My contribution to the Literature and Medicine collection by Anna Elsner and Monika Pietrzak-Franger, ‘Overcoming decline (in) narrative: Episodicity in dementia and ageing’, explores how the culturally and medically prized concept of narrative influences pessimism about ageing. The chapter takes three steps. It reviews seminal texts in the Medical Humanities to illustrate how signature characteristics of narrative dominate cultural and medical expectations of how people experience themselves and think about their lives. Taking dementia as a situation where anxieties about ageing and continuity of self are particularly acute, it illustrates the pressure emanating from narrativity for life as lived and life as narrated, revealing episodicity as a viable response to this two-fold pressure. In looking at the life histories of older people, gathered by in-depth unstructured interviews and published in book-format, this contribution demonstrates that episodicity is hugely relevant also for how older people retrospectively pitch their lives, suggesting that mid-life anxieties about living along a prescribed narrative arc into old age are perhaps exaggerated.