Written by Lia Keeble Otero
When dementia disrupted the rhythm of Lia Keeble Otero’s Spanish family, it forced them to rethink what love looks like – shifting it from habit to care.
“Care may even be the most durable form of love”
In Spain, a Sunday lunch stretches long past dessert, the ritual of ‘sobremesa’ where conversations unravel slowly. Summers begin late, move through siesta, and end at the beach. Card games on the terrace. Arguments over rules, and of course, someone is always in the kitchen.
From the outside, it looks effortless. But this kind of life runs on structure.
In large, extended families like mine, there is always someone who remembers birthdays, keeps track of preferences, grudges, and traditions. The quiet organiser of everything. In mine, that person is my grandmother, Alicia De Agueda, “Yaya”, now 81.
She was the matriarch in the most operational sense of the word: dinners happened because she made them happen. Holidays functioned because she held them together. Our family ran for years on autopilot – and she was the system behind it. So when she began to forget, it wasn’t just dates that slipped away but the rhythm she had built.
Her symptoms began after a stroke in 2022, and the diagnosis was confirmed two years later, in 2024: dementia.
I imagined the worst version of it. The moment she would look at me and not know my name. The slow erasure of her personality. What I did not anticipate was that alongside the loss, something else would take shape – a different kind of love, expressed less through routine and more through attention.
Soon enough, phone calls became deliberate, visits became protective, and patience became essential. My grandfather, Bosco Otero – “Abuelo” – now 84, who she divorced more than three decades ago, now calls frequently to ask how she is. My mother and her siblings coordinate medication, appointments, and companionship. Decisions that once passed through my grandmother now pass around her – not to exclude her, but to hold her up. Nothing about the illness is easy. But it has forced all of us to participate in our family more consciously than before.
At first, the changes were small enough to ignore. Yaya would begin a sentence and abandon it halfway through, or walk into a room and pause, unsure why she was there, or just repeat the same story within one conversation.
Eva Vinader, a cognitive stimulation specialist who has worked with families navigating dementia for over a decade, explained that memory is not singular.
“There is semantic memory – what we learn and store as information – and episodic memory, which is tied to lived experience and emotion,” she said. “In vascular dementia, recent memory weakens first. The brain struggles to store new information, but older memories, especially emotional ones, often remain intact far longer.”
“That’s why someone may forget what they ate yesterday but remember, in vivid detail, the street they grew up on,” she added. “It’s not about attention or care – it’s about how the brain is processing and storing information.”
When my grandmother asks me, again, when I moved to London – despite having lived there for three years – it reflects a difficulty in retaining new information rather than a lack of attention or care.
She now attends sessions twice a week at MemoriK, a cognitive stimulation centre where patients with dementia and Alzheimer’s work on exercises designed to support short-term memory – from spelling to guided recollection. Like many living with dementia, Yaya recognises when something escapes her and feels the
frustration when misplacing her keys. She notices when a thought dissolves halfway through a sentence.
“It’s like waking up and not quite knowing why you’re awake,” she explains.
She laughs as she says it. Humour has always been her instinct – if she cannot remember something, she often makes the joke before anyone else can react. Before the diagnosis, her life ran on routine. She woke up early to prepare a careful breakfast, fruit and tea before taking her morning walk. She had long lunches, siestas, evenings that stretched into cards and conversation. Her routine was what gave her independence, and now that rhythm was faltering.
For someone who built her life on independence, the loss is unsettling.
“I can’t go on my walks alone anymore – I get lost,” she says, half-amused, half-exasperated.
The routines she once maintained now require coordination. Someone checks whether she has eaten and taken her medication. Someone walks with her or calls in the evening if she feels disoriented. What once happened automatically now requires attention.
When the centre of a family shifts, the rest redistributes weight. The most unexpected change has been her relationship with my grandfather. For most of my life, their relationship existed within careful boundaries – respectful, distant, resolved. Their divorce felt like a fixed point in our family history. Holidays were negotiated. Presence was measured. And yet, since the diagnosis, he has stepped back into proximity. He reminds her to take her medication and asks how she slept. He insists she does not walk alone. When she visits Murcia, where he lives, he walks with her along the beach, pushing through the pain of a knee surgery he underwent three years ago, when we were not sure he would walk properly again.
Dementia has not brought them back together in the way people expect. It has not erased the distance of their divorce. But it has changed the way they show up for one another. This is not a romantic reconciliation or the erasure of their divorce. It is something steadier.
Vinader is not surprised. “In general, dementia does bring families closer,” she says. “When someone becomes visibly vulnerable, it often generates a need to protect.”
Not every family responds this way. History, distance, personality – all of it matters. But in ours, something softened.
To understand how illness reshapes relationships, I spoke to Dr Anna Martínez, a psychologist specialising in relationships and family dynamics. What was happening in my family, she explained, was adaptation.
“Illness forces families into awareness,” she said. “What once ran automatically now requires intention. And intention changes dynamics.”
For younger generations, especially, serious illness destabilises our assumptions about permanence. We are trained to archive love – photos, messages, shared timelines – as proof of continuity. We fear disappearance more than transformation. But illness resists documentation. It demands presence.
“What often determines how families experience illness is not only the diagnosis itself, but the response they choose,” she said. “Some resist it, some deny it, others reorganise around it.”
“Cross each bridge when you reach it,” … “Live in the version of your loved one that is in front of you.”
Speaking to both Vinader and Anna changed the way I understood what was happening in my family. What I had first experienced as disruption began to look more like something else – quieter, more deliberate.
It wasn’t that the illness had brought us closer in the way people often describe. It was that it had changed how we showed up for one another. “Care may even be the most durable form of love,” Delso said.
My grandmother still laughs when she forgets something obvious. Once, when she couldn’t remember whether she had already eaten breakfast, she shrugged and said, “Well, if I eat twice, at least I won’t be hungry.”
We laugh, and so does she.