First, my deepest empathy for your feelings on the condition in which you find your old friend. I have seen what both Alzheimer's and other things (TIA's, for example) do to people's memory and cognition.

And you have mentioned something which triggers memories of my own - conversations with friends who worked with the elderly, including those with such conditions, and song (your "chant" reference) and visual arts have profound effects in reaching people in such states. Please try them, and encourage others to do the same. You and your friend have nothing to lose for the attempt and potentially, much to gain.

George Carlin once observed, in monologue, that there's never a "now" - just "coming" and "gone". Beautiful.

....Without the framework of passing time, what does our life and consciousness consist of? Do even pleasure or pain become abstractions under those circumstances? Would our consciousness be akin to being born again, without any hope of outgrowing our child's mind? Would the ego still exist in such a state?....

You mention "Memento," but don't forget that some of these things are also addressed in "Awakenings," as well in many of Oliver Sacks' consequent books. (I think one of the best things about Sacks is that he is the rare kind of scientist who likes to share his nonscientific thoughts about what he is seeing, learning or experiencing, it's the ponderings we all have but he has seen mysteries we haven't.)

I have worked in pharmacy for over 20 years. I have seen many horrible things along the way. I have seen wealth people rendered penniless trying to fight cancer... I have seen young people get sic and die, leaving their parents dumbstruck and destroyed. I have seen people get an injury requiring narcotic pain meds to help them out, only to find themselves "hooked" for the rest of their life...
All kinds of horrible things.

I try to point out to my employees that nobody comes to a pharmacy because they feel good. I try to make sure we become involved in the lives of the patients... It's possible that their time at our pharmacy will be the best 15 minutes of their day. That's good for me (keeps a loyal customer base)... and it's good for the patient, too.

But Alzheimer's is a different kind of sadness.

I've seen some pretty amazing people just crumble and disappear under the weight of alzheimers. Not just the patient, but their families, have a very rough time.

BOTH of my grandfathers had Alzheimers. My maternal grandfather was a most remarkable man. I could write an entry that would make Dickday blush if I had the time... Suffice to say that he was truly remarkable. He only had an 8th grade education but served on Generals Staff in WWII... He figured out RADAR before there was RADAR (That should explain a lot).... He still holds the record for the most number of man hours worked for US Steele without an injury (He was the boss and wanted to make sure no child lost their daddy the way he lost his....).... When he was retirement age, he bought a computer and tought himself how to program. He did radio, electronics, photography, astronomy, and flew airplanes. He was astounding.

By the end he had no idea what planet he was on. You could visit him, but he had already checked out.

My other grandfather, although not a genius by any stretch of the imagination, was a very decent man. Honorable and hard working. My grandmother took care of him as if he were a baby for the last 7 years of his life. He actually lived for 7 years!!!! My poor grandmother. She's the best.

I often think to myself that I've seen my future. I know what's in store for me. I understand the weight of it as good as one can. I don't have any answers.

But I do take comfort in humor. A joke I told my grandfather before he slipped away... He knew he was slipping, but he still had his wit.

...
A man goes to the doctor and has a bunch of tests run. The doctor comes back and says, "Well, I have bad news... and more bad news..."
The man says, "Sheesh, Doc... that doesn't sound good. What's up?"
The doctor says, "Well... you have Cancer."
The man puts his head in his hands and says, "Doctor, that's just terrible. How am I going to tell my wife? What will I do?"
The doctor says, "That's not all."
The man says, "Really? What else?"
The doctor says, "You have Alzheimer's."
The man relaxes and breathes a sigh of relief. He smiles real big and says to the doctor, "Whew! At least I don't have Cancer!"

My grandfather laughed and laughed and laughed.

For some reason I find comfort in that.

May you find peace. May your friends family find peace. May your friend find peace.

Piggy, what a heartbreaking story that I so very deeply understand. Years ago, when my mom had been sick about 5 years and was maybe just a little bit further down the road than your friend, I had an angry day, complaining about how much I missed the mother that raised me and, her being only 50 when it started, how unfair it was that she should be taken away from me at such a young age. A kind and wise friend said to me, "If you only think about what you're missing, you'll miss what you have." In the ten years that followed, I returned to those words again and again, for strength and for guidance.

I don't know about the meaning of a life as it relates to the passage of time and, honestly, it's a bit too painful for me to ruminate on just now, my mom's death being so recent. But I know that for the final years of her life, I tried as much as possible to live in the present and to meet her where she was. I don't think it made it any easier to go through but it did make it easier to accept.

Hmmm, what about a memory that leaves out every 8th word? (Please insert "for" in between "you" and "sharing" in my previous comment.)

It was good of you to share your thoughts on this. It enriches all who might read it. Masterful how you did it so with such economy of words and images.

(I will respect your wish that this be a prayer and not a sermon.)

Thanks to all for your kind words and thoughts. As so many of you have pointed out, this disease is quite different than most others. I think the confounding part is that, at least for a while, we have our loved ones with us and on the surface they seem intact. The cruel aspect is that they are in fact, not as they appear. Yet we endure, and hopefully still share some tender moments as they continue to slip further and further away from what they once were. I'm traveling West today, and will check in when I can.

This place just never ceases to amaze me.

Piggy, beautiful writing. Friends, great comments and support. Seems like no matter what the subject, there is always someone/multiple someomes here who have been where we are, and are there with support and insight. It warms my heart.

Thank you for your chant, and its considerations. My husband is leaving tomorrow to drive to his hometown a thousand miles away to see his mother who has AD; a recent scan showed her brain has shrunk at least 10%. He has been full of many of the questions you've asked, especially the ones about pleasure and pain becoming abstractions. She knows when she is in pain, but can describe where or what it is. Her husband spends most of his time at her nursing home with her, and he sees his life as being a Patient Advocate for her floor. He already seems to have a timetable worked out in his mind for how much time (lots) my huisband spends with her; we have been asking how useful/important that is. She certainly won't know it, beyond maybe having him show up at intervals. She never had an inner life, so it's not as though that has been lost to her. I'd almost wish he could spend time with his dad; they have much to work out, and it may be now or never. His mom was not a likeable woman in any sense, and oddly, Alzheimer's has cooled out some of her pissiness, except when she is in the throes of some AD angst. and then they slip her some more valium. I am hoping she might die while my husband is there; things are getting worse for her, and in her few lucid moments she says she just doesn't want to do 'this' any longer.
It is an evil disease, especially for the sufferer's family; some call it The Death That Keeps on Giving.
My Evil Twin admits that she has enjoyed one small part of her mother-in-laws dementia:
She has despised me since I married her son. When her condition began, whenever my name was mentioned, apparently she would go into a tirade about 3 or 4 of my transgressions toward her; now she has forgotten she hates me. As irony would have it, I have spent thousands of hours on the phone and internet procuring aid and a nursing home for her, and home help and financial aid for my father-in-law; I have sent them one of my bird cards every week for a long time (they like birds, too). To Mabel, I am now the 'Someone sends me a bird card every week' person. I like that much better. I wish her a peaceful death, but sooner, rather than later.
Another question: Would you know if someone is by your bedside and would their chanting your life aloud be heard, or just the familiar sound of a kind voice, urging you on toward your upcoming journey?
My husband is looking forward to reading your chant; thanks, Miguel.

Without the framework of passing time, what does our life and consciousness consist of? Do even pleasure or pain become abstractions under those circumstances? Would our consciousness be akin to being born again, without any hope of outgrowing our child's mind? Would the ego still exist in such a state? It appears to be a sort of variation on the question, "If a tree falls in the forest, devoid of ears to hear it, does it make a sound?". Does a mind devoid of a temporal framework for self examination still embody a 'self'? How small a unit of time does the human mind require to retain a semblance of the ego?

You are required to write at least one New Yorker-length blog on each of these seven existential questions. (It's the only way I can hope to wrap my head around any of them.)

A large part of the reason for my absence from TPM has been my 91-year-old grandmother. I had to go through hundreds of hours of phone conversations, lawyers in two states, my own indigent mother, and two 20-hour roundtrip drives to St. Louis to finally be declared her legal guardian.

Now, I have her in a nursing home 10 minutes from my place, and I visit her 3-4 times a week.

My grandmother holds a M.Ed from the University of Illinois, plus 30 hours toward her doctorate. She taught for 43 years, 38 of them in the same classroom at (the now-defunct) Lincoln Senior High in East St. Louis, IL. She founded numerous local charitable organizations. She has scholarships and awards named for her back home.

When I visit her now, she asks me to go to her house and get her favorite pair of slippers. (She lost her home over back taxes while I was living near Chicago, and I never knew until it was too late.) She asks me to have the administrator investigate who stole her black Bible that had $4 tucked in it. (There was no Bible in her possessions when I moved her into this nursing home.)

She asks me when she can go home. This question is almost too much for me to bear, every time she asks it. I have to will myself not to scream, even though I know it's not her fault she's asking.

What I try to do is focus on the victories. She still plays solitaire. She still loves to write, and has the same authoritative script that she had when I was a small child. She still loves to do crossword puzzles and word searches. She's still capable of having conversations and making logical deductions. She's still feisty and jocular.

There's no doubt she has the beginning stages of Alzheimer's. But we focus on the positive - the things she likes to do, and does well.

In the meantime, much of the money that I used to keep for poker, pool, new gadgets and the like now gets donated to Alzheimer's research. Alzheimer's doesn't just rob one of one's life. It robs the spirit. It enervates the soul. And it takes the measure of everyone who must watch a loved one descend into its clutches. Defeating it has become a highly personal cause for me now.

Whatever progress is made in fighting this beast likely won't save my grandmother. But, if no other grandson has to endure it, then the money is well spent.

Thank you for writing this, Piggy. Highly recommended.

miguelitoh2o, I was at 175, but suffered a traumatic head injury on the left frontal lobe 15 years ago - dropped to 145. I write memos to myself all the time. I'm still sharp in my vocation, but I have to constantly work at it - always reading, reviewing, researching and working problems, logic puzzles and sudoku. Just this week I had a lapse of memory right in the middle of a conversation. Took me about two minutes to remember the point I was trying to make. A very embarrassing moment. If I've learned anything in the last 15 years, it's that my mind is telling me to slow down...it can't process info as fast as it use to - right lobe working overtime and left lobe still hasn't completely rewired itself. I need to be a little slower on my delivery and link my thoughts, like links in a chain, to the point I wish to make. Slow and deliberate is the key for me to follow. For me, distractions are the root of my loss of mental focus. And as the years have passed, they seem to be ever so present - I can get sidetrack easier than before. I suspect will power to stay on track is a left frontal lobe function. Hope this may give you some insight on how to help your friend work through his temporary situation - that's what I call mine.

When I posted this blog, I thought it would be of interest to only a very few of you. I [almost] felt guilty for getting more recs than Rowan Wolf's, Rooties, and SFCurt's excellent blogs from yesterday. Thanks again to all of you for reading and sharing your own thoughts and experiences here. When I wrote this yesterday, I was writing for myself as much or more than anyone, but I see this disease has touched so many others lives, that my words apparently did likewise. Thanks again to you all for your contributions here.