Life’s last act, with dignity

For all the recent very public indignities surrounding the unfortunately euphemistic-sounding “end-of-life issue,” it is refreshing to see the final stages of one woman’s life and eventual death treated with such humanity, compassion and dignity as is the life of the mother of author Elinor Fuchs in her memoir of those last years, “Making an Exit.”

After a life of detachment from her mother, Lillian Kessler, Fuchs is thrown into what she describes as a decadelong “emergency” when it is discovered that her mother has been diagnosed with Alzheimer’s disease. From that point on, the life story of this woman Lil, who is slowly losing her mind to dementia and her body to age, is thrust upon Fuchs to deal with, examine, and finally reconcile with and come to love.

The relationship of the mother to the daughter hadn’t been close until the disease arrived, a disease that an estimated 4.5 million Americans have. As for the family members (who suffer as well from the disease), about one in 10 of us has a relative with Alzheimer’s.

Fuchs, a longtime theater critic, playwright and professor at the Yale School of Drama, uses her talents from the stage to dramatize the remarkable figure cast by her mother -- a mother who had divorced when divorce wasn’t as acceptable, stripped away her husband’s name, shipped her only daughter off to be raised by Fuchs’ grandparents, and embarked on a life of high society and entrepreneurship as a Washington, D.C. exporter, a lifestyle that took her around the world.

With the onset of the disease, that wide world of Lil’s shrank as her business and apartment were sold to cover medical costs, as she was moved to an assisted-living facility and as her mind, memory and speech became more and more fragmented. Fuchs discovers a mother she never really had by going through a lifetime of documents, art and artifacts from abroad, and receipts, bills and business paperwork to piece together those years her mother was absent from her life. After having long been resentful of her mother’s inattention, Fuchs eventually comes to terms and even respects her mother’s life choices, finally seeing her more as a person and individual than a metaphorical mother figure.

Early in the book, when the reader is transported forward to discover Fuchs’ mother in the late stages of Alzheimer’s, it is as if the roles have been reversed and the mother is the daughter, that Lillian has reverted to a kindergartner and Elinor to a stressed and devoted parent.

Those horrible phrases that many adult children whose parents succumb to Alzheimer’s, senility or disablement eventually have to deal with -- “assisted living” and “nursing home” -- are stripped of much of their mystery in Fuchs’ book and are shown for their absurdity, stark reality, banality and also moments of joy. Moments such as those showing Lil’s attachment to a fellow patient, a former university literature lecturer called only “The Professor,” as well as a similar relationship through dementia with a man named Mr. Blue, bring out much of the sad but touching spectacle Lil’s life has become in her last days at Washington Home. Through the efforts of Fuchs as well as a cadre of family, friends and volunteers, the final years of Lil’s disease not only test patience and finances, but ultimately bring people closer.

For millions of sufferers and their families, Alzheimer’s is a bleak and arduous experience. Yet Fuchs’ unsentimental and often wry memoir should help them by showing that though there are certainly dark and precipitous times near the end, a life examined with totality and compassion can make that eventual end an experience not only of tragedy but dignified fulfillment.

Michael Standaert has written for the Boston Review, San Francisco Chronicle and Far Eastern Economic Review.