Lou arrived alone when she’d come for her blood pressure and itchy skin. Sharp, funny, she told me of her daughters, grown up and far away, and her life in the neighborhood as it changed around her. She had lived there for decades, long after her husband left, long after raising two on her own, long after the cottages around her were torn down for industrial sites. Neighbors were scarce and stray dogs plenty.
When her daughter arrived with her, I knew something had changed. Having driven sixty miles to bring her, Lou’s daughter was here to report on the increasing forgetfulness, the neglect of her garden. She was worried her mother was developing dementia and wanted her to move closer, where she could keep a better eye on her. Lou was having none of anyone else keeping an eye on her, though. We talked about memory and independence and safety and planning—at least as much as one can squeeze into a protracted twenty-minute visit. We all agreed to watch.
Lou started letting the food in her refrigerator grow mold and the oven fill with casseroles unheated. She bathed less and less and lost weight. Her daughter now came to all her visits, and Lou spoke only to answer questions. Her formal mental status testing was abysmal. Now, finally, Lou agreed to go.
For half a year they went missing, and I assumed they had found care closer to her new home, but there she was on my schedule. As I walked in the room, Lou launched into jubilant detail of the view out her new front door. She was living alone in a small house, one of a cluster for seniors, with a path that linked all to a community space. Every day the groundskeeper would wander by and greet her. Every day she watched the wild turkeys and deer in the park next door, keeping mental notes of their families. She watered her flowers. She cooked for herself. She had returned.
Together and out loud, her daughter and I marveled over the change. By formal measurements, she had had dementia, and yet clearly she had not. She had loneliness and isolation and their subsequent depression and its indifference that ultimately leads to doing nothing at all. It was the turkeys, she said, that brought her back. If only I’d had a prescription for them, I mused.