Watching my grandmother deteriorate is agonizing.

She has been under the knife several times throughout her life, having undergone a bilateral mastectomy and various eye operations. The latter few have been less than successful; she had detached her retina after losing her balance and hitting herself in the eye with a broomstick. Glaucoma set in later and her vision declined gradually. On good days she says light manifests itself as a shade of dark gray – but otherwise, she lives her life in darkness.

To say she doesn’t see anything, though, is a lie.

For months she has told us stories of doctors and nurses mysteriously appearing in my grandparents’ apartment. She has lost track of ten years nearly overnight and refuses to believe that she doesn’t live in Montreal anymore. She is adamant about this to the point of accusing my grandfather of lying to her when he tells her the truth.

They have been married for nearly 54 years. He couldn’t lie to her if he tried – and he has tried, if only to keep her from worrying about events of little importance in the grand scheme of things.

The memory lapses first seemed to be a reaction to her medication. Doctors attempted to wean her off of it and put her on something else but things became dramatically worse in too short a time. The fire that burns in our loved ones often dims as they age; it is not an original notion. Everyone experiences this at some point. This, however, is not just lapsing memory or dimming sensibilities. It is taking my grandmother away.

And she was feisty at one point, once upon a time. I know because I was there.

I found a stack of old pictures in the basement a few months ago – some of them date from before I was born – and the first thought to cross my mind was how much weight she’s lost. She’s so frail. She looks as though she’d fall right over if you touched her hand.

She’s on cross-country skis in one picture. In another, she (along with my grandfather and two of their closest friends) is visibly tipsy at the cottage – but the grin is infectious. After her mastectomies she told my grandfather that everything was going to be all right – besides, now she could go to church Halloween parties as a topless dancer.

The pictures are not much comfort once I remind myself that she’s 76 now and hardly ever leaves the chair in her living room. She can no longer differentiate between her dreams and reality and wakes up in the middle of the night asking my grandfather where their son is. He’d asked to sleep in their bed with them, she says, and now he’s gone. He’s 47 and lives several cities away but in these lapses he’s still her little boy.

I think it’s destroying them. It’s destroying me and I don’t even physically see it on a daily basis.

Caregivers always seem invincible when one is young; the idea that she needs so many people to take care of her now and will likely have to be moved to a long-term care facility seems so backwards. It seems to be what’s best, though, and she’s even said she wants to go.

There are issues, of course; my grandfather is hesitant to enter a fully long-term facility because he knows that sort of environment would destroy him. We have to find one that offers long-term care in a retirement-friendly environment. We have to find one close by. These places also don’t, apparently, pay for themselves.

The hardest part so far has been watching my fun-loving grandmother so affected by such unfortunate and painful developments. Sometimes, when her spirits are particularly low, she tells me that she knows things would be better if she were to end things herself. She always adds, “I can say that sort of thing to you. You’re grown-up now.”

It slays me.

She is a deeply religious woman and since her eyesight started to fail years ago, she’s prayed for a miracle that hasn’t come. She woke up every morning for years hoping for full restoration of her sight. It never happened, as the doctors told her it wouldn’t, but that didn’t matter to her. She says she’s past that now and is only praying to accept things as they come.

Whenever I see her she asks - she begs - me to pray for her.

I hate to think about it but I can’t shake the thought that she might not be around on my twentieth birthday from the back of my mind. She is suffering but I don’t want to lose her. I know that the her I know best is probably already gone, but I couldn’t bear it. I couldn’t.

When it finally does happen, I will lose a huge part of myself.