Mental Health Monday: Plaques and Tangles

Thomas meets his great-grandmother Effie

I usually don’t visit my mother in the nursing home on Saturdays. But this past weekend my niece, Aubrey Leigh, who lives in Jackson, wanted to bring her 9-month-old son, Thomas, to visit her grandmother. His great-grandmother. So I scheduled my regular visit for a Saturday. And this time I brought her favorite cookies from McAllister’s deli, instead of her favorite candy, M&M’s.

Maybe Granny Effie often sleeps in on Saturdays, I don’t know. But here we were, eager to introduce Mom to her new great-grandson, and she was in bed at 12:30 p.m. Usually she is up, dressed, and has just finished lunch in the dining room by 12:30. The aids tell me she was “kind of tired” this morning and didn’t want to get up. I’m actually glad they don’t push her when she doesn’t want go get up—it encourages me to continue to believe they treat her with respect. But in the nearly four years that Mom has been at the nursing home, this has only happened one other time on a day when I visited, so I was a little flustered, since she had “company” that day.

Thomas looks so much like my brother, Mike, his grandfather

I was anxious that Thomas would get tired or fussy waiting in the lobby while I helped one of the aids get Mom dressed, into her wheelchair and out into the lobby. Fortunately, he’s an easy-going tot, and was still in a good humor when I finally pushed Mom up to the visiting area, nearly 30 minutes later.

“Look, Mom—it’s your granddaughter, Aubrey Leigh, here to visit you. And her husband, Tommy. And this is Thomas—your great grandson.”

Mom smiles through the tangles and plaques that are gradually killing her brain cells. Who are these people?

The brain has 100 billion nerve cells (neurons) that operate like tiny factories. Alzheimer’s disease prevents parts of a cell’s factory from running well. As damage spreads, cells lose their ability to do their jobs and, eventually die, causing irreversible changes in the brain.

With this loss of brain cells comes the loss of stories—the fabric of a person’s life—as well as the inability to perform everyday life chores.

Plaques and tangles tend to spread through the cortex as Alzheimer’s progresses.

Plaques are deposits of a protein fragment called beta-amyloid that build up in the spaces between nerve cells.

Tangles are twisted fibers of another protein called tau that build up inside the cells.

“Whose baby is that?” Mom asks, once I get her wheelchair positioned close to the couches where Tommy, Aubrey Leigh and I are sitting. Thomas is still in his stroller, his big blue eyes glued to Granny Effie.

“He’s ours.” Aubrey Leigh indicates herself and Tommy.

“Is he your first child?”


“Do you have any other children yet?”

“Not yet.” Tommy chimes in—like the sweet and patient man he is.

Aubrey Leigh and I exchange looks. I decide to try again for a memory jog.

“Mom, Aubrey Leigh is Mike’s daughter. Remember Mike, your son? Thomas is Mike’s grandson—your great-grandson.”

Too much information for Granny Effie’s tangled cortex.

Aubrey Leigh moves Thomas’s stroller closer to Granny Effie, which seems to encourage a little more interaction. When he tosses a toy onto the floor, she lights up.

“There went one of them!”

And then his engaging smile and infectious laugh lights up her countenance, if only for a little while.

When Aubrey Leigh gets Thomas out of the stroller, I take the opportunity for some cuddles and hugs—he’s a terrific hugger. And then some time on a mat on the floor with a few toys, including the Rebel bear I picked up for him, complete with its own tiny football. Mom seems to enjoy watching him play while I feed her bites of the cookies from McAllister’s.


I’m glad that Tommy is there—not only for the visit but to serve as official photographer for this first gathering of four generations of my family. I’m wishing my children and grandchildren could see Mom again, but it’s difficult with them living in Denver and Savannah. The last time my daughter, Beth, rode down from Memphis to Jackson with me to visit Mom was two years ago, and Mom had already lost whichever cells stored her memories of her other granddaughter, Beth.

In Lee Martin’s wonderful new book, Such a Life, (read my interview with Lee here) he talks about his mother and his mother-in-law’s decline. At one point he says, of his mother, she “babbles, unable to say what rises up inside her, whether it be love or rage.”

As my niece and her family prepare to leave, I hold Thomas close to Mom, encouraging her to hug or kiss him, or just to reach out and touch him.

“Want to hug Thomas goodbye, Mom?”

“No.” Her voice is completely flat.

I move him a little closer and try again. He is all smiles and ready to give and receive love.


I think of Lee Martin’s words on Saturday, as Mother struggles for words. I wonder what feelings might be trying to rise up inside her. Aubrey Leigh and I know that for most of my life—and especially my brother’s life (her father, who died in 2007)—our mother’s words were not kind. In recent years I’ve come to believe that the verbal abuse she dealt out to Mike and me, and her alcoholism and obsession with weight—hers and mine—were results of emotional, and possibly sexual abuse by her father. My grandfather, who molested me when I was only five years old.

This information has helped me forgive my mother and work towards accepting the childhood I had, such as it was.

Aubrey Leigh’s visit, and her eagerness to introduce her son to his great-grandmother—in spite of the past—brought more healing for me. Hopefully, for all of us. Maybe the plaques and tangles can’t keep the love from getting through to Mom’s heart.

[If you’re new to my blog, please read “Disappearing Stories,” at the end of which you will find links to more posts about visits with my mother. Also, my review of Robert Leleux’s wonderful book about dealing with his grandmother’s Alzheimer’s, The Living End: A Memoir of Forgiving and Forgetting.]

4 thoughts on “Mental Health Monday: Plaques and Tangles”

  1. a couple of weeks back on 60 minutes, there was a segment on people who have face blindness.they don’t recognize faces of people they met or even family members. i was thinking if maybe they could figure out if that had a tie to alzheimer’s as far as brain chemistry. it was very interesting.
    good blog post.

  2. Thanks for reading and commenting Cindy. Interesting thought about the possible connection with face blindness. I’d love to think someone will figure this thing out soon… I’m third generation ….

  3. I love reading about your visits with your mom. I think its always a challenge to think of our parents as whole people in their own right. It’s terrifying as a mother to think of how my children will view me, especially all the mistakes I will make. It seems you are learning to see your mother this way, and that’s encouraging.

    1. Thanks (again) for reading, Laura. It’s definitely been a lifetime getting to this point with my mother. And yes, I often think of how my children may be taking care of me one day, and I hope they will forgive me for my mistakes and be merciful to me.

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