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Karrie Higgins is a writer based in Portland, Ore.

AFTER Lauren Kessler lost her mother to Alzheimer’s, she couldn’t shake the feeling that she should’ve learned something, that so horrific a disease should at least be “instructive if not life altering.” So she went searching for “important life lessons.” She wrote a magazine article. But journalistic detachment taught her little. If Kessler, director of the University of Oregon’s literary nonfiction program, wanted to face Alzheimer’s, she needed to stop “hiding behind her reporter’s notebook” and tackle the dirty work. She landed a job at Maplewood (her fictional name for a real Alzheimer’s facility), thinking it would last only a couple of weeks. “Dancing With Rose” is her memoir of the backbreaking but tender care she gave its residents -- and more important, how she looked past the Depends and found life.

Ironically, as Kessler works with the residents, her own mental fog begins to dissipate. Glancing back and forth between “Old Frances” and “Addie,” desperate to remember who is who, she realizes that she’s never really looked at elderly faces before. To her eyes, they all appeared the same. How often do we brush past old ladies leaning on walkers or ignore trembling old men tottering by? As Kessler discovers, refusing to look -- really look -- at the elderly is based in both narcissism and denial. During a failed feeding attempt at the home, Kessler experiences a revelation: She flashes back to her dying mother, whose every refusal of food or drink stung like a personal rejection. Now she sees that it had “more to do with transformation than death, more to do with her than with me.”

Most profound, Kessler learns that rather than stripping humanity away, dementia lays it bare. A resident she calls Hayes pleads constantly, “What’s next? What’s next?” He means this literally; everything must be “broken down into small steps.” At first Kessler finds him exasperating. She already feeds him, dresses him, scratches his back and helps him urinate. Now she must explain it all too? But after she reflects on his job as a mechanical engineer, and how “orderly and logical” he is, suddenly it clicks: This is the essence of Hayes -- authentic and real. She resolves to treat him like the “methodical, systematic, organized engineer he was.” Life as pure process.

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As the only middle-class worker at Maplewood, Kessler also awakens to the pain of living on minimum wage, of missing teeth, broken families, subsidized housing and dreams put on hold. In one scene, she confesses to wishing that she could freeze time, to keep her kids with her forever. A co-worker replies, “There’s never been a time I wanted to stay frozen in. Things have just never been that good.” Here, surrounded by Alzheimer’s patients, this woman would prefer to leave her memories behind. Do we of sound mind have a monopoly on happiness?

This is the true brilliance of “Dancing With Rose.” It upends our assumptions and forces us to ask: What do I have to hold on to? Who would I be if my memories were stripped away? What is my essence?

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