Body Language by Meg Howrey explores the complicated choices of family, autonomy, and Alzheimer’s

Body Language by Meg Howrey is a deeply thoughtful and surprisingly funny literary novel about three sisters forced to confront their mother’s wishes, their own differences, and the difficult question of what it means to honor someone’s autonomy when they can no longer make decisions for themselves. The novel releases September 1, 2026.

Body Language is a great literary novel—profound, evocative, and layered—but perhaps more importantly, it is a readable literary novel. There is a difference. Literary fiction can sometimes become so enamored with its own language and philosophical underpinnings that reading it begins to feel like work. Meg Howrey avoids that trap. Her prose is clear, concise, intelligent, and often very funny, while still giving the story the depth and complexity I want from a literary novel. In my opinion, clarity is one of the major requirements of a good novel, and Howrey demonstrates just how much can be accomplished without burying a story beneath unnecessarily elaborate language.

At the center of Body Language are three adult sisters who could hardly be more different. Sloane, a former actress turned therapist, is trying to navigate menopause on her own terms. Laurel is juggling environmental nonprofit work, teenagers, and a growing sense of rage and restlessness. Nanette, the youngest, has answered a religious calling and entered a convent as a novice. When their mother, Barbara, begins to sink more completely beneath the surface of Alzheimer’s, the sisters are drawn back beneath the same roof and forced to confront a decision their mother set in motion before the disease had so thoroughly loosened her hold on herself.

The characters aren’t always likeable, but they are always real. I could recognize something in each of them, even when I didn’t particularly agree with their choices. Howrey does an especially good job of showing how three people raised by the same mother can grow into such radically different adults.

Then again, the sisters have such significant age gaps that they may as well have been raised by three different mothers. Nanette’s experience was particularly different from that of her older sisters. Much of her formative childhood happened after their parents divorced, and their father was largely absent after moving overseas. The sisters may share DNA and a mother, but they don’t necessarily share the same memories of growing up.

That becomes important when Barbara’s daughters discover that their mother has long intended to end her life once her Alzheimer’s becomes too advanced for her to recognize herself or live with any meaningful sense of autonomy.

Barbara has already watched this disease take people she loves. After witnessing the long goodbye with both her father and her sister, she has no desire to endure the same fate herself, nor does she want to subject her daughters to years of watching her deteriorate. She has made her wishes known to her best friend and Nanette, and she believes she will recognize the moment when it is time.

But Alzheimer’s is not a disease that makes anything simple. Barbara’s doctor has not been entirely honest with her about what is happening to her, and the disease itself makes her understanding of her own condition increasingly unreliable. She sometimes shows flashes of the woman she used to be, but most of the time she is frightened, agitated, confused, and increasingly uncertain about who she is and what is happening around her.

This is where Body Language becomes especially compelling. As someone who has watched Alzheimer’s affect members of my own family, I found Barbara’s situation particularly difficult to read at times. I’ve seen the disease make its way through generations of my family, and there is something uniquely frightening about knowing that a disease can run through your family without knowing whether it will eventually come for you. It’s like carrying a time bomb that may or may not be ticking its way down to your demise.

Because of that, I found myself very much on Barbara’s side when it came to her decision. If a person reaches a point where the disease has progressed so far that they are no longer themselves, I believe they should have the right to decide that they do not want to continue living in that state. But that belief comes with an enormous complication: the decision has to be made while the person still possesses the cognitive ability to make it. Once the disease has progressed far enough to make that decision necessary, the very discernment required to make it may already be gone.

That is the impossible position Barbara’s daughters find themselves in. Barbara made her decision long ago. She told people she trusted what she wanted. She has been clear about how she wants her final days to unfold. But now the decision isn’t entirely hers anymore. Her three daughters must decide whether honoring their mother’s wishes is the right thing to do. And they don’t agree.

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The alternative is for one or more of them to take responsibility for Barbara’s care indefinitely. With Alzheimer’s, “indefinitely” can mean years or even decades. That isn’t a small sacrifice, and Howrey doesn’t pretend that it is. The sisters have to consider not only what their mother wants but what they themselves can realistically give. They also have to confront an uncomfortable question: Are they making the decision that is best for Barbara, or are they making the decision that is easiest for themselves?

There are no easy answers here, which is exactly what makes the novel work so well. Howrey doesn’t turn Barbara’s decision into a simple argument about assisted dying, nor does she make any of the sisters into a convenient mouthpiece for the “correct” position. Instead, she lets the issue remain messy and deeply personal. Each sister brings her own beliefs, fears, history, and relationship with her mother to the question. Their disagreements aren’t merely philosophical. They are rooted in decades of accumulated family dynamics.

And yet, despite the weight of the subject matter, Body Language isn’t relentlessly bleak. In fact, one of the things I enjoyed most about the novel was how funny it could be. Howrey finds humor in the absurdity of family, in the sisters’ wildly different personalities, and in the uncomfortable situations that arise when people who might never have chosen one another as friends are nevertheless forced to figure out how to coexist.

That is the real strength of the novel for me: its understanding of sisterhood. Sloane, Laurel, and Nanette probably wouldn’t have sought each other out as friends if they hadn’t been born into the same family. They have different beliefs, different priorities, different personalities, and vastly different ideas about what constitutes a meaningful life. Yet when circumstances force them back together, they have to find a way to relate to one another.

That doesn’t mean they suddenly become best friends. Family relationships rarely work that neatly.

Instead, they learn how to listen to one another. They learn that loving someone doesn’t necessarily mean agreeing with them. And they eventually have to find a way to make a decision together—one that each of them can live with, even if none of them is completely certain that it is the right one.

That uncertainty is what makes Body Language feel so true to life. Some decisions don’t come with a satisfying answer. Sometimes all you can do is gather the information you have, consider the people involved, examine your own motives as honestly as possible, and choose.

Body Language is a thoughtful, funny, emotionally complicated novel about memory, aging, autonomy, family, and the ways our relationships shape who we become. It asks difficult questions without pretending to have easy answers, and it manages to do so with prose that is both intelligent and remarkably accessible.

For readers who enjoy literary fiction with plenty of story, characters who feel like actual people, and ethical questions that will keep you thinking after you’ve turned the final page, Body Language is well worth picking up.

What would you do if someone you loved had made a clear decision about how they wanted to face the final stages of an irreversible disease—but was no longer able to make that decision for themselves? Would you honor their wishes? I’d love to hear your thoughts. Share your perspective in the comments below.

An advance reader copy of this book (ARC) was provided to me by the publisher via Netgalley in exchange for an honest review.

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