was over-medicated, with several drugs carrying side-effects of dizziness, fatigue and depression, but it would be a few more years before we faced into this truth, stepped in, confronted her physicians and managed down her scripts.
Bob and Helen moved into their new independent-living apartment in November of 2006 with the big work of managing the move and clearing the old house handled by Dawn, Kurt, and Dawn’s husband Rudy. Son Robert was unable to help as he was seriously injured on the job in May, with a long and difficult recovery in front of him.
2007 - Bob and Helen are age 81
There is an injection of energy with the novelty of the sunny new apartment and the social opportunities that come with living in a senior community. Calendar items tend toward simple bill paying, family visits, occasional shows and barbershop singing. Use of the Westwood and Williamsburg timeshares continue, but other travel is greatly curtailed.
While Helen’s energy and tendency to stay in bed resumes, they both continue to make crisp and distinctive entries in the calendar.
2008 - Bob and Helen are age 82
Medical appointments outnumber all else in the calendar. Other entries again tend toward simple bill paying, family visits, occasional shows and barbershop singing. And a new type of entry is becoming dominant: funerals. There are lots of funerals to attend. An entire generation is rapidly slipping away.
Bob’s calendar entries continue firm and distinctive, and Helen’s now show a tremor.
2009-2010 - Bob and Helen are age 83-84
Bob continues his long engagement in developing a Memorial Garden at Saint James for interment of parishioner’s ashes. Any out-of-town trips are assisted by Rob or Dawn otherwise they are too daunting and risky to consider.
This is the timeframe where Rob, Dawn and Kurt gain knowledge and control of all the medications Bob and Helen are taking. Kurt does some research and analysis and shows that some of Helen’s medications seem redundant and are likely leading to her fatigue, depression and alarming tendency to lose consciousness and fall. Helen’s lead physician agrees to taper off several of the medications and Helen dramatically improves in energy, mood and awareness. It is nice to have her back. Even so, Helen’s calendar entries are very few and labored.
Bob and Helen manage their last few out-of-town trips, including a Columbia River cruise aided and attended by 6 family members and separately a flight to Raleigh to see grandson Tyler graduate from NC State.
The Columbia River cruise was revealing to Rob and me. Bob and Helen were very dependent on us to negotiate the flight to Portland and all the other travel details before, during and after the week on the river boat, much more than we expected. Upon arriving at the Portland airport for the journey home well ahead of our flights, I made the big mistake of suggesting a sit-down lunch before going through security. We were, after-all, many hours early for our departures. I failed to appreciate just how completely Bob was locked into his methodical routines. As the lunch wore on, I became aware that our time cushion was burning away, and tried to get us moving toward the security checkpoint. Bob simply could not be rushed. I carry a bit of this trait so I normally smile at this behavior in him. Nothing short of physical force would get him moving any faster. On arriving at the security checkpoint, the lines had grown and our times to departure were nerve-wrackingly short. The good officers of TSA sealed our fate by pulling Helen aside for more a thorough search. What she may have said or done to attract this I do not know. Maybe nothing. Maybe it was just bad luck. We all missed our flights. Now began the hard work of finding available flights to get an elderly couple across the nation to Philadelphia, hoping to avoid a hotel layover in some charming hub city or another. This significant dose of travel trauma was enough. No more big trips for Bob and Helen.
2011 - Bob and Helen are age 85
Calendar entries by Helen are now very rare. While she is very slow and unsteady with her walking, Bob continues to pilot their Cadillac for groceries, church and medical appointments on local and well known routes. Helen gave up driving years back after an unexplained crash likely due to a momentary loss of consciousness. Dawn or Rob increasingly provide transportation to family events and traditional vacation weeks in Ocean City and the Poconos. Vacation trips, even attended by Dawn or Rob, become difficult as the change of surroundings and disruption of routine is increasingly disorienting and stressful.
This is the year that Bob is honored by Frankford High School’s Pioneer Award, given for lifetime achievement. The one page summary of his professional attainments prepared for the ceremony stands as an important family document.
2012 - Bob and Helen are age 86
Now even the two bedroom apartment is too difficult to clean and so Dawn and daughter Rachel begin coming in regularly to clean. Rob starts taking Bob and Helen to all their medical appointments so we have a good record of the outcomes and medications prescribed. We have no wish to allow either Bob or Helen to suffer from over-medication again. Medical advocacy is a principal responsibility for Rob, Dawn and Kurt.
Bob speaks with Kurt often as they struggle to dispose of timeshare ownerships that cannot be given away in the down economy. Bob often laments that he feels his mind slipping. Short term memory is more and more a problem. His keen ability to analyze, reason and plan is fading. His sense of self as a professional is slipping away. Thus begins an extended period of mourning, as Bob and Kurt see this important part of Bob’s being fade away. In a few years time he will no longer clearly sense the loss.
Helen begins falling occasionally probably due loss of consciousness. She has been lucky and her landings have been soft, with no serious injury.
Helen wrote a calendar entry, now very rare from her, noting the October 6 wedding of grandson Jason to his Colleen. Driving to the reception in West Philadelphia is well beyond Bob’s comfort range and so they ride with Kurt, Nancy and Coleman who have traveled to Philadelphia for the event.
In early December Helen’s luck runs out. She loses consciousness and falls in the bathroom, where soft landings are nearly impossible. Striking hard porcelain on the way down she breaks multiple bones, including the infraorbital foramen below her left eye, requiring difficult surgery. These are serious injuries, an enormous insult to an 86 year old body, requiring lengthy and difficult rehabilitation. Will Helen find the strength and drive to do the work of recovering to the point of walking again? We can only offer encouragement and hope.
2013 - Bob and Helen are age 87
Calendar entries are now very sparse with most events missed due to medical issues. Bob is alone in the apartment for a month as Helen remains in Moss Rehabilitation Hospital until she is deemed to have stalled in her recovery and must be moved to a skilled nursing facility. Bob visits her every day while at Moss, driving himself there most days. Home life routine is shattered by this accident and Helen’s absence, and Rob, Dawn and Kurt begin searching in earnest for a way Bob and Helen can live together again in an apartment while Helen receives the skilled nursing care she now requires. Helen manages to gain mobility aided by a walker, which is the minimum threshold required by Paul’s Run for admittance to a personal care apartment. Bob is leery of the loss of personal control he will suffer by moving to such an apartment, but to be with Helen, he agrees, and we plan for the move.
On April 25 Helen is released from Lafayette Redeemer, essentially a hospital-like nursing home setting, to move into Paul’s Run B331, a personal care apartment. This has the jubilant aspect of a jail-break, and as Kurt wheels Helen out of Lafayette, he clips the ID band from her wrist and keeps it as a totem of a harrowing passage completed. Bob and Helen reside together once again and we entertain hopes that Helen may yet recover beyond the need of her walker.
Bob does indeed suffer a significant loss of personal control and sovereignty under the regimen imposed on the personal care floor at Paul’s Run. There is no real kitchen in the apartment, the nursing staff now controls his medications (an insult, but very much for the best), and he is being pestered to bath more often (also a good thing as he has lapsed a bit on the personal hygiene front). For the love of Helen, he endures it all.
Helen has several brief hospital visits due to significant pain, and Bob’s loss of mental acuity is now precipitous. The move to the personal care apartment seems to have triggered the slide. Would this have happened if Bob were still forced to mostly fend for himself? Impossible to know, but it is tempting to see a surrender to the inevitable on his part and then a plummeting of his competence to match what little self determination is left to him.
2014 - Bob and Helen are age 88 (this is the final calendar book)
Bob’s calendar entries are now quite sparse. Mostly entries are in Dawn’s hand, or some helpful Paul’s Run staffer. Mostly they are for medical appointments with transport always provided by Rob or Dawn. Other entries document the most basic rhythms: Rob picking up clothes for laundering, showers at three day intervals, Bob starting up the Cadillac without moving it, just to run it a bit, the engineer in him hanging on.
In the U.S.A. the car is the freedom machine. Loss of the car is a bitter curtailment of liberty and sovereignty. Bob sells the car on January 28, after a frightening solo driving episode where he is lost and disoriented for hours, and decides for himself that it is time to let his Cadillac go. This had to be a difficult blow, but he had the dignity of making the decision himself.
December 3 is the last entry in Bob’s hand. “Dawn coming”.
No further calendar books were kept by Bob and Helen. Helen became wheelchair bound in 2016 and so had to move to the skilled nursing ward of Paul’s Run. After several months apart, Bob, still ambulatory, moved in with Helen so they could share a large hospital room together. Living apart was far too sad for him. Again Bob voluntarily surrendered more self determination as he entered Helen’s skilled nursing care world. And again his capacity seemed to diminish as a result.
Childhood is a time of learning and growth and an ever expanding world. Advanced age is the reverse: an ever shrinking world. In the U.S.A. we are very good at prolonging life. The quality of that extended life is not always a consideration.
Bob doted on Helen for the entire 69 years they were married. When his short-term memory was failing he would make an observation or ask a question at three minute intervals, and Helen, though physically the weaker would from her wheelchair make the gentlest, tiniest of eyerolls, to communicate: “Yes, I know he just asked the same thing for the fourth time, but expressing annoyance with him will not help, so we quietly let in pass.”
Bob’s doting, when combined with his short-term memory trouble sometimes created more of a problem for Helen. While eating together Bob would see that Helen had left a substantial amount of food on her plate, and out of love and concern would anxiously suggest that she eat more. Helen would quietly pronounce she was not hungry for more. Three minutes later, having forgotten the exchange, Bob would again notice the uneaten food, again feel concern for her, and repeat his suggestion. Again, with patience, Helen would decline. After maybe 5 cycles of this, Helen would surrender and eat more to please him, often to her detriment.
Love-bird behavior in a long-married couple is rare and pleasant on a skilled nursing ward. The staff noticed this magic and loved them for it. Even as both Bob and Helen declined mentally, possibly losing the sympathetic filtering performed in the frontal lobe, they remained gentle and sweet to each other and all around them, unlike some in the ward who grew bitter and bellicose as they lost their facilities in loneliness. Either Bob and Helen somehow defied the odds and maintained sophisticated social filtering, or, in the absence of these filters, they were revealed to be at their core as kind and gentle and sweet as they always had seemed. I prefer this latter interpretation.
In late July of 2017 I got the phone call from brother Rob that Bob had been rushed to the hospital and found to have multiple organs on the brink of failure. At age 91, with so many systems in imminent shut down, the medical recommendation was to accept that life was ending and switch to hospice care, providing oral morphine and supplemental oxygen for comfort as the process of death played out. Together Dawn, Rob and I reviewed Bob’s health care directive and found language in support of a comfortable, natural death rather than a protracted and possibly grotesque attempt to prolong life at all costs. Clearly, shifting to hospice care at this point was in keeping with Bob’s long held beliefs, and we, as jointly authorized agents of Bob’s medical care wishes, agreed. All other medications were withdrawn.
I was vacationing in Seattle at the time, due to fly back east in two days, and I grappled with the merits of immediately flying to Philadelphia rather than arriving three days later via my scheduled flight to Raleigh followed by the eight hour drive north. Still weighing this while walking the wooded paths of Discovery Park in Seattle, I was surprised to have the opportunity to speak with Bob by phone. He seemed remarkably coherent and I had the opportunity to speak with him of his wonderful life and of my love for him and assure him I’d be in for a visit in just a few days. This unexpected gift of communication and Bob’s seeming strength helped me decide to avoid the emergency travel.
When I walked into Bob & Helen’s room three days later, hoping for a last bedside visit, it was not to be. Bob was up in a chair, lucid and aware. I sat with both Bob and Helen and enjoyed a really great visit, rich with remembrances and shared values. I played my ukulele and sang. I read Helen’s poems aloud and took every opportunity to discuss the family events that might have inspired each one. I came back the next day and enjoyed another such visit. Over the next days I read aloud the whole of Charlotte’s Web and got well into Where The Red Fern Grows, selected because Bob always loved dogs and so a heart-wrenching tale of a boy and his dogs would be a clear winner. It was. After six days of visits like this I had to conclude that oral morphine and supplemental oxygen were quite agreeable to Bob, and he might do well for some time under this level of hospice care. He had settled into a new normal. I went home to Raleigh.
With some ups and downs Bob continued to do very well on the oral morphine and supplemental oxygen and even did well without the oxygen at times. I came up to Philadelphia for several visits that fall, knowing full well that each visit might be my last. And that was OK. I was enjoying the gift of important visits well beyond anything I could have hoped for back in July.
Bob Arehart took his final turn on December 16, 2017. Mercifully, Helen’s awareness of his condition was limited and intermittent. She knew something was wrong, but was not really clear what that might be. As Bob was unconscious and breathing his last, attended by Rob and Dawn, Helen was in her wheelchair out in the hall chatting with a few nurses who sought to distract her. I like to think that Bob’s passing was eased by the sound of his Helen’s voice drifting into the room.
Bob was in hospice care for more than five months. They were mostly good days. The U.S. medical system may treat advanced aging poorly, dulling lives with over-medication, and tilting toward prolonging life with little weight given to the quality of that life, but the system of hospice care seems very good. Once Big Pharma loses its grip on the course of treatment and the priority becomes a comfortable and dignified end, an elder’s life experience can improve. Hospice care certainly did well by Bob Arehart, and we who loved and revered him.
Helen’s lack of persistent awareness of Bob’s passing allows her to pass time in an apparently untroubled dream state. She may be distantly aware that something has changed, that Bob is not there with her, but she seems not to dwell upon it or suffer a sharp sense of loss and mourning. Certainly not one that she reveals. Any such despair is deeply compartmentalized and shielded, if it is there at all. I believe her days pass without a conscious sense of time. When I walk in for a visit after 2 months away, she takes a minute to pull me into mental focus and then greets me enthusiastically, picking up where we left off, much as if I had been in the day prior. So I play my ukulele and sing for her, and she sometimes sings along. I read her poems to her, and she often supplies the last line from memory. And we speak of many things.
Helen Arehart continued her decline mentally and physically, confined to a wheelchair and then her bed. Lost in a fog of quiet, gentle disorientation and confusion, she lived far longer than she would have liked, dying in February of 2019, fourteen months after Bob’s death.