Go ask Alice

For the past 10 months I have been caring for an elderly woman with senile dementia. Her name is Alice, she is 89 years old, and she was raised in East Texas. I know a lot about Alice. I can recite the names of her four sisters in chronological order, recount stories of her childhood spent apart from her siblings following the untimely death of their mother, and list the places Alice has lived throughout her long and busy life.

For Alice, these isolated and disjointed memories are all she has left. She cannot tell you a thing about the last year or more of her life. From day to day, minute to minute, she cannot remember where she is or how she got there. She just wants to "go home." In varying forms that is her constant mantra. She is very frail and weak now but still determined. She struggles to get up from her chair or the couch, asking "Where are mah shoes?" She knows she can't walk to the car and drive home without them, even though she has not driven a car for more than 2 years.

No matter who tells her or how many times she is told that she is already home, that she lives now with her daughter's family, Alice cannot accept our reality. For that's what it is, after all. We are trying to impose our reality on her when she insists on existing in hers. Alice's reality is about living in her own home, going to bridge games, teaching school, baking cornbread, and working at her daughter's gallery. All are things and activities now lost to her forever, yet still she persists.

Alice's granddaughter calls her "fierce" and it is a very apt term. If she doesn't want to do something, there is no power on earth that can force her. She is indomitable in her struggle to remain independent in the face of insurmountable physical and mental challenges. Despite the fact that she cannot walk even the shortest distances without her knees giving out or becoming short of breath, Alice is often amazed when her caregiver offers to take her to the bathroom in a wheelchair. "Whose wheelchair is that?" she will ask in a puzzled tone of voice. "Why is that here? Ah'm not sick."

Alice and I have had many memorable conversations, often the same one more than once. Some days she is like the proverbial broken record, asking me the same questions over and over. "Where's mah purse? How did I get here? What state are we in?" I am a patient person by nature but this job has taught me to try to live as Alice does, moment by moment, because in the end that's really all we have.