I live 500 miles away from my parents, so when I go to visit I usually stay a while. My mother has parkinson’s dementia and lives in the “special care” unit of a nursing home. I’ve just returned from a two week visit there, supporting her care for about 10 hours a day.

The special care unit is a lot like a loony bin. The people there are in various stages of mental disarray. Some are catatonic and maintained in upright positions by fancy wheelchairs. Some wander all day long, in and out of other peoples’ rooms, stuffing blankets in toilets, urinating at will in the hallway. Others are trying to go through the motions of a previous life, fiddling with books and newspapers they can no longer read. There is a lot of raw emotion: occasional angry outbursts and a constant cacophony of wailing and hollering for help. It’s a stressful place to hang out. I can’t imagine what it’s like to live there 24/7.

The people who do live there have no control over their lives. They can only eat what is fed them, and only at certain times of the day. Even toileting is scheduled, and the overburdened aides cannot take them when they need to go, so there are a lot of adult diapers. They get a shower once a week. A giant tv is on all the time, even though no one can understand what’s on it. To prevent falls, few people can even get up and walk around without help. Because it’s an upper-end home there are quite a few musical and religious activities in the afternoons, but almost all the residents spend most of their time falling asleep in their chairs.

I found myself wondering: what purpose do these people feel in their lives? Inside every one of them was the faintest glimmer of who they used to be. Several women passed the time by holding dolls, somewhat filling their need to provide care. For those who were verbal, it was possible to have interesting and lengthy conversations about the past. There is a wealth of history available there. But no one is listening––I saw very few visitors and the staff are too busy.

What is anyone’s purpose during our time on earth? Are we just watching each day pass while we eat and pee and sleep? Obviously, quantity of life is not as important as quality. What creates quality??