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When I started as a social worker in a nursing home many years ago, Alzheimer's Disease wasn't as studied as it is today.  There were many in the nursing home diagnosed with "probable Alzheimer's" or "senile dementia" but we had no special unit, programming, or training for these patients.  They were mingled within the general population of chronically ill and, as this was a time before assisted living was prevalent, Medicaid recipients with no where more appropriate to go.

As the Social Services Director I also served as the Admissions Director and met with all families as they brought their family members to the nursing home under a variety of circumstances.  One family member, Anne, came to meet with me as her mom was admitted to the nursing home.  Her mom had been found walking far from her home, again, and was not able to tell responding police where she lived.  Anne and her mom, Shirley, had been estranged for a number of years for a number of reasons, none of which I can recall this many years later.

I do remember she would visit almost every day.  She'd come to my office, always with a smile, to say "Howdy!"  (We were in Texas - that's a normal greeting there....)  Shirley had no idea who Anne was, often smiling at her politely and then returning to the company of another patient who was also confused.  Anne would provide anything her mother needed - clothes that continually grew in size as her mother was eating nutritious meals, possibly for the first time in a while; money for the beauty salon; toiletries and, eventually, incontinence products.  She was persistent in her involvement despite her mother's lack of recognition.

One day, I watched as Anne approached Shirley and her friend, choosing a seat immediately behind them so that she could listen to their conversation.  She smiled as she listened for a few minutes before going around and greeting her mother, "Howdy, Shirley!" with a big smile.  Shirley looked up at her, clearly annoyed that her conversation had been interrupted.  Shirley looked at her friend and said, "Come on.  Let's go."  They got up and walked in my direction.  "Who was that?" the other patient said.  "I have no idea," said Shirley, "Mickey Mouse for all I know!"

I could see from Anne's faltering smile that she had heard what her mother said.  I approached her, but I had no words.  She looked up at me and said, "She may not know who I am but I know who she is - she's my mom.  I'll be Mickey Mouse.  I'll be whoever she wants me to be.  I'll see you tomorrow."

Back then, I only knew Anne as one of my favorite resident family members.  Today I know Anne was a trail blazer.

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