Sociolinguists and discursive psychologists interested in the construction of identity in discourse have focused their attention on how people recount their life events, arguing that narrative choices can reveal much about how narrators see themselves and how they wish to be seen by those listening to their stories. What happens, though, when severe memory loss interferes with this process? This article examines the intersection of narrative, identity and memory by revisiting five (total of 2 hours and 39 minutes) tape-recorded conversations over 4½ years with a woman, Elsie, in her 80s at the moderately severe stage of Alzheimer’s disease (Hamilton, 1994). Focusing on a set of 204 clauses spoken by Elsie that contain past references within these conversations, the study differentiates those clauses that are part of conversational narratives (56 or 27%) from independent clauses, termed ‘narrative traces’ (148 or 73%). The paper then identifies and examines in greater detail the linguistic construction of the storyworld within fifteen short narratives comprising the 56 narrative clauses. Special attention is given to nominal, verbal, spatial and temporal reference. The paper identifies problems in orientation that have consequences for the coherence of the narrative as a text, as well as for the discursive construction of the narrator’s identity. It closes with thoughts about how identity construction can be understood in the (near) absence of coherent reconstructions of the past. Possible useful approaches include Bakhtin’s (1981) notion of word “flavors,” Agha’s (2005) work on enregistered voices, and discourse strategies anchored in the interactional here-and-now, such as “small” talk and politeness work (Brown & Levinson, 1987).