Emma Healey’s debut novel, Elizabeth is Missing, deals with the issue of dementia. The protagonist, Maud, forgets the simplest of details. She writes things down that she does not want to forget and then stuffs those notes into her pocket where they become crumpled. Her daughter comes over every day to help out, plus there is a part-time hired assistant who arrives in the morning.

The effects of aging concern all of us who have reached a certain age. We have relatives who have dementia or other forms of cognitive deficits and worry that the same thing will happen to us. We see them struggling with basic tasks such as feeding, toileting and self-care. They lose their driver’s license and eventually can no longer live alone. They wear diapers, become confined to wheelchairs, cannot walk and lose the ability to recognize people that once were important in their lives.

Dementia is a frightening affliction as there is no cure. Drug companies are test-marketing medications that might slow down the process, but none can stop the progression of the disease.

We live in an instant-gratification world. When we want something, we can find it online if we can’t get to a store. Food, electronics, books, clothing, shoes, music are all available with a click of the mouse. But what happens when our memory fails and we can’t remember what we want, what we already have, what we have dreamed about?

In the novel, Maud is obsessed with one worry: she believes that her friend of many years is missing. She cannot remember what she has been told about her friend and so goes about pestering people with her concerns.
Spotty recall is one of the indications of dementia. Initially short-term memory is affected. The individual cannot remember what he/she just ate, who called or visited, what she watched on TV or whether or not he had a bath. Yet for some reason, he remembers the names of his children, but not grandchildren, where he lived as a young man, and even when he bought his television and computer. She isn’t able to turn on the computer or operate a remote, and following a conversation is nearly impossible. The only possible blessing is that dementia destroys so many connections in the brain that the individual eventually loses herself in the fog of the disease.

Of course there are other afflictions that are equally disabling. For a lover of books and movies, there is the loss of sight. Those inspired by music fear deafness. The physically active are troubled by impairments that leave them unable to walk without assistance. For the ones who cherish independence, the inability to drive and to live alone are profound.

Maud is a sympathetic character. We expect our protagonist to experience change in response to the plot, and are most pleased when the change leaves our character better off then when the story began. Unfortunately dementia has no happy ending.