Nana's house in California.   (Photo: Courtesy of Colin Harrison)

Maybe that’s why she got pregnant so quickly.

Almost exactly nine months after we had moved in, my wife had a baby, a daughter we named Sarah. Nana beheld this newborn creature in her lap a few days later, too nervous to lift her. “My hands are no good,” she cried happily. Not only was the baby precious, but the meaning of the baby was precious, too. Two generations removed, this flesh was her flesh.

From there, Kathy and I fell into the difficult time of being new parents. Working, taking care of a newborn and a 90-year-old, the days went past in a blur of sleep-deprivation. My wife worked herself to a deep exhaustion, losing weight, running the baby to the doctor’s office, shopping, cooking, cleaning. Sarah was fat and cackling, and we loved her more than life itself. The deal we had made with Nana seemed completely logical in retrospect, preordained even. Each piece had fallen into place.

Except the last one, the most obvious piece. Our baby girl was not 10 months old when it became clear that Nana had started to fail. She was tired, she was weak, she was irritable. Getting her to and from the hairdresser became more difficult. She didn’t want to go out to shop anymore. She wobbled alarmingly upon standing. Her skin was now so thin that it tore easily if she lurched against a piece of furniture.

Her mood deteriorated as well. Now she said that we spent most of our time and energy on the baby. If we wanted to take Sarah for a walk, she cried piteously on the sofa and wouldn’t look at us. “Nana, we’re just walking around the block,” my wife would say soothingly.

“Just go and leave me!”

As the weeks tumbled by, my wife and I sliding along, dumbed by exhaustion, Nana required ever more care. Now I carried Nana up the stairs for dinner and then down again. Sometimes she urinated in my arms. I didn’t much mind. She had given me my house, and in a way, she had given me my daughter. But we were never free from her. My wife bathed her every day or so, changed the sheets. I would check her nose with the flashlight, adjust the blinds, the heat, the blanket.

We lay on the floor gazing up at the impossibly high ceilings. What life would we live here that otherwise would never occur?

Nothing we did could address her looming terror. She began to scream at night, a kind of frightened wailing that rose and fell. Two floors above, my wife would lift her head.

“Oh, fuck,” she’d say. “I can’t take this anymore.”

I, the fool who had suggested the whole arrangement in the first place, would stumble down the stairs and stroke Nana’s forehead and promise her that if anything happened, I was there. In the darkness, Nana would cry a little and then passionately thank me, and then maybe she would fall asleep and maybe I would, too, or not. This went on for months—how many I can no longer remember.

Then came the next-hardest part, when we had to stop kidding ourselves. We had promised Nana we would take care of her to the end, but now she was losing blood from her rectum and losing consciousness. My wife took her to one doctor after another, but soon the doctor’s visits became hospital stays. She was dying, her doctor told us. Her heart was failing, and she might live another six months. This meant that she would either die at home, or she would not.

Either option was bad, but one of them was worse, given the circumstances. I began to look into what a nursing home might cost.

Meanwhile, my parents visited us and were shocked by how exhausted we appeared. “You are caring for two human beings in diapers,” my mother said. “You think you’re managing this, but you’re not.” She was right. The moment of clarity came when Nana fell badly, cutting her chin, and while attending to her we neglected to check on Sarah, who was by then crawling. We found our daughter eating cat food out of the bowl on the floor in Nana's living room.

Finally, we did it, wringing our hands, anxious, guilty, sad, trying our best to explain to Nana. She went to the hospital one more time and never came home. We placed her in the nearest nursing home we could find, a hulking institution about a mile from our house in a bad neighborhood. It was the only place even remotely close that had an open bed, and we tried to look on the bright side: We could take her out in a wheelchair onto the roof garden when the weather turned warm . . .