Elizabeth Parker Garcia, author of Elizabeth Parker Garcia, author of "Where the Truth Lies." The story took second prize in this year's John A. Hartford Foundation Heroes of Geriatric Care Story Contest.

In the second installment of our look at the prize-winning stories from the John A. Hartford Foundation’s Heroes of Geriatric Care Story Contest, we are pleased to present Elizabeth Parker Garcia's "Where the Truth Lies."

Her story, which took second prize in the contest in May, offers an example of geriatric care that recognizes the family’s role in caregiving. She tells a deeply personal and heartbreaking story about her father with advanced-stage Alzheimer’s disease.

Her heroes are the nurses at her father’s assisted-living residence who teach her the tools to guide her father through his alternate universe by using “patience, creativity, consideration, and love.” By teaching her the skills to cope with the (sur)realities of her father’s mental state, she was in turn able to help him relax, allowing their “hearts to connect the same way they always had.”

We hope you enjoy and will pass along Garcia’s moving story about heroic geriatric care. Check back next Tuesday, when we highlight the final prize-winner from the Heroes of Geriatric Care Story Contest.

Where the Truth Lies
By Elizabeth Parker Garcia

My father doesn’t know that my sister, Alice, is dead. He doesn’t know that she had cancer, that she suffered, or that she, in a pain-pills slur, asked to be buried in a red dress with no shoes.

My father doesn’t know that I am his daughter, Elizabeth Emily, the girl he nicknamed “E.E.” for brevity and affection. He thinks I’m my other sister, Valerie, because in his mind I am still 20-years-old, not 30. I am 50 pounds lighter, with a ponytail and headphones. In his mind, I have never changed his diaper.

My father doesn’t know he has Alzheimer’s disease. He thinks it is 1964 and that he has just signed up for another tour in Vietnam. He’s leaving tomorrow, so can we please stop worrying and press his uniform?

Some days, my father is no longer a man who needs Medicaid to share a nursing home room that barely fits its three patients’ beds; he believes he is a California millionaire with so many servants and staff members he can’t keep track of them all.

There was a time I felt a naïve ethical duty to correct him.

You see, my father has never lied to me. Ever. Not even about Santa Claus or floating goldfish. Growing up, if I got caught in a fib, he’d gently warn: “Our Heavenly Father hates a liar.” I knew from his steady example that my earthly father did, too.

So, when the most honest person I’ve ever met started losing his grip on the truth, I panicked.

LizGarcia_Dad300I will never forget the first time his reality didn’t match mine. He looked up from his hospital bed and asked, “Where’s Tippi?” I froze. I couldn’t remind him that he’d asked the vet to put his dog down three years before. I couldn’t lie, not to him; yet I knew the truth would be painful, confusing, and thus, cruel. Luckily, my husband piped up, “Tippi’s in Texas.” Technically, this was true. Hubby simply left out that Tippi was in Texas buried beneath our favorite tree.

Several times after that, I tried to tell my father the “real” truth about things he’d say. “We sold the house in Tennessee 10 years ago, remember?” I very quickly found myself unintentionally hurting him. Worse, he often forgot the content of my messages and then suffered a disorienting grief from a source he couldn’t place.

I needed help learning how to give him back the very thing my “truth” and his Alzheimer’s disease were taking, his dignity. In the worst moments of seeing him succumb to the disease, I prayed, Give him dignity or give him death. My prayers were answered by a few rare, heroic nurses who showed me that the tools for maintaining dignity are patience, creativity, consideration, and love.

There was the first nurse, an unlikely baritone who harmonized “Que Sera Sera” with my dad when he started belting out the song at 2 a.m. The nurse could’ve demanded that my dad “shut up,” or worse, he could have medicated him. Instead, the nurse sang a few choruses like they really were listening to old records, and his reassuring voice lulled my dad to sleep.

Another aide with a soft pink sweater taught me that it’s okay to answer some of my dad’s tough questions with calm ambiguity and chocolate. Sometimes, a shrug, a warm smile, and a Hershey’s Kiss provide more reassurance than anything we could say.

The very best nurses taught me that when a loved one’s mind deteriorates, you must talk to his or her heart. Though they taught me, they never told me. Their actions spoke to my own heart and changed it as I witnessed the gracious acts of kindness they shared not only with my dad, but with other dementia patients, too.

I remember watching a favorite nurse ask one reluctant woman if she was ready to come downstairs for brunch. This puzzled me because the nursing home stood one-story high and it was 5 p.m. It seemed to make sense to the patient. I later found out why she grinned and hurried toward the dining room. Her mother had called her “downstairs for brunch” every day in her youth and her mind had returned to those happy days.

Another tired afternoon, I heard a different elderly woman cursing and screaming down the hall. A flustered new aide, in a rush to get everyone to supper on time, had wheeled her out of her room against her will. She fully believed that she’d been kidnapped. She scooted to the edge of her wheelchair seat and thrust both feet at the floor, slamming an imaginary brake. Her hands clutched a plastic baby doll with no shirt and wild hair. She shouted for the police, for a gun, for Jesus. A wise, older nurse ran up to her, smiling an authentic smile, the kind you know is genuine because it lifts the smiler’s eyes. This nurse put some sugar in her voice, too—not any artificial sweetener, but the real deal. She said, “Mama, the baby’s hungry. Shall I take you to the kitchen and get her some milk?” The patient relaxed, nodded, and picked up her feet. She cradled her baby doll tightly and off they went with purpose, with dignity, with choice.

I once saw a beautiful young nurse let a gentleman patient believe she was his late wife. She blew him a kiss before she turned out his light.

Sometimes, my own father thinks one of his nurses is one of us (a daughter). He says, “Be good, honey. I love you.” She replies, “I’ll try. I love you, too!”

Now, when my father tells me he’s a millionaire or that a dead loved one has stopped by for a pleasant chat, I am genuinely happy for him. I relax and smile. He relaxes and smiles back. Our hearts connect the same way they always have. His reality is every bit as real to him as mine is to me, and it is okay for me not to shatter the truths of his world.

Alzheimer’s disease has tripped my father and he has spiraled down a rabbit hole. His nurses have shown me that if I appear in a tree and tell him that this way is this and that way is that, he will simply lose his head. I have given up hope that, like Alice in Wonderland, he’ll wake up from his surreal dream and come back to us. The nurses who have loved and cared for our entire family (not just him) have helped me to make peace with the fact that he is headed to the same place the other Alice, my sister, has gone. These heroic nurses have rushed around in scrubs and coats like White Rabbits. They have hurried between our world and the equally “real” places and times in their patients’ minds.

I am grateful to these nurses for showing me the way through the darkness and chaos of my dad’s dementia.

I will be forever grateful to them for showing me my father’s truth where it lies.

If you missed it, read the first installment in our look at the prize-winning stories from the John A. Hartford Foundation Heroes of Geriatric Care Story Contest:

Geriatrics Expertise Saves the Day—and a Life

You can read more about the contest and submissions from the 20 other story-telling finalists here.