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Mario Gregorio, 63, never married, so he is facing his disease wiithout the help of a spouse or children.

Peter Power/Peter Power/The Globe and Mail

"It's like a Christmas tree, and I have all these lights on, and somehow these little lights are turning off - that's your memory cells - and you don't know which ones are turning off when, and you don't know when everything will be turned off. But eventually, there will be no lights. … Hopefully when that happens, I will no longer be alive."

Mario Gregorio makes lists on neon sheets of paper and posts them like beacons around his small bachelor's bungalow, beside his bedroom light switch, the back door, the stairs to the basement - stern commandments to keep basic life in order, and, more urgently, to prevent himself from burning down the house: Lock the Door. Check the Faucet. Turn off the Stove. Don't Go Downstairs When Cooking. The lists grow: Turn Off the Lights was added in June.

A large calendar on his wall reminds him, for instance, on Wednesdays, to Clean the Toilet. On the day we meet, there's a note by the phone, written in bold letters: Don't Go Out All Day. If he left the house in the morning, he would forget to keep our appointment. There is no one to remind him; Mario never married, and now, at 63, with his brain slowly rotting from dementia, he is trying to live alone for as long as he can.

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Caregiving scenarios often assume the presence of an able spouse or nearby son or daughter, but the number of Canadian seniors living on their own continues to rise, so Mario's challenge is not unique. He has siblings, but he is a private and independent man, shamed at the thought of needing their help.

He tries not to think of the future, all those lights blinking out. For what is man without memory? What happens when you lose your past, when you can't produce the picture of who you were, or the chronology of where you've been? How do you live when you can't stop what's coming, when you know that one day you will wake up having forgotten everything that was once the most important part of you, and you won't even care?

Right now, Mario still knows himself. He can still recite the facts of his life, although he does so, sitting in a chair in his slightly dishevelled living room, as if taking a test: eldest son of eight siblings, arrived in Canada from the Philippines in 1973, no kids, university-educated, retired in 2007 from a customer-service job at Telus troubleshooting for banks when their credit card communication lines broke down, diagnosed with dementia in January, 2008.

The main art on his wall is a picture of his family - a crowd of siblings, nephews and nieces, and their children - and he jumps up to list their names, their jobs, their marital status, giving more detail than a stranger would need, another memory test he can still pass.

Eventually, those names and dates will vanish. He can live with that. What scares him most is slowly becoming dim and witless, forgetting how to pull on a pair of pants and zip a zipper, how to take a shower and get himself to the toilet.

A few months ago, the doctors insisted that his sister come to an appointment to keep the information straight, and they talked about him as if he weren't in the room. "That hit me hard," he says, "that I would have no control, that I would become an object for discussion." Like a lazy, useless cat on the sofa chair, he imagines: "Oh, there's a very nice cat," visitors will say indifferently. "Does he crap in the living room?" He thinks of being that frail, mute old man in the wheelchair at the nursing home, and hopes that his family will never visit. He's praying for a heart attack before it gets that far.

At first, his doctor shrugged him off. Mario had ignored it himself, retiring from his job in 2007. He had started forgetting his computer password and had trouble following the discussion at meetings. He told himself that he was just getting old. But one day, he got mixed up walking home from his sister's condominium, a route he travelled countless times. Another time, taking Vancouver's SkyTrain into downtown, he forgot he was going to the grocery store and hopped off at the stop for the drugstore; it wasn't until he got home without the food that he realized his mistake.

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A neurologist confirmed the diagnosis. In 1984, Mario had suffered a stroke. Three fingers on his left hand went numb, and he experienced some minor memory problems. Those symptoms, the doctors told him, were progressing, a combination of vascular dementia and Alzheimer's. They gave him 10 years, if he was lucky. "I wasn't devastated," he says. "I had an inkling. It's more, 'Now that it's here, what will I do?'"

First came the paperwork: He gave his brother power of attorney, and expects that by early next year, he will also have to pass over control of his finances. Already, he has trouble with math. And he had to think seriously about his care, while he still could. Mario's siblings live nearby - a sister leaves food in his fridge and empties out the mouldy plates. But he doesn't want to burden them. His parents died when he was a teenager, leaving Mario and his siblings to support each other. That's why, especially after having a stroke so young, he says, he never had his own family, who could be left to fend for themselves if misfortune should strike. "It looks like that was the right decision," he says.

A few months ago, he investigated moving into an assisted-living residence, but it was too expensive, and now his plan is to stay home as long as he can with paid help. He's in the early stages of his disease, so he still gets frustrated when the word for "apple" slips out of his mind, or he has to call the tiles in his garden "the square things." That's a good sign: He still remembers that he forgets.

But this year has been the worst so far. "Something bad is coming; that's what scares me," he says. He had to get an alarm after leaving the back door open one night. He avoids answering the phone, increasingly suspicious of voices, even familiar ones. One afternoon, his sister called and he didn't know who she was. He has found frozen meat dripping in the pasta cupboard above the fridge, and forgotten dinner cooking on the stove, not recognizing even the sound of the smoke detector when it went off. "Even if I smell the smoke," he says, "it doesn't register." He loses track of the ingredients when he tries to cook - his specialty, he jokes, are "guess what" meals - so he eats a lot of peanut butter and jelly sandwiches.

"I'm becoming a slob," he says, offering a tour of his one-bedroom home.

Mario himself is a tidy-looking man with a full, friendly face, his keys and watch dangling from his pants on a bungee cord so he doesn't lose them.

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But his house shows the signs of a scattered mind: His garden clothes have been tossed on the floor by the kitchen table - sometimes he finds six jackets piled there, forgotten.

There's homemade berry compote thickening on the grimy stove, books with plots he can no longer follow askew on the shelf in his bedroom. He owns six MP3 players and five pairs of reading glasses, because he keeps losing them in plain sight. He will go looking for them, but then forget what he's looking for, and not recognize them lying out in the open. And, though he is an enterprising gardener, his long backyard is a patchwork of unfinished projects - a Japanese meditation space, the aforementioned tiles arranged in an attempt at a patio, pots of flowers waiting to be planted.

He has stayed home today, but this is not his practice. He spends almost all his time outside his house, even taking his naps under his apple tree. "Every day must have a purpose," he says. "Otherwise, I sit home brooding." Otherwise, he would be giving up.

He walks every day because he has heard that exercise might slow his memory loss, and, for the same reason, he forces himself to listen to opera and French and Italian songs on his music player, though he's not really a fan.

On our afternoon, he takes the SkyTrain downtown to show off the site of the Olympic flame, and, sitting on a bench overlooking the harbour, he explains a local fight over how late the seaplanes should be allowed to fly. Eventually, he offers a friendly goodbye and, disappears into the rush-hour crowd, leading with his cane.

For now, he still knows his way home.

See more from The Globe's Dementia: Confronting the Crisis series here

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About the Author

Erin Anderssen writes about mental health, social policy and family issues. More

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