I followed up my third Sue Miller novel, The Lake Shore Limited, with her only work of nonfiction, a short memoir about her father’s decline with Alzheimer’s and eventual death. James Nichols was an ordained minister and church historian who had been a professor or dean at several of the USA’s most elite universities. The first sign that something was wrong was when, one morning in June 1986, she got a call from police in western Massachusetts who had found him wandering around disoriented and knocking at people’s doors at 3 a.m. On the road and in her house after she picked him up, he described vivid visual delusions. He still had the capacity to smile “ruefully” and reply, when Miller explained what had happened and how his experience differed from reality, “Doggone, I never thought I’d lose my mind.”

Until his death five years later, she was the primary person concerned with his wellbeing. She doesn’t say much about her siblings, but there’s a hint of bitterness that the burden fell to her. “Throughout my father’s disease, I struggled with myself to come up with the helpful response, the loving response, the ethical response,” she writes. “I wanted to give him as much of myself as I could. But I also wanted, of course, to have my own life. I wanted, for instance to be able to work productively.” She had only recently found success with fiction in her forties and published two novels before her father died; she dedicated the second to him, but too late for him to understand the honor. Her main comfort was that he never stopped being able to recognize her when she came to visit.

Although the book moves inexorably towards a death, Miller lightens it with many warm and admiring stories from her father’s past. Acknowledging that she’ll never be able to convey the whole of his personality, she still manages to give a clear sense of who he was, and the trajectory of his illness, all within 170 pages. The sudden death of her mother, a flamboyant lyric poet, at age 60 of a heart attack, is a counterbalance as well as a potential contributing factor to his slow fading as each ability was cruelly taken from him: living alone, reading, going outside for walks, sleeping unfettered.

Sutton Hill, the nursing home where he lived out his final years, did not have a dedicated dementia ward, and Miller regrets that he did not receive the specialist care he needed. “I think this is the hardest lesson about Alzheimer’s disease for a caregiver: you can never do enough to make a difference in the course of the disease. Hard because what we feel anyway is that we have never done enough. We blame ourselves. We always find ourselves deficient in devotion.” She conceived of this book as a way of giving her father back his dignity and making a coherent story out of what, while she was living through it, felt like a chaotic disaster. “I would snatch him back from the meaninglessness of Alzheimer’s disease.”

And in the midst of it all, there were still humorous moments. Her poor father fell in love with his private nurse, Marlene, and believed he was married to her. Awful as it was, there was also comedy in an extended family story Miller tells, one I think I’m unlikely to forget: They had always vacationed in New Hampshire rental homes, and when her father learned one of the opulent ‘cottages’ was coming up for sale, he agreed to buy it sight unseen. The seller was a hoarder … of cats. Eighty of them. He had given up cleaning up after them long ago. When they went to view the house her father had already dropped $30,000 on, it was a horror. Every floor was covered inches deep in calcified feces. It took her family an entire summer to clean the place and make it even minimally habitable. Only afterwards could she appreciate the incident as an early sign of her father’s impaired decision making.

I’ve read a fair few dementia-themed memoirs now. As people live longer, this suite of conditions is only going to become more common; if it hasn’t affected one of your own loved ones, you likely have a friend or neighbor who has had it in their family. This reminded me of other clear-eyed, compassionate yet wry accounts I’ve read by daughter-caregivers Elizabeth Hay (All Things Consoled) and Maya Shanbhag Lang (What We Carry). It was just right as a pre-Father’s Day read, and a novelty for fans of Miller’s novels. (Charity shop)