Aggie's Smile

In the Reserve, the memory unit where I work part-time, people with advanced stages of dementia are placed. It’s the end of the road for them. People die, about two per month on average. It’s usually a slow process, due to Alzheimers. The brain takes its time in clogging up with the particular detritus of this disease. The malfunctioning of different parts of the brain often follows a pattern of unwinding backwards, through the stages of development. First the cognitive thinking & memories of the forebrain goes. Then it moves slowly deeper and deeper. Impulses lose control. Words disconnect from meaning and finally are often lost altogether. At the end they often do not wish to eat or drink. Finally the swallowing reflex or breathing reflex goes, bringing the end. Others die of concurrent diseases or the influenza.

One of my favorite women, Aggie, was quite feisty, though almost deaf, when she first came to us a couple of months ago. She was stocky, with beautiful, soft, white hair down to her shoulders. It reminds me of angel hair. She loved playing kick ball—yelling –“KICK IT!” when another demented elder lagged in her duty to the game. She puzzled over puzzles, relished eating snacks, and dabbled with watercolors. When I rouse her from her inner world and she sees my face, she breaks into a smile that encompasses her whole face.

But about a week ago she began to decline. Now she declines activities and declines food. Or, if she eats food, she pockets it in her cheeks and later spits it into tissues, if she has them at hand. Otherwise it’s headed for the floor. I see her skin hanging looser on her bones. Each day, I wonder if I will get to see her smile again, whether lost because she dies or because her brain loses even that small blessing of social interaction by the time I am there to see her again.