I found this book less of a novel – as in that it is fictional – and more of a memoir of a woman whose life has been brutally upended by her husband developing early onset dementia and how she copes with it. (Spoiler alert – she doesn’t cope well.)

Addie and Leo are a happily married middle-aged couple settled in New York City living full lives, both personally and professionally. Leo is a research scientist, and his intellectual disposition nicely balances out Addie’s artistic bent – she is a successful collage artist who often has her work exhibited and sold in galleries. They do not have children, but they have a cat they love, a nice apartment, and a sufficient level of financial security to be able to travel, eat out, go to the theatre and other events, etc. Above all, they have each other. And Addie has no reason to think that this will change anytime soon – after all, they are only in their early 50s.

But in a cruel twist of fate, Leo starts showing signs of mental instability and is eventually diagnosed with Lewy body disease, a type of early onset dementia. Counting Backwards is a detailed account of the progression of the disease, starting with some sporadic instances of hallucinations and forgetfulness that Addie is able to cope with as Leo is still Leo, to the point where he is no longer himself and has to be fed, clothed, and looked after just like a baby. It is somewhere between these two points in time that Addie gives up and hands off Leo’s day-to-day care to others, first to Leo’s sister who is happy to look after him until he gets too difficult for her to handle, then to care homes but which don’t work out for too long,  and finally to a full-time caregiver Addie hires to live with Leo in a separate apartment since Addie cannot bear to have him living at home as his condition deteriorates.

Needless to say, all of this – in addition to Leo slowly disappearing to the point where there is nothing of him left in his body – completely erodes all aspects of Addie’s life, including her work, her relationships with her friends, her finances, and most of all, her sense of herself as a good and kind person and a loving and devoted wife. With her life in disarray, Addie has a hard time creating art, leading to lackluster pieces that are rejected from galleries and exhibitions that had earlier clamored for her work. This also means that there is no income coming in, and with the astronomical costs of Leo’s care, she is incurring a huge credit card debt. Her hitherto close friends don’t really understand what she is going through and are therefore not supportive, leading her to distance herself from them. She has no family she is close to. Except for her cat, she is all alone.

But even that loneliness would be easier to bear if she was not consumed by guilt, guilt not just for not wanting to care for Leo herself, but for actually thinking he would be better off dead and actually wanting him to die.

It might sound shocking, but this is the reality that most people who have a close family member with dementia have to live with. It’s not just the physical caregiving which can go on for years – since many dementia patients are physically healthy and can live for many years after their diagnosis – but also the draining of finances, the mental exhaustion, and the wanting it to “be over.”

The ability to capture this so authentically and so heart-renderingly in a novel is not something I would have thought possible.

Counting Backwards
Author: Binnie Kirshenbaum
Publisher: Soho Press
Publication Date: March 2025

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Contributor: Lachmi Khemlani is a fan of the written word.