How People With Dementia Make Sense of the World

How People With Dementia Make Sense of the World

Elizabeth often met her husband, Mitch, after work at the same restaurant in Lower Manhattan. Mitch was usually there by the time she arrived, swirling his drink and joking with a waiter. Elizabeth and Mitch had been friends before becoming romantically involved and bantered back and forth without missing a beat. Anyone looking at their table might well have envied them, never suspecting that Elizabeth dreaded these pleasant get-togethers.

Elizabeth, a tall, elegant woman, told me about those evenings in a composed, confiding tone, which only makes her story more uncanny. (Both her name and Mitch’s have been changed to protect their privacy.) Once the meal was over, Mitch would invariably give her a wary, skeptical look and say, “Now you’ll go to your place and I’ll go to mine.” Hearing these words, Elizabeth would nod meekly, then duck into the bathroom for a minute before running out. She’d cross the street, wait for Mitch to emerge—making sure that he was headed in the right direction—and then hurry home to wait for him.

It always struck her how normal Mitch appeared. It was herself she barely recognized: the nervous, frazzled woman hiding behind lampposts, following a man who looked so at ease in the world. Then, with a burst of speed, she managed to get back to their apartment a few minutes before he did.

Arriving home, Mitch always gave her the same cheerful greeting: “Hey, honey, how are you?” He had already forgotten their rendezvous.

The nightmare would officially begin after Mitch had made himself comfortable. Without any warning, he’d look up from a magazine or the TV, stare at Elizabeth, and ask her to leave. Calmly at first, he’d order her out of her own home. When she tried to convince him that she was home, he’d scoff. How could it be her home, when he lived there? Although he sensed that they knew each other, he had forgotten they were married. Moreover, he felt threatened by her presence.

When Mitch first began to act this…

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