Page 7 of Her Last Refuge

"Of course. It's the least we can do." Miriam glanced toward the hallway, then back, her patience visibly polite but also visibly strained. "He shouldn't be more than a few minutes."

Rachel thanked her again and settled onto one of the lobby chairs near the fountain, hands folded loosely in her lap, and waited.

CHAPTER FIVE

"—and this is the sunroom, obviously." Brian gestured through a set of glass doors as they passed, not slowing his pace. "This is a very popular spot in the mornings. Less so this time of day, once the light gets harsh."

Rachel glanced through the doors as they walked. The room beyond was flooded with afternoon sun, potted ferns arranged along the windowsills, and a scattering of wingback chairs positioned to catch the view of the pond outside. An aide sat with an elderly man near the far wall, guiding his hand gently over a puzzle board. The air in the hallway smelled faintly of lavender, some diffuser tucked into a corner doing its quiet work beneath the low murmur of a television down the corridor.

Brian walked with a casual gait, the kind of pace that came from years of moving through a building where nobody wanted to be rushed. He was younger than Rachel expected, maybe early thirties, with the build of someone who spent his off hours at a gym. Yet, at the same time, there was a soft tone and kind patience in his voice. Rachel supposed that was the result of working hours with people who needed things repeated more than once.

"It's a beautiful facility," Rachel said, and meant it. The carpet beneath her shoes was thick and quiet, patterned in soft blues and creams. The walls were hung with framed watercolors that actually paired well with the paint and carpet colors. And the large windows, looking out onto a side lawn and a garden, were immaculately cleaned.

"I think it’s all part of the design,” Brian said. “Low stimulation, but not sterile, you know? There's actual research behind a lot of it—the colors, the layout, even the lighting." Brian nodded toward the overhead fixtures, warm and indirect, nothing like the fluorescent strips Rachel associated with most institutional buildings. "Harsh light and clutter can trigger agitation in a lot of our residents. So can loud noise, sudden movement…that kind of thing. We try to keep everything calm."

"Do you get a lot of agitation? I guess I assumed dementia care would be harder to manage than this looks."

"Confusion, sure, every day. That's just part of it." Brian slowed as they turned down a quieter hallway, his voice dropping slightly even though there was no one else around to hear. "Most of our residents have moderate to advanced Alzheimer's or some other form of dementia, vascular, Lewy body, a few mixed cases. So we see a lot of confusion about time, place, and people. Someone might not remember it's Tuesday, or they might ask about a husband who passed twenty years ago like he's due home for dinner. That's not agitation, that's just the disease doing what it does."

"And what’s the difference between that and something more serious?"

"Agitation's usually tied to something specific. Pain they can't communicate, a change in routine, sundowning, which is when symptoms get worse in the late afternoon and evening—we see a lot of that. Sometimes it's a UTI, believe it or not, those can cause a huge behavioral shift in an elderly patient almost overnight." He held up a hand briefly, ticking through it like it was a list he'd recited a hundred times before. "But full-blown violence, real aggression, that's actually pretty rare here. We keep a good ratio of staff to residents, and everyone gets trained in de-escalation before they're ever alone on a floor."

Rachel had more questions but wanted to make sure she didn’t come off as suspicious. Though, with the way Brian was walking her through things, it seemed like he enjoyed it. She doubted she’d raised any red flags for him just yet.

"What does that training look like?"

"Redirection, mostly. You don't argue with someone who's confused, you don't correct them and expect it to land. If someone's convinced it's 1985 and they need to pick their kids up from school, you don't tell them their kids are grown. You ask about the kids. You go along with the world they're standing in instead of trying to drag them back into ours." He said it simply, without any sense that he found the philosophy remarkable, though Rachel found herself struck by it.

They passed a nurses' station tucked into an alcove. A young woman behind the desk glanced up briefly before returning her attention to a chart. Rachel let a few seconds pass before asking the question she'd actually come to ask.

"Would it be alright if I saw Ruth's room? I know that might be a strange thing to ask."

Something shifted in Brian's expression, quick and involuntary. But he quickly folded it back beneath his professional calm and charm. He didn't try to hide the fact that he had to give it some thought.

“I think that should be okay. I know it’s already been scrubbed down. If it hadn’t…well, I probably wouldn’t be able to. Some of her stuff is still here, but the room itself has been cleaned.”

"Has anyone from her family been in since it happened?"

"Just her grandson. Caleb." Brian said the name carefully, as if he wasn't sure how much he was supposed to share. "He came by yesterday, mostly just sat in there a while. He's supposed to come back tomorrow to clear everything out. We don't rush families on that, not usually, we like to give them time."

They stopped in front of a door near the end of the hall, the number 114 mounted beside it in brushed steel. Brian knocked once out of habit, an old reflex that seemed to embarrass him slightly when he caught himself doing it. With a wry smile, he then pushed the door open.

The room was small and quiet, softened by late-afternoon light filtering through sheer curtains over a single window. A twin bed sat against the far wall, neatly made. The quilt that was folded across the foot of it looked hand-stitched, older than anything else in the room. A dresser stood beside the closet, and on top of it sat a scattering of framed photographs: Ruth younger, standing beside a man Rachel recognized as Walter, both of them squinting into sunlight in front of a car that looked decades out of date.

A small shelf near the bed held a handful of paperback novels with cracked spines, a rosary draped over the corner of the frame, and a ceramic dish holding a few pieces of costume jewelry. It was quaint and rather sad, the kind of small collection a person accumulated without meaning to. She’d seen lots of the same sort of thing during her years serving in hospice.

Rachel stood in the doorway a moment, taking it in, and felt something tighten quietly in her chest. It was not grief, not really. After all, she had barely even known this woman. What she was feeling was closer to a feeling of trespassing. The weight of a life had been reduced to this little room, and for a while, it felt almost holy. And she was intruding.

"Had she had any episodes recently? The kind you were talking about, confusion or agitation?"

"Not that I saw. Honestly, she'd been pretty settled the last couple weeks. Good appetite, good mood, mostly." Brian laughed softly and added, “But Ruth seemed to always have an appetite. She was forever snacking on things. Keep in mind, now, I'm only here during the day. My shift ends at seven, so anything that happened at night, I wouldn't necessarily know about. You'd have to ask one of the night staff for that. But I don’t recall seeing anything in her notes."

"Was there a night nurse who worked with her regularly?"

"Donna, mostly. She's been here a long time." He said it and then seemed to catch himself, straightening slightly, his tone shifting back toward something more careful and rehearsed. Rachel wondered if he was finally starting to smell something fishy. "I really can't speak to what happened overnight, though. I wasn't there."

Rachel nodded and let her eyes move once more over the room. Then she stepped back out into the hallway, and Brian pulled the door shut gently behind her, careful with the handle in a way that seemed almost reverent.