Mary and Joseph Washburn are moving back to Massachusetts tomorrow after a dozen years in our little town. They were active retirees from the big city, involved in the community in several ways. Joe was a baseball coach, Mary was on the board of more than one charitable organization, and their home was a beacon on the local cocktail circuit; Joe was the best amateur bartender our community had ever seen.
Over the past few years, Joe’s faculties failed him rapidly, and Mary came down with rheumatoid arthritis. For a while, between his strong body and her sharp mind, they were able to hold things together, but as his dementia worsened, Mary’s ability to reign in his confusion lessened and a few weeks ago she told me the time had come for them to leave their adopted home town and move back to Massachusetts in order to be closer to family.
Today I saw Mary for her last visit and it was a profound ten-minute encounter.
As I entered the exam room, Mary was writing out a deposit slip for ten thousand dollars.
“I sold Joe’s truck,” she explained, “but he doesn’t know yet. He thinks it’s in the shop. He is so much worse just since you saw him last. He doesn’t even know who I am. Sometimes he thinks I’m a friend and sometimes his sister.”
“I can’t do this paperwork in front of him, so I had to do it now”, she continued. “We bought this little row house so I can continue to take care of him because we promised each other a long time ago that we’d never put each other in a nursing home, although we have long term insurance.”
I found myself counseling a woman about the same age as my mother.
“We sometimes make promises without ever imagining what circumstances we might end up in,” I began. “Don’t be hard on yourself. Do the best you can, but if you find that the situation isn’t safe for one or both of you, do what is best at that time. If he is restless or agitated and you can’t keep him safe with just the power of your wit and your love for him, you will need to find another way.”
She nodded and sighed.
“It’s gone so fast.”
Shrugging, she added: “Do you know we got a thirty year mortgage on our new home – at our age. Who knows how long we have together.”
A Country Doctor Writes: 
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