Does She Know You?

The Question Everyone Asked

“Does she know you?” That’s the question everyone asked and I understand why. There is much anguish in anticipating that someone you love deeply and know intimately might not respond with that familiar smile.

“Yes, she knows me,” was my answer but it was a qualified yes that required more explanation. Part of me wanted to say, “Yes, definitely,” though a better answer was, “Yes, on a good day.” Over time I edited my response to what felt more accurate: “She knows we belong to each other.” 

In the four years after my father died, Mom lived in a smaller setting, an assisted living home with memory care. Especially during the earlier part of that time, she smiled when I arrived. She couldn’t come up with my name but if someone looked my way and referenced me as “Ginny,” Mom seemed to make the connection in the moment.

As time went on, her engagement level depended on various factors: whether she had slept well, how she felt physically or what kind of day she was having. There were times when she was awake but detached – not seeming to recognize me at all – and just staring into space. After that kind of visit I would leave concluding that she was starting the permanent slide and would remain disconnected but then that would be followed by a better day or sustained period of time.

Throughout the last three years, Mom did not talk much aside from sentences here and there. She did not know the words “mother” or “daughter” or she might have known them but mixed up which one applied to whom.

From the time we were married, Jess had alternated how he addressed my parents, sometimes calling them Mom and Dad and other times by their first names: Grace and Tony. In the years we were taking care of Mom, he would playfully call her by her name in Italian: Graziella. Jess would say, “Grazi” and Mom would respond with the second half of her name, “ella.” Somehow she rarely missed her line and would not deny his call for “ella.” His playful drill stayed with her. I’m not sure how that happened but she answered Jess with “ella” to the very end.

Initially I assumed the reason that Mom still knew us was due to the fact that Jess and I visited her frequently and were familiar faces, however she continued to know my siblings who lived across the country and were unable to see her as often. In the last two months of Mom’s life and while receiving hospice care, my sister and brother flew out to Arizona.

Grace and Lori

When Lori entered the room, Mom’s face brightened with a look of surprise and recognition and she reached out to touch Lori’s face. A month later when Tom visited, Mom immediately beamed and was awake for a good portion of the day, listening to Dean Martin songs playing through my iPad and holding my brother’s hand. Knowing it would be Tom’s last visit, I was glad he had that kind of interaction with her. The very next day after he left, Mom retreated within and slept the entire time, while I sat bedside.

Over the following two weeks before she died, she drifted in and out between two worlds and yet was often strikingly present to me.

But We Know Them

The exact relationship may have eluded my mother, but overall she recognized us and knew there was a connection. She happily held hands with her granddaughters who were able to fly out to visit her occasionally. When my cousin Philip (Mom’s nephew) visited with his wife Marie, Mom was very pleased to see them. Did she see the resemblance in Philip’s face to my Uncle Joe (her brother) or was she simply responding to two loving faces who were happy to be with her?

Even when friends who were less familiar visited, she would usually return a smile. We were lucky in this way, because that is not always the case. I observed other residents who were less emotive, more withdrawn and not able to connect with their relatives in the same way. We were grateful for Mom’s ability to recognize us, though she was still on the same trajectory in terms of Alzheimer’s: a slow recession accompanied by physical decline.

Inside the does-she-know-you-question that people ask is actually another unspoken question: How would I handle it if my loved one didn’t recognize me? As painful as that is to contemplate, the answer is that you find a way.

My friend Kim’s husband, Norm, was around the age of 63 when the first symptoms of early-onset Alzheimer’s appeared and he died at age 78. She calls it a long journey. I asked her how she felt about this do-they-know-you question. Kim’s emphatic response says it all: “But we know them.” She explained further:

“We know them. I used to worry about when the day would come when maybe he would no longer see me or would look right through me. Then I realized that I would always know and remember who he was and what we meant to each other. My heart was full of our past experiences and treasured memories. I would have to do my best to help him, not as much to remember, but to assist him in somehow knowing that I was someone who mattered to him and let that love I was carrying be enough for the both of us.

Ultimately there were almost 30 years of adventures and life happenings that we shared. If I could just keep as much of that as possible in mind, I hoped I could bring him the comfort and peace he so richly deserved.”

We know them. We can remind them of who they are and convey that they are still important to us. 

Even when a response is absent and there is no returned smile, I believe they receive the love we offer on some level, if not cognitively perhaps emotionally and spiritually. This cannot be proven and it is somewhat like wondering what a person in a coma hears or senses, yet if you believe it – that they are able to benefit from your calm and loving presence – it will impact your actions as well as what you are able to receive. Regardless, how could love offered every be wasted?

It is also important to acknowledge that certain circumstances necessitate the setting of healthy boundaries. When Alzheimer’s produces extreme irritability and aggression, there are times when love can be offered from afar.

To Gently Reassure

I wanted to avoid having Mom feel badly for not knowing something that she was “supposed to know.” It was a delicate balance to sense if an explanation would be helpful. I tried to simplify rather than complicate and reassure rather than press to remember. Sometimes I made the wrong call and my words didn’t land, but overall, I learned to feel it out and determine when a gentle reminder would be helpful.

Sometimes I’d say:

You’re my mama.
And I’m your daughter.
I love you.
And you love me.

I’d smile. She’d smile.

I delivered those words with lightness, when the moment seemed to call for it. It soothed her and was a little reassurance: We belong to each other.

One afternoon, three weeks before she died, in a very casual manner she asked, “What’s your first name?” This didn’t make me sad. I was happy to answer with the name she gave me. “You named me Virginia and my nickname is Ginny.” I told her that I liked my name. That produced a big smile.

What part of her knows me even when she doesn’t know me?

That’s the question I often pondered. And that’s the question I liked better:

What part of her knows me?