Meticulous grooming and a bit of theatrical flair fooled most people. When Carole acknowledged an acquaintance, the woman looked up and half-shouted over the bin of bananas, “You look well. Really well.”

Wear a big smile and a colorful scarf, Carole thought, and no one notices your white-knuckled grasp on the grocery cart. Her son and daughter-in-law would be harder to convince. They would see the lines of fatigue that creased her face and know the rheumatoid arthritis controlled her life.