A deceivingly heavy bag of groceries in one hand, two gallons of milk in the other and newly bloomed daffodils that smell of spring in abundance balancing in the crevice of my right elbow. I struggle slightly to reach the doorbell, and while doing so, I try to brush off and leave the look of agitation of Saturday afternoon traffic through the roads of North London behind. If anyone deserves a smile, she does. I ring the doorbell once more, just in case. I hear the faint, yet rapid footsteps of my 87-year old grandmother and chuckle to myself, thinking, If I can walk that fast when I’m her age, I’ll be lucky! There’s a pause. The little fish-eye lens of the viewing hole suddenly changes colour and just as I’m trying to fix my windswept hair, the door opens. I can’t help but notice it opens reluctantly, after undo-ing three sets of security locks, if I counted correctly. Normally, it’s a greeting with her tea-stained dentures on show, and a few words of wisdom on the principle of punctuality. Today, her face stands expressionless, yet it was evident she was in the deepest of thought. The door is open, wide enough to only cover two-thirds of her petite stature, one hand still gripping securely on to the door handle. As we catch each other’s eyes, I see a concoction of fear, confusion and guilt in hers – it’s highly likely she’s forgotten who I am, she’s forgotten my name, she’s forgotten I am her granddaughter. She must feel like she’s opening the door to a cheerful stranger holding milk and flowers. Trying to disguise her confusion, a reluctant smile radiates from her aged face. “Hi Nana, it’s me, sorry I’m late. Traffic, again!” – I try hard to not make it obvious that I realise she can’t recognise me. It’s not long before the reluctance in her smile is replaced by remorse – my heart sinks; if I feel this bad that I was nearly forgotten, imagine how she feels that she forgot. It’s not her fault, it’s Alzheimer’s.
I picture an army of little beta-amyloid plaques, marching uniformly towards the limbic system. Eventually, they build a wall around it, attacking all the neurones in its vicinity in a passive aggressive manner. The hippocampus withers away and as much as it fights back, it’s a losing battle.
Every morning she wakes up unsure of which memories she’ll have lost during that night’s sleep. Every morning she wakes up wondering what challenges she’ll have to face today. What will she forget today – to turn off the gas? To take her medication? Where she kept her hearing-aid? I realise that must be such a vulnerable position to be in, to be expecting the worst.
As I walk in, I lay the daffodils down on the table, place the bag of groceries on the floor and, as I make my way to the fridge to house the milk, the condensation from the plastic gallon marks my journey. As I stand there rubbing the circulation back in to my hands, I see Nana aligning the pillows on the sofa, and rearranging the coasters on the coffee table – she’s always been a perfectionist and I’m glad that’s a quality she hasn’t yet lost. To her, I am an unexpected visitor, even though I actually called a mere 20 minutes before arriving. It can’t be a nice feeling for such drastic, unexpected changes and I can only imagine it being rather over-whelming for her. She’s handling it really well though, she’s much stronger about this than I think I would be.
I ask her whether she wants a cup of tea, partly out of politeness knowing her answer to be a definite yes, and partly because I’m still worked-up after sitting in that traffic and I want a cup of tea too. There’s nothing like bonding with a grandparent over a hot cup of masala chai. As I source the pan and place the correct measurement of water in it, she joins me in the kitchen, looking over me, ensuring I’m doing things correctly. I propose that she make the tea while I put away the groceries which still lay leaning on the leg of the chair near the dining table. As I lay things out on the table grouping them by location - fridge items, storage room items, cupboard items - I hear an unusual amount of rummaging in the kitchen, especially for someone who is just making some tea. I grab some fridge items, as many as my petite hands can carry, and use them as an excuse to see what’s going on in there. I see the pan on the stove, water boiling but still clear. Now, I’m confused, but I ask gently as to why. “I can’t remember where the tea leaves are for the life of me. I’ve looked in the fridge and everything,” she replies. Once again, my heart sinks. For as long as I have known Nana, tea is made at 8am and 4pm, without fail. And now, she can’t remember where the tea leaves are; she must feel like a stranger in her own home, in her own kitchen. I trace my mind back to visiting her a few weeks ago and vaguely remember the tea leaves being in the top left cupboard. As I reach for them, I place my hand on her shoulder, give her a smile, and reassure her: “It’s okay, Nana. We found them!” As the tea brews, I rummage through by bag to the post-it notes I keep in my Filofax and clearly write ‘TEA’ in capital letters and stick it on the top left hand cupboard – hopefully, this little aide memoir will ensure she gets her bi-daily caffeine dose. I knew those post-its would come in handy some day!
I continue putting away the last of the groceries when I hear a disappointed, guilt ridden, heavy-hearted, “Oh gosh, no...” followed by the sound of the tea spilling over, sizzling as the liquid hits the flame, and burning on the side of the pan. She’s flustered. She’s deciding on whether to move the pan and still trying to figure out how to switch the gas off. I didn’t need to ask – she’d forgotten which knob turns the gas of that particular hob off and the consequences have left her feeling embarrassed and annoyed, mostly at herself. I, for one, am just glad it didn’t lead to anything dangerous. After switching off the stove, I lead her calmly in to the living room. I hand her her tea and strike up a general conversation, as if nothing went wrong. Her initial confusion gradually dissipates as I try to counterbalance her embarrassment, confusion, guilt and frustration with laughter and light-hearted banter.
Midway through the conversation, her face drops slightly, her eyes lower and her shoulders slouch. I rapidly retrace my last few sentences in my head to see if I’ve said something that could have triggered this. After asking her why the sudden change, I realise that indirectly, I was the trigger:
“Look at you, so young, so fast and with so much to explore and see, but your mind can handle it and I’m slightly envious. As you talk about your studies and your projects, I can feel your drive, your inner passion, I have it in me too even at this age, except I can do nothing about it. I am helpless. I can’t even make a cup of tea for you, yet once upon a time I would have made fifteen cups for a houseful of people. When I was your age, I was a self-established woman who ran a business, a mother of three children with three to come, and had an exceptional social life. And now, I can’t recognise my own granddaughter? I’m trying to understand and accept this at the same time, and both are crucial because this condition is progressive, but I need the world around me to be slightly patient. I feel like a burden on to those who have to care for me, a liability. But I promise you it’s not intentional. I’m not in control here.”
Her eyes welled up, her vulnerability staring me in the face.
Mentally, I take a step back to see the bigger picture. I detach myself from the fact that she is my grandmother. In black and white, sits a frail, feeble elderly woman. Just as her neuronal impulses are trapped, preventing her memory from functioning optimally, she feels equally as trapped, unable to express herself. This is a lady who was once a successful businesswoman but now feels like she is constantly failing, a woman whose thoughts (or lack of) are now her greatest enemy. No one pictures their old age like this. I am aware that she struggles to remember events, or people, or mishaps, but I also realise that she remembers feelings and from the expression on her face and the sadness in her eyes, there’s a part of me that wishes she couldn’t remember those either.
Our identities are made up of our experiences, and our experiences are captured in our memories. These memories are deceiving – we think they’re stored forever in the supposedly infinite storage capacity that is the human brain but in fact, all it takes is a miniscule protein to come and strip you of your memory, your identity. Unfortunately, it comes at a stage in your life where you actually have the time to ponder upon the memories you’ve collected during this journey called life.
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Alzheimer’s disease is a form of dementia that has the potential to affect all, but is most prevalent in the elderly, affecting approx. 50 million people worldwide. Patients with Alzheimer’s suffer internally in ways which are not so simple to understand, but it’s a demeaning disorder which requires the help of those around them – one of the greatest forms of aid is empathy and patience. Cherish your memories, value your memory, realise its profound beauty and appreciate it – one day, it may not be as easily accessible.