Today a letter arrived from a friend of a friend. She asked for advice on activities to bring to a friend diagnosed with dementia. Here is what I told her.

I am so sorry for your friend and all who love her. She is lucky to have you in there pitching.

For a decade I’ve led art groups for a decade in long-term elder communities, including locked dementia wards. Most of what I know I learned by doing.

I recommend the The 36-Hour Day by Nancy Mace. Also, the Alzheimer's Association. Loving someone in mental decline - even if you are not the direct care-giver - is like being the frog in that pot of heating water. You go along with incremental changes, but the grief and anger and helplessness can overwhelm. (They undid my mother.) Companionship can help. A support group lets you talk with or listen to others on the same path. It saves you from isolation, makes you feel less crazed. Also it could lead to good ideas and referrals.

As for activity ideas, try your local library. No need to read things back to front. Just scan the table of contents. Grab what sounds right for you and your friend now. The Montessori model may be especially helpful in designing activities.

The key, for me, has been to think of time with elderly art students, including dementia patients, as improvisational theater. Come with a plan; be ready for surprise. (Here's a a short story those techniques.) Say "what if?" Follow their lead. Build on whatever happens. Say yes.

If you can be alone with your friend, you'll do her husband a world of good. One of the best and hardest things a care-giver can do is get away for a hour. I can't think of a greater gift you could give.

Regardless of why you visit, remember that the person with dementia changes every day. The person you met last week may not be there today. Skills diminish instead of grow. Moods change. Join in, rather than teach. Words disappear before comprehension. Polite behavior can mask confusion. Slow down. Listen. Avoid "No." Back off when anger flares. If nothing works, embrace their story as best you can, like the folks in this incredible story from Radio Lab. Even the difficult moments pass.

Music helps. Ask her family what tunes she loves/d. Play that music when you are together.

Celebrate achievement, whatever it looks like. Always let her know you are glad she's there.

When you work with a mentally diminishing person, you clear a path, however briefly, for the person to think and be creative. You help them have fun and feel productive. Art, baking, gardening, folding laundry - each structures time, makes the self visible, gives them a sense of accomplishment and usefulness (so needed, so hard to come by). Folks with dementia may not remember but they still feel. That's the part of their soul you nurture when you spend time together.

Best,

Linda Dunn

Another student’s work, continuing care art class

If you love someone with dementia...

Getting the nerve

Grace