Michael Sedano
I am living After Alzheimer's. Dementia books provide valuable insight for spouses or families. When undertaking caregiving for a person living with dementia, it's like taking on a new career. Reading and research provide valuable insight into what's to be. Here is such a story.
Sinking Together brings readers a horror story of unadulterated evil people exploiting an elderly couple. Sinking Together is also a story of the power of cultural mores, and above all, a story of love and character, reflecting the book’s subtitle, Honorable Acts With Love.
Haruko is a Japanese-born daughter-in-law whose cultural norms demand she be caregiver to her estranged husband’s parents. Bill, Jr., doesn’t visit his parents and grows to resent Haruko’s presence in their lives. “You’re in it for their money,” he whimpers.
Marriage difficulties create a parallel world of misery and resentment even as caregiving provides joy and fulfillment. Life continues its pace irrespective of the singular importance of caregiving.
The old couple, Bill and Mary, are easy prey to a series of daytime caregivers. One after another enters the home and begins stealing and conducting themselves in brazen, shameless, manners. One moves her husband and kids into the main house while Bill and Mary live in a smaller studio. Instead of paying bills, caregivers write themselves generous checks. One takes an “all-expenses paid” vacation to Hawaii on her employers’ money. When confronted, the thief lies and gets away with all sorts of crap because finding caregiving is difficult.
These are not isolated, nor rare, occurrences. My own in-laws hired a caregiver who, like Mary and Bill’s caregiver, started feeding her husband and kids in the home. Rosemary and her husband cleaned out my in-laws’ checkbook. "I had their permission," she said. And that was so. I hired a caregiver for my wife who inflated her hours to three-times the hours she’d actually performed. Did she think I didn’t notice? I discharged her and the agency repaid the theft.
It's not just caregivers who spot easy prey. Haruko rescues Mary and Bill—she calls them Daddy and Mother—by relocating them to their mountain cabin. It’s a two and a half hour drive, but Haruko visits regularly and responds to calls for help with frequent unplanned drives out and back again. Bill hires a “carpenter” to build a greenhouse. The thieving louse buys wood for his other jobs, expensive tools, and the greenhouse never gets finished. Haruko confronts them while they're eating Mary's lunch, one of the bennies of the job.
A reader turns the pages wondering how this evil exploitation can happen, not just once, but caregiver following caregiver does this stuff. At first the caregiver is all nice and considerate. When no one’s around, Bill gets punched and bruised. Another uses psychological torture to terrorize helpless Bill, who’s by that time, blind in both eyes.
Mary is a domineering woman whose Alzheimer’s Dementia hasn’t been diagnosed as the book opens. Mother’s behaviors reflect symptoms of dementia but, like many families, the behaviors are attributed to other causes. A former dancer, Mary’s strength challenges Haruko and the caregivers. Mary’s behavior is dangerous, not to herself alone but Bill.
Mary demands to see Bill’s eye under an eyepatch. The surgeon instructed Bill to keep the eye covered, and he refuses Mary’s demand to see the wound. Irate, Mary punches Bill in that eye and he loses that eye.
Mary’s dementia doesn’t incapacitate her. She wants to be Bill’s caregiver. But she burns the food when she cooks, and leaves the house unkempt. Caregivers complain to Haruko that Mary interferes with their work caring for Bill.
A reader will wonder why Haruko doesn’t hire better people? Haruko relies upon recommendations that so-and-so is a good Christian woman the recommender knows from church. These good Christians emerge as brazen thieves and elder abusers.
When Mary begins to wander—a typical Alzheimer’s behavior—Bill can only call police when Mary’s “escaped.” Why not move Mary to a memory care facility? Out of the question; the couple’s Will specified they would not be placed in nursing homes. Not many families can afford Memory Care, so in-home is their only option. I told my wife that I'd find us assisted living but Barbara told me she wanted to remain in her home. Of course, I acceded to my wife's desire and it was the right thing to do. I am so relieved my story is not Sinking Together.
Haruko is trapped by her Japanese culture. Bill, Jr., wants nothing to do with her parents and wants Haruko to obey his commands and find other people to care for the parents. In the middle of the book, they divorce. Haruko, however, remains dedicated to her culture and her commitment to Daddy and Mother.
Culture doesn’t fully explain why Haruko does the right thing. This is character. Faced with onerous demands, Haruko complies without complaint. A late-night phone call for help summons Haruko’s presence. Bill and Mary live only a few blocks away. But when they’re up in the mountains, that call obligates the loving daughter-in-law to make that two and a half hour drive up to Idylwild and back to Laguna.
Haruko is the nom de plume of the author, Hiroko Falkenstein. The author wrote the book thirty years ago and only this year, 2025, has the experience and memory bubbled up to the surface driving Falkenstein finally to tell this story.
Dementia of the Alzheimer’s type is a growing health issue in the world, not just the U.S. Falkenstein’s/Haruko’s experiences are neither rare nor unexpected. Sinking Together, Honorable Acts With Love, offers a cautionary message for spouses or families beginning their own careers as caregivers to a loved one stricken with this uncurable, untreatable disease.
Vetting caregivers comes first. No one can be a full-time caregiver without help. A spouse has to find respite hours, if not daily, regularly. This subject is not entirely absent from Falkenstein’s narrative. Haruko takes a European vacation and feels guilty about leaving her in-laws to the hands of such strangers.
Consequences come into demand when a thief is discovered, but only one gets jailed. Haruko accepts feeble excuses, in part because she is “nice” and in part because firing a caregiver without a replacement puts the onus on Haruko to devote 24/7 to Mary and Bill, while still working to please that resentful husband. Jail time would be a suitable reward to elder abusers of the ilk whom we encounter in Sinking Together. My mother's elder abusing, thieving, caregiver was a family member whose crimes go unpunished to this day.
Dementia behaviors are unique to the individual. Mary’s outlandish behaviors were particular to her personality, the book is not a prediction of anyone else’s Alzheimer’s Dementia experiences. There is only one Mary, only one Bill, in the world.
Much of the narrative, however, is universal to all dementia caregivers. Adult diapers. Bathing. Diarrhea covering the floor and person’s body. Impatience and anger both from the cared-for and the caregiver.
And death. Mary dies with Alzheimer’s but Bill won’t learn the fact until later. An ugly later, as a caregiver torments Bill telling him Mary’s dead.
Falkenstein ends the story with tenderness.For his 90th birthday, Haruko locates several of Bill’s former friends and employees. These people celebrate their memories of a generous, kind and giving, boss. Bill’s gratitude to be reminded of who he used to be provides a boost to his spirit. It’s that Bill, not the weak exploited abused husband, who lies on his futon on his final day.
Readers will be aghast at the depths of human depravity, reading about the bad caregivers. But there’s respite for readers, tenderness as Falkenstein closes the story with Bill’s death. He lies on a futon with Haruko and another caregiver holding his hands. “It’s OK to go, Bill.”
Falkenstein keeps her focus on behaviors without moralizing on the depths of depravity she witnesses. The book reflects the work of a talented story-teller. Despite the awful events, readers will keep turning pages, led by the writer’s foreshadowing of events at the ends of chapters and the arresting details of living with dementia and old age.
Reliving events like these brings profound trauma. I admire Falkenstein’s strategy. Hiroko Falkenstein maintains a safe perspective on the developments by turning her first-person story into the third-person story of Haruko. I have not yet been able to write extensively about my five-year career as a dementia caregiver. It took Falkenstein thirty years to get this story into public.
