I tried to brace myself but it was still a shock as I pulled into the driveway of my Aunt Grace's house and saw her coming out to meet us. She's my mom's younger sister, and has always been strong-willing and resourceful. She raised two kids alone after a bad marriage, had taken care of my grandmother through her latter years and still managed to own her home in a small suburb of Birmingham, Alabama.

But everything is run down now. Her kids are gone--one dead and the other living in a state of denial and far away. The suburb is shabby and sliding down the socioeconomic scale at a rapid pace. The house is showing its age. The neighborhood is no longer safe. And Grace is a walking shadow of her former self as dementia ravages her mind and she struggles to maintain enough of a grip to keep herself going, which she does only through the frequent intervention of scattered family members who try to explain that she still has to pay her bills and that she shouldn't be driving her car.

But the state of what her life has become is complicated by her weakening ability to recognize what she needs to survive. And here we come to the shock of seeing her again for the first time since March. She comes out to greet us wearing a loose-fitting top that only hints at what a quick hug confirms: she is starving herself to death not because she wants to lose weight but because she forgets to eat and no longer recognizes signals of hunger.

Now, I must admit the whole concept of forgetting to eat is foreign to me. But it does make me thing about the whole notion of food and quality of life. A standard of veterinary practice is to watch the appetites of our pets; once they lose interest in food it signals that the end of their lives is near, that a certain quality of life is something we can no longer provide. Others of us suffer from too much interest, such a great fixation on the pleasures of food not only to sustain our physical selves but to provide that quality of life.

I don't know where all that's going, just something to ponder on a quiet Tuesday morning. And it's all very sad.