“Can I help you?” the woman asked.

“Um, yes. Do you care for Alzheimer’s patients here?”

“Yes, we have a unit specifically dedicated to patients with Alzheimer’s. Would you like to have a look at it?”

“Yes.”

She followed the woman to the elevators.

“Are you looking for a parent?”

“I am,” Alice lied.

They waited. Like most of the people they ferried, the elevators were old and slow to respond.

“That’s a lovely necklace,” said the woman.

“Thank you.”

Alice placed her fingers on the top of her sternum and rubbed the blue paste stones on the wings of her mother’s art nouveau butterfly necklace. Her mother used to wear it only on her anniversary and to weddings, and like her, Alice had reserved it exclusively for special occasions. But there weren’t any formal affairs on her calendar, and she loved that necklace, so she’d tried it on one day last month while wearing a pair of jeans and a T-shirt. It had looked perfect.

Plus, she liked being reminded of butterflies. She remembered being six or seven and crying over the fates of the butterflies in her yard after learning that they lived for only a few days. Her mother had comforted her and told her not to be sad for the butterflies, that just because their lives were short didn’t mean they were tragic. Watching them flying in the warm sun among the daisies in their garden, her mother had said to her, See, they have a beautiful life. Alice liked remembering that.

They exited onto the third floor and walked down a long, carpeted hallway through a set of unmarked double doors and stopped. The woman gestured back to the doors as they shut automatically behind them.

“The Alzheimer’s Special Care Unit is locked, meaning you can’t go beyond these doors without knowing the code.”

Alice looked at the keypad on the wall next to the door. The numbers were arranged individually upside down and ordered backward from right to left.

“Why are the numbers like that?”

“Oh, that’s to prevent the residents from learning and memorizing the code.”

It seemed like an unnecessary precaution. If they could remember the code, they wouldn’t need to be here, would they?

“I don’t know if you’ve experienced this yet with your parent, but wandering and nighttime restlessness are very common behaviors with Alzheimer’s. Our unit allows the residents to wander about at any time, but safely and without the risk of getting lost. We don’t tranquilize them at night or restrict them to their rooms. We try to help them maintain as much freedom and independence as possible. It’s something we know is important to them and to their families.”

A small, white-haired woman in a pink and green floral housecoat confronted Alice.

“You’re not my daughter.”

“No, sorry, I’m not.”

“Give me back my money!”

“She didn’t take your money, Evelyn. Your money’s in your room. Check your top dresser drawer, I think you put it there.”

The woman eyed Alice with suspicion and disgust, but then followed the advice of authority and shuffled in her dirty white terry-cloth slippers back into her room.

“She has a twenty-dollar bill she keeps hiding because she’s worried someone will steal it. Then, of course, she forgets where she put it and accuses everyone of taking it. We’ve tried to get her to spend it or put it in the bank, but she won’t. At some point, she’ll forget she owns it, and that’ll be the end of it.”

Safe from Evelyn’s paranoid investigation, they proceeded unimpeded to a common room at the end of the hallway. The room was populated with elderly people eating lunch at round tables. Upon taking a closer look, Alice realized that the room was filled with elderly women.

“There are only three men?”

“Actually, only two out of the thirty-two residents are men. Harold comes every day to eat meals with his wife.”

Perhaps reverting to the cootie rules of childhood, the two men with Alzheimer’s disease sat together at their own table, apart from the women. Walkers crowded the spaces between the tables. Many of the women sat in wheelchairs. Most everyone had thinning white hair and sunken eyes magnified behind thick glasses, and they all ate in slow motion. There was no socializing, no conversation, not even between Harold and his wife. The only sounds other than the noises of eating came from a woman who sang while she ate, her internal needle skipping on the title line of “By the Light of the Silvery Moon” over and over. No one protested or applauded.

By the light of the silvery moon.

“As you might’ve guessed, this is our dining and activities room. Residents have breakfast, lunch, and dinner here at the same times every day. Predictable routines are important. Activities are here as well. There’s bowling and beanbag toss, trivia, dancing and music, and crafts. They made these adorable birdhouses this morning. And we have someone read the newspaper to them every day to keep them up on current events.”

By the light

“There’s plenty of opportunity for our residents to keep their bodies and minds as engaged and enriched as possible.”

of the silvery moon.

“And family members and friends are always welcome to come and participate in any of the activities and can join their loved one for any of the meals.”

Aside from Harold, Alice saw no other loved ones. No other husbands, no wives, no children or grandchildren, no friends.

“We also have a highly trained medical staff should any of our residents require additional care.”

By the light of the silvery moon.

“Do you have any residents here under the age of sixty?”

“Oh no, the youngest is I think seventy. The average age is about eighty-two, eighty-three. It’s rare to see someone with Alzheimer’s younger than sixty.”

You’re looking at one right now, lady.

By the light of the silvery moon.

“How much does all of this cost?”

“I can give you a packet of information on the way out, but as of January, the Alzheimer’s Special Care Unit rate runs at two hundred eighty-five dollars a day.”

Alice did the rough math in her head. About a hundred thousand dollars a year. Multiply that by five, ten, twenty years.

“Can I answer anything else for you?”

By the light.

“No, thanks.”

She followed her tour guide back to the locked double doors and watched her type in the code.

0791925

She didn’t belong here.

IT WAS THE RAREST OF days in Cambridge, the kind of mythical day that New Englanders dreamed about but each year came to doubt the true existence of—a sunny, seventy-degree spring day. A Crayola blue sky, finally-don’t-need-a-coat spring day. A day not to be wasted sitting in an office, especially if you had Alzheimer’s.

She deviated a couple of blocks southeast of the Yard and walked into Ben & Jerry’s with the giddy thrill of a teenager playing hooky.

“I’ll have a triple-scoop Peanut Butter Cup in a cone, please.”

Hell, I’m on Lipitor.

She beheld her giant, heavy cone as if it were an Oscar, paid with a five-dollar bill, dropped the change in the Tips for College jar, and continued on toward the Charles River.

She’d converted to frozen yogurt, a supposedly healthier alternative, many years ago and had forgotten how thick and creamy and purely enjoyable ice cream was. She thought about what she had just seen at the Mount Auburn Manor Nursing Center as she licked and walked. She needed a better plan, one that didn’t include her playing beanbag toss with Evelyn in the Alzheimer’s Special Care Unit. One that didn’t cost John a fortune to keep alive and safe a woman who no longer recognized him and who, in the most important ways, he didn’t recognize either. She didn’t want to be here at that point, when the burdens, both emotional and financial, grossly outweighed any benefit of sticking around.