She's been renting a room by herself since September, when her 90-year-old sister decided she couldn't handle being housemates anymore.

The highlight of Bea's afternoons comes when the mail arrives. She pores over sweepstakes offers and letters promising instant wealth in exchange for her small investment or credit card number. She answers each letter and writes copious notes about when her money should arrive.

Sometimes she slips cash in the envelopes or writes checks, such as the million-dollar one she sent to Publishers Clearing House (which didn't cash it). The Prize Patrol has yet to knock on her door, but Bea is expecting them.

"You know what my sister called me today?" Bea says, in an impressive instant of short-term memory recall. "A jackass," she whispers, leaning in close.

This is a little of what it's like to hang out with Auntie Bea, as her family calls her. They love her, but it's not all pretty.

From moment to moment, Bea's life is a contrast of clarity and haze. She's one of 4 1/2 million Americans who suffer from dementia and disorders related to Alzheimer's, a brain disease that causes a steady decline in memory and affects about 27,000 people in Hawai'i. (We're identifying her and her family members by first name or relationship only to protect their privacy.)

Forgive her sister, Violet, for cursing. Fiercely independent and sharp as a tack, Violet still drives twice a week, to church and to the market. But her little sister wears on her nerves. Violet was afraid she'd have a nervous breakdown or a stroke trying to put up with her sister's eccentricities.

Despite her frustration, Violet continues to do what she can for Bea, spending time with her and worrying over her safety.

In recent months, Violet helped convince her sister to give up driving. Bea could barely see over the steering wheel, and she no longer had a valid license, much less insurance and a safety check.

Preserving peace

Preserving peace in a family with a deteriorating relative can be spinning a spiderweb, said Dan Taylor, author of "The Parent Care Solution" (www.parentcaresolution.com). The process can be blur of emotions, he said, but you have to learn how to think and communicate differently.

"It's a whole family dynamic that we're not even equipped to deal with," said Taylor, whose book offers a series of guided conversations to help families address the emotional and financial issues of long-term care. "Most people put off talking about it until it's too late."

Bea's adult niece knows the challenges. The niece, a grandmother herself, has been looking after her aging aunts since her mother — the aunts' oldest sister — died of stomach cancer in 1986. The niece quit her full-time sales job to take care of her mom and now works as a substitute teacher.

Bea's niece also handles whatever crisis is happening on her aunts' home front. She takes them on outings, such as a shopping trip to Sam's Club. There, Violet got her first experience riding an electric shopping cart as Bea shuffled behind, amazed at all the packages stacked to the warehouse ceiling.

Bea can launch into a story about how her dad, a former plantation worker from South Korea, used to take her on buggy rides when he was a vegetable farmer in Kalihi. She can list the states where she's lived and the countries where she'd like to visit.

But like her height, which used to be about 5-feet-2, Bea's memory and her world seem to be shrinking.

She still likes to go out to lunch to her favorite Korean restaurant, but she'll forget to let go of the glass in her hand when it's time to leave.

She has to keep a tassel on the door of her room at the Y so she'll remember which one is hers.

She talks about moving back to California, and she can't remember whether she sold her house there before or after her ex-husband died. She also doesn't know who might take her in, now that she's estranged from her children on the Mainland.

And, in another whispered confession, she says she thinks her niece is stealing from her.

Reshuffling roles

Jackson, who went on to start the planning and support service Eldercare Hawai'i, realized it would take the effort of the whole family.

"Everybody has to reshuffle their roles," she said.

Similarly, Bea's niece has had to take on a larger role than she ever expected. She and her aunt still struggle over control of decisions about where and how Bea should live. Bea's niece has gone to court to try to get control of her aunt's bank account, just so she doesn't waste it all away.

Trying to get Bea's life in order has proven to be a frustrating experience. Even basic paperwork has been a battle. But the niece has found a case worker at the Department of Social Services to help her figure out how to legally filter her mail and manage her finances and health care.

"She has no clue she's not well," her niece said. "She thinks to this day she can travel and take care of herself."

Bea says she's just fine.

"If I get real sick and I can't do anything, I might as well die," she said. She says she'll just "take a pill" and end it all if she can't keep living on her own.

"Haven't you heard? Everybody's going to die," she said. "Why worry?"

Worries never end

Bea's niece can't help but worry. She sees no way to mend the relationship with Bea or to make all of their problems go away.

In the niece's view, her aunt hasn't worried enough or made any preparations for old age. Since her aunt is not destitute, criminally inclined or someone who otherwise qualifies for government assistance, Bea has no one else to turn to, and the future is uncertain.

Eventually, the niece said, she'll have to put her aunt in a care home. For now, she's trying to help her lead an independent, active life. She knows the way the story will end, but her role is to help as best she can, because she is family.

"I got involved because who else would?" said the niece, who's dreading breaking the news to Bea that she's going to take over her bank account.

"She thinks I'm the bad guy, and I'm the only one doing anything to help her," the niece said. "It's so ironic. Someday, I might be in that position. I don't resent it. I'm glad to help her. But there is no happy ending."