I was so used to going to poorer neighborhoods, visiting those on the edge of poverty, or deep within it, that when I found myself in more affluent parts of town, I had to curb an instinctive critical voice that questioned why these people, in such privileged surroundings, needed our service. These were the thoughts I was fighting off as I drove through San Marino, a lush enclave next to Pasadena, the bastion of old money and what passed for old society in brash Los Angeles. Not surprisingly, we had never had a client here before, and judging by the measured, well-spoken tones of the mother on the phone I had assumed that this would be a “polite” visit.

I drove up to a house that was large, but not as opulent as its neighbors, not protected and hidden by high, well manicured hedges. If anything it looked slightly neglected, unkempt, with a sort of faded gentility. At least the doorbell still worked, sonorously in fact, the intimidating chimes that proclaim ‘old money’.

As I expected, the door was opened by the client’s mother, Mrs. Winner. She was a soft, pastel kind of woman, her face set in a faint social smile of welcome, but with signs of weariness bordering on disdain. Her clothes were of the classic twin-set-and pearls kind, and would have been elegant had they not been marred by the same slightly disheveled neglect of the house.

She shook my hand and invited me in to the rather gloomy hallway. The inside of the house, once comfortable no doubt, now also looked weary. We walked past several tight-shut doors to the far end of the hall.

“Rodney’s through here.”

He was sitting in a wheelchair, gazing at the floor, but raised his head as she introduced me. He smiled, loosely shook my hand.

“This doesn’t take long. I’ll just perch here on the edge of the bed.”

I didn’t need to look at my computer printout to know that he was very sick. Close to the “end-stages” as it was called. Thin, gray, slumped in his robe and doing his best to concentrate. As I began to go through his nutritional needs his mother hesitated, then, as if having decided that I was a benign influence in the room, felt it safe to leave.

“I’ll leave you two alone. Just call if you need anything.”  

I didn’t spend long with Rodney. It was one of those cases where there was not much to say, where any optimism came out as false platitudes, and where the weary client would rather be left alone with his own thoughts. I made sure we were doing all we could in terms of special diet and nutritional supplements.

“Yes thanks, I’m fine.”

“You certainly seem to be comfortable here. And you have your mother. Is she here all the time?”

“Yes, always here. I don’t think she’s taking enough care of herself.”

“Well, I’ll mention that to her too. Be sure to call if we can do anything else.”

I bent over the wheelchair, hugged him, said goodbye and left the room.

Mrs. Winner was hovering near the other end of the hall waiting for me to finish. As I came toward her she said,

“Would you like to see my husband?”

“Yes. Please.” I had been wondering about Mr. Winner. Thank God there was one.

She opened another door off the hall.

“Oh, I’m afraid he’s asleep.”

I looked into another bedroom, larger than Rodney’s but even more redolent of the sick-room. The bed was a hospital bed, with Mr. Winner propped up, dozing.

To the question that hung unasked in the air, she said,

“He has cancer.”

“Really. Where is the cancer?”

“All over, really. The doctors don’t give him too much longer.”

“I see.”

She closed the door and led me into the kitchen. Judging from the medications and the food preparations, this was her base of operations.

She looked up at me with the same polite, weary smile that said wordlessly, “Is there anything else?”

“Now how about you? Are you getting any breaks from all this?”

“Not really. I’d rather be here all the time. There’s a lot to do.”

“Are you getting any help? Any home health care?”

“Not so far. We kind of fall between the cracks. Too much money to qualify for free care but, under the circumstances, not enough any more to pay for it ourselves. But I really can cope on my own.”

I felt sure that was the real reason. She was reluctant to let some attendant or social worker into her tight, discreet world. I was surprised she was accepting our help.

“My sister drops in sometimes and we have a meal or a cup of tea.”

“Right now you’re just down for one lunch each day, for Rodney, but we can easily send one for Mr. Winner.”

“Oh, I wouldn’t want to……”

“Nonsense. It would help you out a bit in the middle of the day. We can send one for you as well.”

“But I’m not…..”

“No, of course, but we routinely send meals to full-time caregivers.”

As soon as the phrase was out of my mouth I realized how inadequate, almost insulting it was to this wife and mother.

“So, we’ll send three meals every day. Between twelve and two p.m. It’ll take the burden off just a little bit. Is there anything else we can do to help?”

There was a sudden impression that I was getting a little too close, too into her world and I sensed in her an imperceptible pulling back.

“No, no. You’ve been very kind. I do thank you for coming.”

“It’s my pleasure.” Pleasure? Another awkward word.

“I should really get back to Rodney.”

“Of course. I’ll be off. Be sure to call us if we can do anything else.”

“I will.” I knew she wouldn’t.

She walked me to the big front door and I turned to her. The most natural thing in the world would have been a hug. Often that’s when they broke down. But Mrs.Winner extended her hand. As I shook it, her smile grew slightly warmer. That was all I was going to get.

Back in my car I completed my notes. ‘Cared for by Mrs. Winner’. Why were the names so often the most inappropriate you could imagine?

I updated the order. ‘Three meals. Two disabled (bedbound) and one full-time caregiver.’