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If Only There Was A Second Time Around

Posted on July 9th, 2015 by karen

by Kim Keller

As another anniversary of our father’s passing — July 16th, to be exact — approaches, my sister Karen and I find ourselves once again filled with regret for all the lessons learned, far too late in life, about how to help someone you love through serious illness.

Dad’s health issues lingered for quite some time, but during the last year of his life, he deteriorated at a tumultuous pace. It was a painful ordeal, and if it were possible to go back in time, Karen and I would do many things differently.

We would have more actively:

Insisted that our father seek better medical care earlier in his illness. The critical lesson here: sometimes you just have to travel farther for better hospitals and doctors. Dad made his choices based primarily on location, and while we often questioned the quality of his doctors and their related facilities, we weren’t comfortable pushing this point with him, until it was far too late in the game. Given what we now know, we would have kept researching hospitals in the region until we found a teaching hospital with MAGNET status. Teaching hospitals generally attract higher caliber doctors, and a MAGNET designation indicates an impressive level of quality care bestowed upon patients by the nursing staff. Naturally, there are great hospitals that are not teaching facilities, as well as many without MAGNET status, but it’s an excellent place to start.
Focused on how Dad could reduce the amount of medications he was taking. He had lots of specialists, especially as his health unraveled, and each doctor added a new prescription or two. Not enough attention was paid to the possible side effects and adverse interactions caused by combining so many medications. In fact, rather than scrutinizing the burgeoning list of drugs that were being pushed at our father, each new medical issue that cropped up heralded another new prescription. Given what we know now, we would have discussed the medication list with all the various specialists, starting with these five questions: (1) Are any of Dad’s symptoms a possible side effect of another medication? (2) What are the potential side effects of each drug? (3) Is this drug safe and/or effective for someone over 65? (4) Are there any issues to watch out for when this drug interacts with Dad’s other current medications? (5) Is there any harm in changing Dad’s diet and/or exercise regimen rather than prescribing another new medication? And to help us with our own research, we would have used MediGuard.com, which is a great tool for fleshing out medication problems.
Talked with our father about end-of-life issues. Dad already had a living will in place, so we thought we were covered in this important area, but we were wrong. We soon discovered that many common scenarios needing to be fully vetted are not handled by the average living will. For example, do you continue with aggressive treatments when they can’t cure you but can only sustain a bedridden life? Not an easy question to discuss, and we certainly never discussed this as a family, but at a certain point late in the illness, Dad was no longer able to give his input, and continuing treatments no longer held any promise of recovery. We decided to maintain the full-on treatments, but we’ve never been sure this was what Dad wanted. If we’d known back then about the critical importance of a wide-ranging end-of-life discussion, we would have used www.agingwithdignity.com. It’s an important resource that walks you through the fundamental questions that every family needs to consider.
Established ourselves as coordinators for keeping track of all communication between and amongst the various medical personnel and caregivers attending to Dad. Karen and I just didn’t understand, at least not at first, that someone had to pull together all the various pieces of information relating to Dad’s care, from medication mandates and treatment instructions to exercise orders and diet alterations. Counting on the medical teams to coordinate and communicate was not realistic. We eventually learned to keep track of everything and to communicate everything. There was nothing too big or too small. Here are some of our charts and checklists.
Created a support team around us to help us anticipate needs, develop a plan, make better decisions, and clue us in on available resources and tools. Frankly, back then we didn’t even realize we needed a support team, other than our father’s medical attendants. Dad had been sick for so long that we never would have believed we were facing his final year. Without a support team, we spent way too much time being reactive, putting out fires, floundering with decision-making. If we could do it all over again, without the pain and torture that Dad surely experienced, we would’ve reached out to people who had been down this path before. There are many places to start building a team: in-home care agencies, for example. Or local religious organizations, many of which have outreach programs, geriatric care managers, and senior centers. When we finally did build our team, we were relieved and finally confident that we were making sound decisions. We didn’t understand at that point how close we were to the end, but we were at least able to spend our time in a far more important and valuable way: loving our father and enjoying every last minute with him.

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Advocate For Your Own Health: Balancing Trust With Facts

Posted on June 24th, 2015 by karen

Nonno surrounded by his family

by Nadia Fiorita

My grandfather was diagnosed with lung cancer about four years ago at the age of 82. At the time, it was absolutely devastating news. The doctors gave him only 3-6 months to live.

I’m happy to report that Nonno (as all us grandchildren call him) surpassed everyone’s expectations and is still alive today. And he was able to survive without chemotherapy or radiation treatments, which is amazing.

Unfortunately, after a recent follow-up visit, his doctor found multiple tumors on the left side of his brain that caused Nonno to have frequent headaches. Again, this was crushing news for my entire family, especially my grandfather, since he was looking forward to going to Italy the following week.

During that follow-up visit, the doctor strongly recommended that my grandfather begin immediate radiation treatments to target the largest tumor. The doctor passed along some information about the potential side effects of radiation, but reassured all of us that my grandfather would still be able to travel to Italy after receiving the first round of treatments. My grandfather wanted so badly to believe that everything would work out that he took the doctor’s reassurances to heart and put the potential side effects out of his mind. He thought he would get better and be able to go to visit his homeland. But right after the initial treatment, my grandfather’s health began to decline rapidly: he lost his energy and his appetite, and it became clear that he was getting sicker with each passing day.

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Transforming A Life One Room At A Time

Posted on June 17th, 2015 by karen

by Karen Keller Capuciati

After one of the meetings I have every month with a group of geriatric care professionals, Kathryn, a gerontologist, was telling me what she had done for a client named “Rosie,” who had recently transitioned from post-operative rehab, where she was recovering from a femoral fracture, into an assisted-living facility.

Kathryn described how she had transformed an empty room at an ALF into a home for her client. I was touched by the lengths that Kathryn had gone to — in my opinion, she went above and beyond the normal bounds of her profession in making sure that Rosie’s new home was as nice and comfortable as it could possibly be.

“Rosie loves the outdoors,” Kathryn told me, smiling at the recollection. “So I loaded the big picture window with flowering plants, and colorful vases that I filled with flowers. Then I bought a brightly colored flowered quilt, a high-back chair and ottoman that is really cozy — in blue, Rosie’s favorite color. I also brought over some of Rosie’s artifacts and knickknacks to have in her new space.” Kathryn smiled again. “It’s a real joyful room.”

Kathryn couldn’t bring too much from Rosie’s home, but she took what she thought was important, such as the antique secretary desk. Rosie had worked her whole life as an administrative assistant, so Kathryn figured that having her desk in the new home, with lots of shelves and compartments and stacked drawers, would be a point of familiarity and comfort for Rosie. Kathryn knew intuitively that Rosie would enjoy sitting at her desk, reading the newspaper, writing cards and letters to friends. It would give the room a point of warmth and familiarity.

Kathryn was detailing the Rosie situation because of an earlier group discussion about how long it often takes new residents to get acclimated to an unknown facility. It’s no surprise really — imagine being moved into a building full of strangers, sometimes against your wishes, sleeping in an unfamiliar bed, eating in a dining room while surrounded by faces you’ve never seen, being given a routine that’s wholly different from the one you’ve been living for years. It feels like the comfort of home has been ripped away from you.

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Five Simple Strategies For Living With Dementia

Posted on June 10th, 2015 by karen

by Kim Keller

Sometimes it’s the simplest action that has the biggest impact. That’s why I love these five “good ideas” to help anyone who’s caring for a loved one with dementia. Take a look.

The Magic of Music — Music, as we’ve come to learn, has a powerful and transformative effect on those with dementia. Check out the movie trailer from this must-see documentary, Alive Inside, and you’ll see what I mean. It’s relatively easy for you to try out — just put together a playlist of your loved one’s favorite music and load the songs onto an iPod shuffle (or any other device with simple controls). To get the biggest benefit, the music should be listened to with earplugs or a headset, in order to minimize potential distractions and allow your loved one to be totally engaged by the music. By the way, Alive Inside is now available for purchase on DVD or iTunes.
Create a Routine — Have a routine for daily activities like eating, exercising, bathing, sleeping. The discipline of a routine tends to provide calm and focus, and no energy is wasted on superfluous decision-making.
Calling Cards — One of our contributors, Colleen Lanier, gave us this great suggestion: create calling cards for your loved one. Handing a stranger a card that alerts him or her to your loved one’s impairment can discreetly reduce the potential for awkward and/or misunderstood moments.
Sundowning Strategies — “Sundowning” is a psychological syndrome that entails increased confusion and restlessness among patients with some form of dementia, particularly Alzheimer’s. The term itself refers to the most common timing of the confusion. Finding simple activities, whether it’s helping with household chores or playing a board game, can help to ease problematic behavior. Dr. Paul Raia, a regular contributor to In Care of Dad, provides some important insight into sundowning here.
Safe Return — The Alzheimer’s Association has collaborated with MedicAlert to create a nationwide emergency response program called “MedicAlert® + Alzheimer’s Association Safe Return®” which provides a bracelet or pendant for your loved one to wear at all times. The jewelry is inscribed with the words “memory impaired” and an emergency hotline number that operates 24/7, as well as any critical medical information. So if a loved one goes missing, you can call the emergency number and immediately set in motion a search by law enforcement and personnel from the local Alzheimer’s Association. The emergency hotline operators also have full access to all pertinent medical information. The registration is simple and can be done online. The cost, as of this writing, is $55 for the first year, with a $35 renewal fee each year thereafter, plus a $7 shipping fee for the bracelet or pendant. Another consideration is “Comfort Zone,” a GPS tracking service linked to your family’s home computer that monitors your loved one’s whereabouts at all times. The information can also be delivered through text messages. This service is $42.99 per month, with a $45 activation fee. This monthly plan also comes with the MedicAlert + Alzheimer’s Association Safe Return package mentioned above. There may be an additional fee for shipping and handling of the jewelry. Here’s more information from the Alzheimer’s Association.

Kim Keller is the Co-Founder of In Care of Dad. She lives and works in New York City.

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To Drive Or Not To Drive: Help Is Available

Posted on May 14th, 2015 by karen

by Kim Keller

In most of America, people are still very much reliant on automobiles to get around. Not so much in urban areas, where public transportation is highly developed, but everywhere else, driving is pretty much a cultural requirement. So, one of the hardest adjustments my mom has had to make is not being able to drive, even temporarily. She’s had some health challenges during the last few years that have impacted her ability to drive safely, so my sister Karen and I had to find alternate transportation and a pathway for Mom to return to driving her own car.

Here’s what we did:

After she had a stroke in 2009, there was a period when Mom’s cognitive ability was a bit shaky. She had trouble reading some street signs, and her decision-making capacity was not yet ready for the split-second requirements of Florida traffic. Her doctors told us it was a temporary situation, and Mom was certainly eager to get back behind the wheel, but Karen and I were concerned that it was too soon. So, after speaking with one of Mom’s doctors, we contacted a nearby rehabilitation center that had a program for evaluating the readiness of drivers who have incurred a physical and/or mental impairment as a result of injury, illness or normal aging.

A specialized Occupational Therapist conducted the testing. The therapist evaluated Mom’s ability to drive by testing her vision, her physical capabilities and her overall capacity to make quick judgment calls. The sensory testing was followed by an actual driving assessment.

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Water, Water, Everywhere: Preventing Dehydration

Posted on May 6th, 2015 by kim

by Kim Keller

I never fully appreciated how important drinking water was until my dad needed to be hospitalized — twice! — as a result of severe dehydration. He first complained about feeling extremely tired, and then he suddenly became completely confused, seemingly out of the blue. It scared us! Dad was so weak and disoriented that we needed to call an ambulance to get him safely to the hospital.

And as it turned out, the fuss was all about water.

It seems so simple. Water. Yet, severe dehydration is a serious health concern for aging adults. Medications can be dehydrating. The ability to signal thirst doesn’t work quite as well anymore. The ability to store fluids diminishes. Those with dementia can no longer keep track of their water intake. And, for many, the dismay of incontinence makes all fluid intake extremely undesirable.

My sister Karen and I became relentless reminders with our dad, and now with our mom, to drink more water! Talking with friends, we’ve discovered that we aren’t alone. Many of them have experience with this issue as well.

So we asked for some of their tips, and here’s what they told us:

“I am always trying to get my mom to drink more water. Part of the problem is not knowing how much she drank. I always suggest that she put water in a quart bottle and I tell her she needs 2 bottles a day. That way she always knows how much she had.”

~ Mindy, art restorer, Weston, CT

“Most older adults, I have found, if they drink water at all, handle it better in small doses — meaning a small glass, but fairly consistently throughout the day. Encourage drinking a full (small) glass when taking meds, which is usually at least twice daily. I encourage clients to drink about half the small glass before taking the meds, so they go down easier. I try to get them to also drink a full glass (even if it’s small) with every meal. Make it a routine.

“I think water can be boring and uninteresting for many older adults, so we put it “on the rocks,” or we add a splash of OJ, grapefruit juice, cranberry, etc., to mix things up. (Be sure to check if there are any issues with medication interactions here.) We’ve even added a maraschino cherry for fun.”

~ Kathy, a gerontologist and eldercare manager, Hartford, CT

“I recently bought something called a citrus zinger water bottle. It has a juicer on the bottom for lemons, limes and oranges but can also be used for fruit of all kinds. It flavors the water, which sometimes is what’s missing for people: raspberries and lime, blackberries and lemon, melon and mint, etc.”

~ Karla, Darien, CT

“What is their favorite drink? Coffee? Then put liquids in their favorite coffee cup and make sure it’s hot. Whiskey? Then pour apple juice in a favorite whiskey bottle and warm it up in the microwave. Juice? Then pour water in a red-pebbled glass so that it looks like juice. Martini? Pour water in a martini glass and add olives. When it looks like their favorite drink, they are more likely to drink it.”

~ Jolene Brackey, author of Creating Moments of Joy for the Person with Alzheimer’s or Dementia.

“In the last couple of years of my father’s life, he would get so dehydrated that he’d have these episodes. He’d lose contact with reality, start calling out, and become incoherent or delusional. It was always a big emergency, involving ambulances and rushed visits to the hospital. One time they almost had to turn a plane around on the way to Florida. We did everything we could think of to entice him to drink. There was always a water bottle, fruit juice, his favorite drinks like Cel-Ray soda (we had to get it from NYC; soda that actually tastes like celery), non-alcoholic beer or soup at hand. It seemed like we asked him to take a sip of water at the beginning of every other sentence.

“The only time he requested water was one time that he came out of a coma. He was “nothing by mouth” at the time. He asked me for water, and it was quite the moment because we had been told he was not going to wake up, that he was going to die that night. So I had to refuse him. His eyes flew open. He thought it was so funny after all the times that I had asked him to take a drink. He said, ‘WHY? WHY??’ and then asked for the nurse. When she came, he said, ‘Tell her what you just told me.’ I repeated my refusal about the water. The nurse confirmed the medical orders and then went and called his doctor at 1 a.m. to have the orders reversed. When she came back in, she asked him what he wanted. ‘I want what I can’t have,’ he said, meaning Scotch. But he finally agreed to some water.

“I tell this story because I would have to say that, while we were very committed and resourceful in taking care of my dad, I always felt embarrassed when he had these episodes, as if I hadn’t been taking good enough care of him, as if it should have been so easy to simply give him water. So that would be my first piece of advice: to hope that people won’t feel embarrassed when this happens. The other things we learned to look for was his skin tenting or his tongue being wrinkled, but we really could have used a better way to anticipate these episodes.

“It would have been better if we could have made an arrangement to bring him in for an IV drip or, better yet, to have it available at the house, rather than wait until we had to call an ambulance because, by that point, it was very difficult to move my dad around. There were many times, taking care of Dad, that I felt like simple remedies were not available to us. These things would have made our lives easier at such a difficult time, but there was no place for simple solutions in a system that had a rule and a procedure for everything.”

~Grace, photographer, Block Island, RI

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The Flu. Who Knew? A Daughter’s Journal

Posted on April 22nd, 2015 by karen

Arthur Whitman takes a sip.

by Beth Whitman

Dad got the flu this winter. Funny thing was, it didn’t look like the flu. I thought he was just more tired than usual, or that maybe he had the mid-winter blues.

What I discovered, though, is that the flu looks and acts differently in older folks than it does in the rest of us. Dad showed none of the symptoms that we normally associate with influenza, at least not until AFTER he was admitted to the hospital.

Here is what his flu looked like: For three days, I noticed Dad getting weaker and weaker. He started out just lying in bed all day. He had no interest in activity, and he didn’t seem to have much of an appetite. To get him up and moving around, which seemed like a good idea, I had to walk with him the 20 steps out to his living-room chair. He didn’t have the energy to button or even zip up his pants. I asked him if he was okay.

“Yes” was all he said, but it wasn’t convincing.

He soon became incontinent because he didn’t have the energy to get to the bathroom in time, and then not even the energy to stand up and pee in his portable urinal. He had also lost all interest in consuming fluids.

By the third evening, when it was time for him to head into his bedroom, I went over to help him stand up. He was slouched in his big stuffed chair by the window, and seemed unusually extra-tired. I asked him if he wanted to be wheeled into the bedroom. He nodded, and then coughed a little. So I brought a wheelchair over to where he was sitting, and put my arm around his back and gave him my arm to lean on, but he was just dead weight. He couldn’t stand up — even with my help.

I called my neighbor, Steve, and asked him to come over to help me transfer my father into his wheelchair. The two of us were able, with considerable difficulty, to move him into the chair.

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10 Essential Things To Do Now

Posted on April 1st, 2015 by kim

by Kim Keller

My sister Karen and I learned a hard but valuable lesson not so long ago. Even with all the work we’d done on this website, we found out we were not as prepared as we thought, or hoped, we were. The simple truth is, there are certain things that should be implemented to help ensure your parent’s security and well-being in case of sudden illness or decline due to aging. Because of our dad’s prolonged illness, we had many of the items listed below already in place, but there were some things on this list that we just didn’t think about until our mom had a stroke. It took us completely by surprise because she was healthy and leading an independent and active life. For example, we never dreamt it was time for a medical alert button, but her stroke served as a wake-up call for all of us.

Here’s our list of the 10 most valuable things to have in place for your parent right now. In our Checklists & More section, you’ll find blank templates for each of the various lists we recommend below.

A list of all medications your parent is currently taking (including over-the-counter meds, vitamins and herbs). The list should specify all pertinent instructions (for example, 1 pill each morning with food), as well as the reason why each medication is taken (for high blood pressure, for cholesterol, etc.). It’s imperative to also note any allergies to medication.
A medical history, which includes all surgeries and conditions, hospital stays, allergies, important immediate family medical history (for example, if your mom’s mom had breast cancer or your mom’s dad had diabetes), your parent’s birth date, and also be sure to mention information such as whether your parent has dentures, a pacemaker, a hearing aid, glasses, prosthetics, is a smoker, etc. – basically, try to give a complete picture of your parent’s physical and medical state. Also be sure to include health insurance contact and account numbers.
A contact list of all relevant doctors.
Post on your parent’s refrigerator a copy of the medication list, medical history and contact list of doctors, along with all other emergency contact numbers. It’s critical that these lists be easy to find in case of any emergency medical scenarios, such as EMTs coming to the house.
Set up direct payment for bills and direct deposit for income. We did all of this online so that we’d have direct access to each account (billing statements, etc.), and we created a list that includes log-on user names, passwords, contact information, and account numbers, as well as banking information (account, routing and debit card numbers). Having your parent’s social security number is also important. Now, if your parent is still in good health, and these precautions seem premature, then at least have all of this information compiled and ready to go in case the need should arise. Needless to say, this is not the sort of information you want to leave lying around where anyone might glimpse it, but having it compiled in some secure location is still important in case of emergency.
A durable power-of-attorney allowing a trusted person or persons to handle your parent’s personal business affairs, from banking to investments to real estate, etc. A “durable” power-of-attorney is preferable to a standard power of attorney because it’s set up specifically to deal with the possibility of your parent’s becoming disabled or incapacitated.
A living will is essential as an advance medical directive regarding any life-prolonging procedures (such as being kept alive on life-support equipment). A living will can also direct any organ donation, if this is your parent’s choice. A living will is not a Do Not Resuscitate order (commonly called a DNR). A DNR form can be picked up in any hospital and must be signed by your parent’s doctor. It’s undoubtedly difficult to talk with your parent about personal end-of-life wishes, but it’s very important to do so. These issues can prove to be divisive to a family if your parent’s requests have not already been put down in writing. We recommend using Five Wishes, created by the non-profit organization Aging With Dignity.
A healthcare proxy is also necessary in case your parent is incapable of making his or her own healthcare choices regarding such options as surgery, hospice, experimental treatments, etc. A living will already designates a healthcare proxy, but if your parent decides against a living will, it’s essential to have a healthcare proxy drawn up separately.
A will or trust to make sure that your parent’s final decisions regarding the disposition of any estate are followed.
A medical alert button in case of emergency. We set up an account for our mom with Response Link at 1-800-894-1428, responselink.com, and it costs $38.95/month. They provided her with an alert button, which she wears around her neck, and a two-way communication device for her home in case of an emergency. There are many terrific services available – we just happened to choose Response Link because it was recommended to us by a friend. Here’s an important tip: Avoid any service that requires you to sign a long-term contract.

Regarding the legal documents mentioned in numbers 6 through 9 above, you can either use an attorney or draw them up yourself with the help of an online site such as Nolo.com, which offers blank forms for these various documents. If you have a complicated legal situation, we recommend you hire an attorney.

Kim Keller is the Co-Founder of In Care of Dad. She lives and works in New York City.

Photo is by Karen Keller Capuciati.

This blog was originally published on April 7, 2011.

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Transitioning To Assisted Living: A Work In Progress

Posted on March 4th, 2015 by karen

by Joan Blumenfeld, MS, LPC

My 85-year-old client, Henry, lives alone as he always has. He retired long ago from his lifetime career as a history professor. He never married, has no family presence locally and is fiercely independent.

Although his health is generally good and remarkably stable for his age, Henry shows signs of frailty. His mind is quite sharp and he is very charming, but his memory lapses are alarming. He uses a cane to help steady his walk and, although he is still driving, his vision is certainly not up to snuff. He admits to being lonely since his few friends have moved away or died.

Henry has difficulty managing money and paying bills on time. He can barely take care of his marketing, cooking, laundry and housekeeping, but sees no need for help with any of it. He often doesn’t make or keep medical appointments and frequently forgets or misplaces his medications.

Henry is the perfect candidate for assisted living!

I aroused his curiosity about such facilities by telling him stories of how well some of my other clients have fared in them. The idea of eating three well-prepared and nicely served meals a day in a hotel-like dining room was especially appealing to Henry. Having nurses on staff to respond to medical emergencies and aides to assist with personal care seemed reasonable (only if absolutely necessary, of course). And people to talk to and play bridge with actually sounded like fun.

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The Still Moving Story Of “Still Alice”

Posted on February 11th, 2015 by karen

by Kim Keller

I was so excited to go to the movies last Saturday to see Still Alice, the acclaimed adaptation of Lisa Genova’s wonderful debut novel of the same name from 2007, one of my all-time favorite books. And I wasn’t remotely disappointed.

Still Alice is an eye-opening and heartbreaking story about Alice Howland, movingly portrayed by Julianne Moore. Alice is a world-renowned linguistics professor, teaching at an Ivy League university and lecturing all around the world. She is in a seemingly happy marriage, with an attentive husband (played by Alec Baldwin) and three grown children. In other words, Alice is in the prime of her life, until small uncharacteristic memory lapses start to happen.

It begins with brief little moments, like forgetting what she’s about to say or overlooking an appointment. Then one day it escalates. Alice suddenly becomes disoriented while she’s jogging and can’t find her way back home. After the episode has passed, Alice realizes that she had been “lost” right smack in the center of the college campus where she has taught for years. The experience leaves her so shaken and scared that she knows she needs medical intervention. But nothing prepares her for the diagnosis she receives: early-onset Alzheimer’s disease.

I know it may seem hard to imagine loving a movie about someone who is, in effect, losing her mind. It is painful to watch Alice despair as she falls deeper into the grasp of Alzheimer’s indignities. We watch her struggle to fight off the advances of the disease, and her attempt to maintain as much of her life and identity as she possibly can. She uses her cell phone alarms to help her manage her day, and she becomes consumed with memory games. One night as Alice is cooking dinner, we watch her write three words on a little chalkboard in her kitchen. After she writes down the words, she covers them up, sets the timer for five minutes, and walks away to continue making dinner. When the timer goes off, she walks back over to the chalkboard trying to recount those three words, challenging her memory as she uncovers the board. Then she erases the words and quickly writes down three more. Back and forth, back and forth, she goes.

But even with all the heartache, Still Alice is equal parts intrigue, inspiration and fascination. I recognize that fascination might seem like an odd word to use here, but both the film and book allow the viewer and reader the unusual perspective of experiencing the disease from Alice’s point of view. Usually Alzheimer’s is described by medical professionals or by caregivers, but this is Alice’s story, and she gives us a uniquely intimate seat.

I believe the movie strikes a chord because so many people fear what every little memory lapses might mean as they age. I found myself playing the memory games right along with Alice, and I was actually relieved when I got the answers right.

Although Alice needs to relinquish her university position, she nonetheless teaches us all a few valuable lessons about life. She shows us the importance of living in the moment — even after most of her memories and her identity have slipped away, we can see the joy she feels holding her newborn grandchild.

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