"Dancing with Rose" more heartening, thought-provoking than painful

This has all the material for a grim read: Author Lauren Kessler, who's trying to deal with feelings of inadequacy and guilt after the death of her Alzheimer's-afflicted mom, takes a minimum-wage job as a caregiver at an Alzheimer's facility. It's the umpteenth book about a topic that's generally pretty painful.

But wait, don't stop reading. This book is different. Although "Dancing with Rose: Finding Life in the Land of Alzheimer's" (Viking, 304 pp., $24.95) has some bleak moments, it's more heartening and thought-provoking than it is painful.

Kessler decides to spend time at a facility she calls Maplewood — not its real name — to work on a magazine story and search for meaning: "I was going to buckle down and learn all manner of important life lessons." But she realizes that watching isn't enough: To find those lessons, she needs to immerse herself in caring for the residents. So she signs on as an entry-level caregiver.

As she makes her way through a seemingly endless list of tasks each day — waking the residents, feeding them, showering and toileting them — Kessler begins to find some surprises in their personalities. She pulls us into the relationships she builds with her residents: Hayes, endearingly dapper and constantly needy. Marianne, a perfectly groomed former university administrator. And Rose, who shuffles onto the scene as a frighteningly unresponsive figure.

Although the pay is low and the work is grueling — big factors in the high staff turnover — Kessler throws herself into the job: "It matters that I do this job well. The residents depend on me. Their world is very small now, the rooms and corridors of Maplewood, and I am in charge of it all. What is left, because it is so little, takes on great significance."

Kessler deftly marries research with hands-on experiences as she explores ways of looking at the disease — for example, Cleveland social worker Naomi Feil's position that caregivers should adjust to the person with Alzheimer's, rather than the other way around. Behind the scenes, the theory goes, the person is occupied with the valuable task of coming to terms with the past. "You go where that person is going," Kessler explains. "You don't challenge or contradict or correct. You listen. ... You are actually being forced to consider that a person with Alzheimer's might be doing important life work right in front of you."

This sounds pretty lofty. And later in her exploration of ideas, Kessler acknowledges "it is hard to hold onto these wonderfully liberating views of Alzheimer's — as a disease of freedom, as a path to enlightenment — when you are changing adult diapers, or when the person with the disease is your mother, or when the media endlessly repeat wrenching and tragic tales. I think now I've reached some kind of equilibrium."

Theories aside, Kessler dips into the tough realities faced by her co-workers who are doing the diaper-changing. Their low pay, she writes, is a strong sign that society isn't according enough dignity to older people. Kessler doesn't offer specific solutions; it's not that kind of book.

The larger themes are blended with accounts of daily life at Maplewood. Those accounts feel honest and humble, from disturbing vignettes to a few laugh-out-loud moments. One of these comes when she admires a resident's painting. "We looked at it silently, and I smiled at him, and I thought, We are having a Moment, this man and I. This is just what I hoped for when I took the job. Then Dan turned his back to me, pulled down his pants and boxers so they bunched around his ankles, and shuffled over to the bathroom, leaving me to contemplate his skinny white rear end. I deemed the Moment officially over and left him to his business."

Kessler, who directs the graduate program in literary nonfiction at the University of Oregon, has tackled diverse topics as an author, from espionage to the life of a headstrong female stunt pilot. Here, she shows she can engage readers with her own experiences. Kessler is trying to accomplish a lot, and occasionally it shows; the transitions between her mother's last months and the halls of Maplewood can feel jarring. But her feelings as a daughter and her experiences as a caregiver add up to a touching read, and the book offers some unusual ways to think about living and dying with the disease.

Kris Higginson is the news editor at The Seattle Times.