We all knew it was coming.  Every time we visited my aunt and uncle - she nearly immobile with arthritis, he virtually incompetent as a result of Alzheimer's Disease,  both muddling along in the home they built back in 1955 - we realized it was only a matter of time until something bad happened to one or the other of them. And this week it did.

Wednesday night I was out in my yard, happily pottering about in the flowers when the call came in.  My uncle had fallen in the living room, was in horrible pain, and couldn't get up.   The ambulance was on its way, but my aunt would need a ride to the hospital.

So off I went, and what started out as a pleasant summer evening turned into a long vigil in the hospital, while we waited for x-rays and orthopedic surgeons (surely this boy in front of me couldn't be a surgeon- he looked not more than 15!), and finally received confirmation of what we had feared all along -my uncle's right hip was fractured.

Yesterday after yet another interminable day the fracture was surgically repaired, but we now face the task of finding a rehab facility where he might stand a chance of getting back on his feet, and one that can provide continued care from now on for the rest of his life.   So today, less than a year after my mother in law's death, I found myself touring nursing homes and Alzheimer's Care facilities once again.   

I'm finding myself all too familiar with these places - the ubiqutous "activity rooms,"  the wheelchair seated residents, their gray heads slumped over onto food stained bibs, the ever present television or CD player.  Someone is invariably perserverating in a loud voice...the refrain today was "Where is my mother? Where is my mother? Where is my mother?"  The directors and aides are sweet  and well meaning when they talk about "socialization" and "structure in the day," and "doing things for the residents."

But ultimately, it's just ridiculously sad.

Recently HBO aired a documentary  entitled The Alzheimer's Project, a four part series which provided an in-depth look at individuals who have the disease, the effect on their families and caregivers, and finally, the latest research into future treatments.  After watching the final episode in which one bold scientist stated that within the next 10 years there will be real treatments for this disease, treatments which can entirely halt  its devastating progress, I felt a tiny glimmer of hope.   But it was hard to hold onto that hope today, hard to be optimistic when I think about my uncle, and know that he'll never return to the place he's called home for the past 54 years.

Last night I shuffled through some pictures I recently brought home from my aunt's house.  One of my cousins is doing a geneology project, and was searching for some family photos to complete her collection.  My aunt, never the least bit sentimental, urged me to take whatever I wanted.  "It'll save somebody throwing these old things out someday when I'm gone,"  she said dismissively.

So I brought home several pictures of she and my uncle back in the day - the two of them standing side by side in the driveway of their house, leaning against the side of their new 1959 Buick Electra...he pedaling a bike with her perched precariously on the handlebars, laughing.  Shuffling through these photos last night I couldn't stop the tears.   The loss in Alzheimer's is so great - for all these memories are gone for him, all the days and times of their lives together.   When I think of my life, of all the things I've done and have yet to do, the thought of losing every one of those memories is simply terrifying. 

When I was three years old, my uncle bought me a box of candy for Valentine's Day.  I can still see the heart shaped box, and the pieces of chocolate inside.  Every year after that, he brought me candy for Valentine's Day.  Without fail, I knew that box of candy would arrive on my doorstep, usually hand delivered, with a card he bought and signed himself.  Every single year from 1959  until 2005...that was the first year he forgot. 

And that was the year I knew for sure he was gone.

So looking for a place for him to spend his last days is not an easy task.  I thought I was going to be pragmatic about it - after all, I've been saying it needed to happen for months now.  But walking through those doors was pretty heart-wrenching, knowing I was about to start this final process in the " long goodbye."

My Uncle Tex was not a perfect man - he could be demanding and hard to get along with.  But he was a rock of strength for our family many times over the years, going way beyond the call of duty for an "uncle by marriage."    When my grandmother (his sister in law) was in a nursing home, he visited her every day for years, taking her dinner, encouraging her to eat,  making sure she was properly cared for.  He was always available for rides to school or the library, or for shopping trips to the mall.  He paid college tuition for more than one of his nieces and nephews.

 If he cared about you, there was no better, more loyal friend in the world.

And I will never forget it.