This is nothing new, she’s said some variation of this before and I push the laptop aside to go sit on the bed and comfort her.
“It’s okay, Aunt Alice. It’s not my birthday yet but I promise you I’ll be around when it is.”
Three months away and I’m not going anywhere until I know she’s receiving the care she deserves.
“My baby Brooke,” she says, calmer now as I ease her back against the pillows.
She’s staring at me, unseeing, and I hate that she’s reverted to this when she was so much more alert yesterday. I press a kiss to her forehead. “Rest up, I’m right here.”
This seems to placate her and her eyelids flutter shut. I’ve wasted enough time trying to guess the password and I’ve only got another hour to do the online research regarding her meds before Freya gets home and I confront her.
I type “Can medication side effects mimic dementia symptoms?” into the search engine and thousands of hits pop up. I click on the first link from a respected medical journal and start to read. I’m not sure whether to be reassured or appalled.
Freya has been a nurse for six years, not including the practical hands-on experience during her degree. Not only that, she works with dementia patients. So how can she not know the cocktail of meds Aunt Alice is taking can actually exacerbate her symptoms rather than prevent them?
According to this journal, medications can wreak havoc on memory, language, attention, behavior and many cognitive faculties. The biggest culprit is anticholinergics, which treat many things including anxiety, sleep disorders, depression, allergies and high blood pressure. Other meds like benzodiazepines and corticosteroids are also linked to cognitive difficulties and considering how many drugs Aunt Alice is taking… I’m not surprised Dr. Hesham expressed concern.
What draws my attention the most is that medication side-effects may masquerade as dementia, so if loved ones exhibit symptoms like confusion, delirium, memory loss, changes in mood, poor reasoning and speech difficulties, don’t automatically assume it’s dementia.
It makes me wonder if Freya jumped to conclusions about our aunt’s diagnosis and increased her medications, which in turn exacerbated her symptoms? But Freya can’t prescribe medications. A doctor must treat Aunt Alice. I need to find out who initially diagnosed her and get hold of her records ASAP. I spend the next sixty minutes reading but the other articles are similar to the first. They virtually say the same thing but at least I’m armed with information now.
I hear Freya and Hope come home. They go about their usual after school/after work routine and I bide my time. What I have to say to Freya has to be done in private. I wait until Hope’s bedroom door closes, meaning she’s had her snacks and is about to tackle her homework—I can’t believe how much work a ten-year-old has to do at home these days compared to when I was a kid. Aunt Alice is still napping so I slip out of the room and lock the door. I hate the scrape of the key in the lock. If her meds aren’t making her worse and she really does need high care I want her moved to a better facility where she won’t be under lock and key, free to move about in a carefully gated area.
Freya’s in the kitchen drinking a glass of water. Her shoulders are slumped and she’s frowning, the fine lines around her eyes exaggerated in the dim lighting. She looks like she’s shouldering an invisible weight. I hope it’s not guilt for mismanaging our aunt’s condition.
“We need to talk.”
She startles and some of the water sloshes out of the glass. She’s jumpy and when she glares at me I see genuine fear in her eyes.
“What about?”
I point to the back door. “Let’s do this outside so we can’t be overheard.”
She follows me out the door. I walk some distance until we’re halfway between the clifftop and the house.
“Why does Aunt Alice take so many medications?”
Predictably, she bristles, her shoulders squaring, her jaw clenching. “Because she needs them. Why are you questioning me on this? I’m the expert.”
“I need to see her medical records.”
She makes a disparaging pfft sound. “You won’t be able to make head or tail of them.”
“I think you’d be surprised.” I hate that it’s come to this, me doubting her expertise when it comes to caring for the woman who devoted her life to raising us. “I’ve been doing some reading. The side effects of certain medications can mimic dementia.”
She has the audacity to laugh. “The medications are helping her, not causing her problems. Besides, she was diagnosed by our best physician at the clinic.”
I hadn’t planned on telling her about yesterday yet. I wanted to give her the benefit of the doubt, the chance to consider my point of view, to explain if necessary. Instead, her arrogance in belittling me isn’t right. But I know Freya. I need to tread carefully or she’ll shut down completely.
“I’m not questioning your judgment. You’ve done an amazing job caring for her, but you may be surprised to learn when Aunt Alice didn’t take her medications yesterday she was more lucid than she’s been since I came home.”
All the color drains from Freya’s face. “What do you mean?”
“Lizzie didn’t give her the meds because I arranged for her to be assessed by that dementia physician I mentioned to you before, and the doctor says the combination of meds Aunt Alice is on may be exacerbating her symptoms—”
“How dare you!” she screams, anger flushing her face. “I’m her carer. Me. I know what’s best for her, not you, and certainly not some quack I’ve never heard of.”
I love my sister and I accept her faults, but her quick-fire temper and defensiveness when questioned is annoying.
“Sis, I’m home now, and you don’t have to do this all on your own.”
“You’re only home for the wedding and then you’ll be gone.” She snaps her fingers. “And I can’t fucking wait.”
I’m stunned. She’s never sworn at me before.
“That’s harsh—”
“Everything was fine until you came back, so stop your half-assed diagnosing and back off.”
Usually I would. I hate conflict and I don’t like seeing Freya riled up. But Aunt Alice’s care is too important and if there’s the slightest chance my sister has made a mistake, with Alice’s diagnosis or meds, I need to make a stand.
“I’m not backing down, Freya. We need to resolve this.”
For a split second I see her eyes go eerily blank and her hands clench into fists, like she’s going to come at me. Disdain twists her mouth into a grimace, before she turns and sprints toward the house, leaving me chilled to the bone.
Sixty-Nine
Alice
THEN
I rarely hear from Brooke over the next five years and every time she emails, infrequently considering she’s out of Wi-Fi range unless she’s in a town, I experience a pang of heart-breaking guilt that renders me useless for a day.
I should’ve called her back that day before she left for South America. I should’ve told her I loved her and begged her forgiveness for messing with her life when she needed me most.
Now I fear it’s too late.
Something is not right with my head.
I wake up groggy. I forget the simplest of things, like paying the gas bill or buying milk at the grocers. I’m confused when Lizzie and Hope talk at the same time, and following their conversations is increasingly difficult. I walk into a room and forget what I want. And memories of my past are blurring in a frightening way.
I’m worried. If Lizzie has noticed anything she’s not saying, but my sweet girl has never been one to rock the boat. She spent four years at college pursuing an art degree yet returned home to work at the local elementary school for a short time, before quitting to run an online baby business. I expected her to spread her wings, travel the world, but she preferred working from home. I never complained because I love her earnest devotion to me. It almost makes it easier to bear lying to her every day of her life.
; I’ve contemplated telling her the truth, especially now I’m not myself. But what would it achieve other than alienating the one person I truly trust to look after me if I’ve got some horrible disease?
I trust Brooke too, but she’s not here. As for Freya, she’s so self-absorbed she wouldn’t notice if I fainted at her feet. She’s getting married and has been floating since Riker proposed to her two weeks ago. He’s a good guy and I somehow feel safer with him moving into one of the cottages on site.
When he first started dating Freya I couldn’t fathom why a worldly guy like him would see anything in my homebody niece. But as the months passed and I watched them together, I’ve come to value his presence. He has a calming effect on her and that makes me happy. He’s an old soul, one of those unflappable men to depend on, and I’ve enjoyed getting to know him over a coffee in his workshop every morning.
I wander into the kitchen. Freya’s cooking fajitas for dinner, the sizzle and aroma of beef strips sautéing in oil filling the room. I stare at the island bench, covered in small bowls of grated cheese, guacamole, sliced onions and peppers, and wonder why I came in here. Maybe I’m thirsty? Hungry?
Frustration makes me want to thump something. What’s happening to me?
I must make a noise because Freya glances over her shoulder. Our eyes meet and I want to tell her I’m not myself, to ask what’s wrong with me and can she see it. She smiles and I’m momentarily comforted. I’m so proud of the woman she’s become. She’s a tireless worker, a great mom and she’ll make a devoted wife. Riker is lucky to have her.
“Hope you’re hungry,” she says, gesturing to the spread on the island bench. “I’m cooking your favorite.”
I like fajitas? I thought I hated Mexican food. Too much spice gives me indigestion. Brooke’s the one that likes anything spicy… and in that moment I remember why I sought Freya out.
“Did you send the wedding invitation yet?”
Freya nods and switches off the stove. “Yeah, the moment you mentioned Lizzie told Brooke about the wedding and she might come home, I sent it off to the volunteer organization’s head office in South America.”
“Good girl. It’s going to be great having Brooke home and all my girls together again.”
I don’t understand the cunning glint in her eyes. “Yeah, it’s going to be great.”
“I’ve missed her…”
“Me too,” Freya says, dishing the sizzling beef onto a platter. “When I was a new mom I would’ve loved to share Hope’s firsts with her: the first time Hope sat up, rolled over, pulled to stand, walked. Her first word, her first day at kindergarten, her first day at school. But you insisted life would be harder for Brooke if she came home so I cut off contact to make it easier on her. And I understood. Brooke was grieving the loss of her baby while I was raising mine, so it would’ve been too hard on her.”
She fixes me with a look I can’t interpret. “But a small part of me resents you for keeping us apart.”
I know Freya is talking. I see her mouth moving and I hear the jumbled words, but I can’t make sense of anything, a second before I slide into darkness…
* * *
As we leave the nursing home where Freya works, I stumble and her arm shoots out to steady me.
“Why did that doctor ask me so many questions?”
“You haven’t been well, Aunt Alice, so I scheduled an appointment with Dr. Chilthorn. He’s our most experienced physician.”
“He’s too old. That doctor looked about one hundred to me.”
Freya laughs. “He’s seventy-five and very experienced.”
I shrug. “I don’t like quacks and that one looks like he should be a patient in that place, not a doctor.”
Freya smiles and squeezes my arm. “Good to see your sense of humor hasn’t diminished. He says you’re fine to remain at home but you’ll need to take some medication to help you remember things, okay?”
“I don’t need help.” I yank my arm out of her grip and stop, staring at the row of cars in confusion.
“Aunt Alice, we’re parked over here.”
I glance at several SUVs, unsure which is ours. I hate this intermittent disorientation. It’s worsening and I hope I’m okay by the time Brooke gets home.
Freya takes hold of my arm again. “This way.”
I’m docile and compliant as she leads me like a child. She buckles me in, and as I look out the windshield, I can’t remember where we’ve been.
“What’s happening to me, Freya?”
Her smile is kind, her touch comforting. “Don’t worry, you’ll be fine.”
I hope so, because I have so much to tell Brooke when she returns.
Seventy
Brooke
After confronting Freya, I want to hide in my room and regroup. I don’t know what to make of my sister’s overreaction. I need to think, to figure out a way to get those medical records. But my plan to hibernate is thwarted the moment I set foot inside and my niece spies me.
“Hey, Auntie Brooke. Want to see what I learned in science today?”
With her sparkling eyes and animated expression, how can I say no? This girl melts my heart and no matter how moody her mom is I’m glad I got to establish a bond with my gorgeous niece.
“Sure thing, sweetie.”
She slides off a stool and points to the hallway. “I’ve made a start on my science project, it’s in my room.”
“Lead the way.”
I do a funny little bow and she laughs. I follow her to her room, where her desk is littered with markers, cotton, wire and Styrofoam.
“Ta da.” She throws her arms wide. “What do you think?”
She’s constructed a rudimentary solar system, using a bent wire hanger and bits and pieces. For a ten-year-old, it’s magnificent.
“I think it’s fabulous.”
She beams and flings herself at me, and I luxuriate in the feel of her warm body pressed against mine. She’s about three months younger than my son would’ve been and it’s times like this I grieve all over again for what I lost.
It doesn’t matter I was giving him up. I wanted to have the chance to hold my baby, to kiss him, to say goodbye. Instead, I have nothing and my sister has this amazing girl.
“I’m having trouble making Earth, Mars, and some of the smaller planets to scale,” she says after she pulls away. “Got any ideas?”
We chat about her project for a few minutes, when she changes the subject completely. “Hey, I asked Mom when your birthday was and she told me, and I was like wow, you, Aunt Lizzie and Mom have birthdays really close together. How freaky is that?”
“Yeah, your mom’s only eleven months younger than me, and Lizzie a year older…”
I trail off as what Hope said sinks in.
Lizzie, Freya and me.
Birthdays close together.
Aunt Alice has repeatedly rambled about her girls and birthdays. Is the password to her diary our names and birthdays? It’s closer than anything I’ve tried before. It’s definitely worth a try.
“You’re incredibly artistic, Hope, and I can’t wait to see what you come up with next. Thanks for sharing your work with me.” I drop a kiss on the top of her head. “I’m popping in to see Aunt Alice, okay?”
“Sure.”
She gives me a wave and is quickly absorbed in her project again. I race to Aunt Alice’s room, unlock it, and slip inside. She manages a wan smile before turning back to the TV, turned down low on some quiz show I’ve never seen. Her laptop is in its usual place on a side table and I pick it up, my hands shaking as I flip it open and the screen lights up.
I type the first four letters of the online diary site into the search engine and it immediately pops up, considering the amount of times I’ve tried to access it. I try various combinations of FREYABROOKELIZZIE along with our birthdays. I try the full years, abbreviated versions, swapping our names around.
When I hit enter for the fifteenth time and see a green tick, I can’t believe my eyes.
I’m in.
I should feel bad for reading my aunt’s private diary but I don’t. I want to see how this all started and what her early symptoms were, how she coped, and if anything I learn can bring her peace.
The entries are divided into years, the first one the year my parents died and Aunt Alice became our guardian.
I click on the first entry and begin to read.
Seventy-One
Alice
NOW
Brooke is home.
My sweet, caring girl. She and Lizzie are so alike in their gentle temperaments.
Nothing like that other one.
I made a mistake in trusting Freya once. She appears to have redeemed herself over the last ten years but is it all an act? She thinks I don’t notice things because of my confusion. She uses words like early onset dementia that don’t mean much to me. I forget my own name most days and I never want to leave this room I’m in.
But then Brooke takes me outside one day. We travel in the car, and my mind is clearer than it’s been in a long time. I see some lady in a white coat, who asks me a billion questions and makes me do dumb things like tell the time and point to places on a map. I’m not very good at it but she’s nice and I don’t feel so bad.
The fear starts as we return home. My chest tightens as Brooke turns into the driveway. Now I’ve been out of that room I don’t want to go back. But I’m safe there. I know it. But my head’s always worse when I’m in that room, like looking at the world through a kaleidoscope and not being able to make sense of the shapes.
I want to tell Brooke something. It’s important. It hovers at the edge of my consciousness, within reach but nebulous, and it floats away over and over.
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