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I read every personal book I can find about Alzheimer's and dementia, and have reviewed more than 25 of them here on Amazon. Among many excellent books (by Mary Gordon, John Bayley, Sue Miller and Virginia Owens, among others), I found this the very best.

My father died in 2005, after descending into Alzheimer's. During the year I took care of him, I started reading memoirs on the subject--but somehow failed to come across Aaron Alterra's book until this year. From the first paragraph I knew I was in good hands. On page five I noted in the margin, "Every paragraph is perfect." And so it continued, one rich page after the next.

I'm always swayed, pro and con, by a book's writing, and Alterra (a pseudonym for the novelist and short story writer, E.S. Goldman) is a gorgeous writer: observant, deft, succinct and original. He would never heap on the adjectives this way, but I will, about him. The characters are spry, the dialog subtle, the descriptions powerful, his observations pierce like a quill. What can I say? I love how he writes.

My father would never mark a book. I do though, so after I finish I can find felicitous passages or points worth remembering. I use checks, brackets and occasional exclamation points--and after reading "The Caregiver" I went back through the entire book, counting them up. I found over 130 pencilled marks.

Alterra's scenes, of which there are many, are the lifeblood of the book. I ticked the opening of this one on page 63: "Ina Krillman's office decoration consisted of shelves of books and pamphlets and a row of folding metal chairs arranged for a small meeting in front of a small desk that she dominated like an adult on a pony."

I checked this, as well, about how many of the elderly will suffer from dementia: "People are living longer. If you expect to make it to eighty-five, expect also that you or your spouse will have Alzheimer's, the other will be a caregiver. Stella and I did not beat the odds."

His chapter on how the caregiver becomes the de facto primary care physician for anyone with dementia is particularly astute. How I wish I'd found this book when my father was still alive, and I was coping with several physicians. There is so little that doctors can do for Alzheimer's, Alterra points out: "Diagnosis and prescription are professionally satisfying, but a disease that is all downhill with not even pain to mitigate by prescription offers little professional reward."

There are guidebooks which discuss all features of dementia. For me, emotionally, I learn more from a book like this one. Take this passage, in which Alterra, with perfect economy, covers the entire prognosis of the disease: "What are the odds? For recovery, none. For living with it comfortably, we'll have to see. You may just lose a little more memory from time to time. You can live with that. It may be more severe. You may become incontinent, wheelchair-bound, forget how to chew or swallow, want to sleep all the time, be unable to speak. You may take it in stride, step-by-step. Or you may become profoundly unhappy, depressed, suicidal, and need drugs to even want to get up in the morning. Whatever it is, you can't do a thing about it."

The caregiver, however, can read this book--and what a pleasure it is to do so.

This is a most thoughtful insight from both the point of view of the Caretaker and the one for whom care is given. Many of your own thoughts, questions, fears, victories, frustrations and actual experiences are seen and lovingly, yet honestly, shared by a gifted writer. Thought provoking, calming, and a real companion for a Caretaker who feels alone -- as we all do from time to time. Well worth the read!

Thank you, Aaron Alterra, for sharing your very insightful experiences while giving such loving care to your dear wife, Stella. Your touching recount of Stella's final days as a cellist and your countless successful efforts at preseving her dignity brought tears as I (a sexagenerian) empathized with your many dillemmas.
I would certainly recommend this book to anyone with elderly parents or who themselves have become caregivers.

I was very touched by the way he cared and loved his wife. He did a lot of trial and error and gave 110%.