“Mrs. Rodriguez, your mother’s memory medication was tripled three months ago. Did you authorize that?”
The pharmacist from the Canton shop, a woman named Martha, sounded tired. She had that flat, clinical voice people use when they are trying to break bad news without getting emotional.
But there was a sharp edge to her words that made me completely stop wiping down my kitchen counter.
“No,” I said, my voice sounding thin even to myself. “My brother Gerald handles her refills now. Is there a problem?”
Martha was silent for a second. In the background, I could hear the rhythmic clacking of a pill counter. It was a mundane, ordinary sound, but it made my stomach feel completely empty.
“Eva, I am looking at her chart,” Martha said, her voice dropping to a low, quiet tone. “The dosage was increased from five milligrams to fifteen milligrams. At this rate, her cognitive function is going to plummet. Within six months, she won’t be able to care for herself at all. She will need a full-time nursing facility.”
I stood in my own kitchen, staring at a small tear in the wallpaper near the fridge. My mother is 79 years old. She has mild dementia, but she still lives independently in the little yellow brick ranch house my father built with his own hands back in 1974.
That house is everything to her. It is her sanctuary, her memories, and her pride. In the current market, that modest plot of land in Canton is worth 310,000 dollars. It is the only major asset she has left in this world.
If she goes into a private care facility, that house will have to be sold to cover the bills. The state requires it. The system demands that you drain every single asset before they assist you with long-term care costs.
I felt a cold stiffness settle into my jaw. I remembered a conversation from last April. Gerald had come over to my house, carrying a blue plastic folder. He sat at my dining room table, drinking his coffee black, and told me he was adding his name to Mother’s deed.
“It is just a precaution,” he had said, not looking me in the eye. He was busy folding his paper napkin into neat little triangles. “In case something happens suddenly. It makes the estate transition easier later on. You understand, right?”
I had trusted him. He was my brother. He was the one who helped her mow the lawn and checked her gutters. I was busy with my own kids and my job at the local clinic, so I let him handle the paperwork.
I hung up with Martha and walked out to my car. My hands were shaking so badly I could barely get the key into the ignition. The drive to Mother’s house took twenty minutes, but it felt like twenty years.
The afternoon sun was hot, baking the asphalt as I pulled into her gravel driveway. The yellow brick house looked peaceful. Her tomato plants were tied to wooden stakes in the front yard, their red fruit heavy and ripe in the late summer heat.
I walked inside without knocking. The kitchen smelled of cinnamon and stale toast. Mother was sitting at the kitchen table, staring blankly at her blue weekly pill organizer. It was a cheap plastic thing, the letters for the days of the week partially rubbed off from years of use.
“Eva, sweetie,” she whispered, her eyes cloudy and confused. “I can’t seem to find my sewing shears. I know I put them in the drawer, but the drawer is empty.”
“We’ll find them, Mom,” I said, my voice cracking.
I took the blue plastic organizer from the table. I walked over to the kitchen cabinet where her spare prescription bottles were kept. I pulled down the current 90-day bottle of her Donepezil.
I poured the tiny white tablets onto the Formica counter. My fingers were cold as I counted them out, one by one.
There were 47 pills missing that shouldn’t have been. The bottle was nearly empty, weeks ahead of schedule. She was taking three times her prescribed amount. No wonder she had been so confused lately. No wonder she had forgotten my daughter’s name last Sunday.
I put the empty bottle down very carefully on the counter. The plastic made a sharp, hollow sound against the laminate.
I called Mother’s neurologist, Dr. Vance. I had to wait on hold for ten minutes, listening to elevator music that made my head throb. When he finally came on the line, I didn’t even say hello.
“Dr. Vance, did you triple my mother’s dementia medication?” I demanded.
“Absolutely not, Eva,” he said, sounding genuinely startled. “We discussed this at her last appointment.
A higher dose would cause severe confusion and physical side effects. Her liver couldn’t handle it. Why do you ask?”
“The Canton pharmacy received an authorization three months ago,” I said, my chest tightening. “They’ve been filling a fifteen-milligram prescription.”
There was a long silence on the other end. I could hear Dr. Vance typing rapidly on his computer keyboard.
“This is highly irregular,” he muttered. “I am looking at her electronic record. There is no order from my office. But there is a manual log entry. A phone-in authorization was received by the pharmacy on May 14th.”
“Who called it in?” I asked, my voice barely a whisper. My hand gripped the edge of the Formica counter until my knuckles turned white.
