Dementia and Special Family Events…any time of year…

I.  Plan ahead, be prepared.

1. Let family and friends know how they can help.

2.  Be open with everyone about behavior changes.

3.  Offer and ask for suggestions.

4.  Discuss activities and responsibilities. (see IV below).

5.  Organize a ‘tag team’ to help share time with their loved one.

i.  One person should NOT have total responsibility.

II.  Understnad the degree of dementia.

1.  Be sure everyone is aware of the situation and is comfortable with responsibilities.

2.  Is it ‘early stage’ MCI (mild cognitive impairment).

3.  Or a ‘mid stage’ dementia.

4.  Speak clearly, avoid long questions with long answers.

5.  Keep it simple.

6.  DO NOT say ‘Don’t you remember?”

7.  DO NOT  criticize, stay positive.

8.  DO NOT  argue, you won’t win.

9.  Let them repeat the same comment over and over.

i.  Give the same answer with the same enthusiasm.

ii.  ‘Did you have to travel far to be here today?’

1.  ‘No grandma, just a few miles.’

2. Don’t give a long story about traffic or weather.

10.  Most important everyone, BE PATIENT.

III.  Plan activities for early in the day. A noon meal instead of dinner.

IV.  Does your loved one live with you or will they visit?

1.  If visiting, arrange to arrive just before the main event and watch their level of                        involvement to know when it’s time to leave.

2.  If they live at home, try to stay on their routine as much as possible to keep things                calm and fun.

3.  If things become hectic have activities for the ‘tag team’ to use.

i.  Keep old family pictures or albums close by that are familiar and will stimulate a                  personal conversaion.

ii.  If mom always planned and cooked the meal give her an assignment with a ‘tag                     team’ member to ‘help’.

1. Give her an apron.

2.  Set the table, wash dishes, bring prepared dishes to the table, stir mashed                                potatoes.

a. She made hers’ a certain way…let her tell you.

iii.  What did grandpa like to do?

1.  Read the paper, tell stories, play with the train set.

a. Did he hunt or fish?

2.  Guess what’s in gift packages.

3.  Play music, dance, sing.

4.  Find their interest and recreate it.

5.  If he didn’t have an interst in football DO NOT sit him in front of the TV to                             watch the games!

6.  When in doubt, ask him what he liked and follow his lead.

V.  In general:

i. Be aware of this different situation and empower your ‘tag team’.

ii.  Use common sense and consider how you’d like o be treated if the circumstances                   were reversed.

 

 

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With Knowledge We Conquer Fear

“The only thing we have to fear is fear itself!”

Memorable words spoken by Franklin Delano Roosevelt at his first inauguration in 1933. His speech goes on to say; fear of the unknown produces fearful reactions. Knowledge and confidence helps deal with those fears.

His statement:

This great Nation will endure as it has endured, will revive and will prosper. So, first of all, let me assert my firm belief that the only thing we have to fear is fear itself— nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance”.

In the next 20-30 years, some form of dementia will touch our lives. It could be a neighbor, work associate or family member. A fearful thought; it’s time to convert retreat into advance.

When I began as a volunteer for the Alzheimer’s Association, I wanted to learn more about the disease. A quick way to do that was to become part of the Alzheimer’s Speaker’s Bureau.

The more I learned, the more I saw a need to share this [ALZ] knowledge with others. Armed with knowledge, we can fight the fear of Alzheimer’s.

As a volunteer, my goal became, spread the word:

1)   to help others understand what is happening – that’s knowledge

2)   to share information about helpful programs on what to do next and what to expect next -that’s knowledge.

3)  to give caregivers support so they don’t feel alone – that, is knowledge

Until there’s a cure, if we’re armed with knowledge, we can face the challenges of Alzheimer’s and discover meaning in all that we go through.

Become a volunteer and spread the knowledge!

During September & October this fall, watch for the dates of your local Alzheimer’s Associaion annual Walk to END Alzheimer’s. It’s a time to get involved with a cause that will be part of our lives.

Sign up on Remembering When to receive updates on how an individual can gain KNOWLEDGE in the challenge to face Alzheimer’s. If we’re armed with knowledge, we can face the challenges of Alzheimer’s and discover meaning in all that we go through. LEARN to capture the essense of an individual, to look past the disease. So if for only a moment, we’re able to ‘find’ them, there is meaning in what we go through.

Start a team…go to www.alz.org/walk

In the Dallas area:

September 23 – Heritage Plaza, Longview, TX

September 30 – Downtown Ennis, TX  & Grandscape, The Colony, TX

October 7 – Dallas City Hall Plaza, Dallas, TX

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Pick a Person

Take a minute to think about this:

Imagine someone you’ve known a long time, someone close. This might be a parent, brother, sister, spouse, relative or a close friend.

Now depending on your choice, do you like them? Maybe you love them, but at times it can be a challenge to be around them. Or maybe they’re someone you’ve admired and learned from over the years.

They could be younger, but let’s assume they’re over 65 or 70 years of age. They’re vibrant active people. How often do you see them? Have there been opportunities to spend real time with them or has it slipped away? Has that happened too often?

Time passes. When you see them again, there are subtle changes, nothing that would disrupt the day. Something could be funny and you both laugh, but did they get it? Different ‘little’ things become more noticeable…yet they don’t seem to notice. If they do, it upsets them.

Maybe they can’t find something, or don’t know it’s lost. Next you notice questions or comments are being repeated. Or there’s a change in their physical appearance, the smoothness of their gait is no longer fluid, it’s become halting.

Time passes. This special person can no longer be by themselves. They need continued assistance with daily life. Yet they’re excited to see you, to talk, to reminisce.

What has happened to this loved one, this close friend? They don’t know you. Where are they? What’s happening?

Reality sets in…you’ve lost them. It’s been a slow steady decline, but you missed it, it was right there. The ability to speak or write has disappeared, they no longer feed themselves. Yet on occasion, a glimmer of life can be seen in their eyes. The time to share, to understand, to reminisce is gone. The challenges from the past have faded, they’re no longer an issue. Your shared memories are all you have, their memories are silent.

Progression varies but eventually walking and sitting are difficult. In time, your special person is bedridden until the end. It may take a decade or more to witness this entire event.

This is Alzheimer’s disease. Eventually it will affect all of us in some way. What do we do about it? How do we cope?

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The Importance of a Hug

It doesn’t sound like much, a hug, but it’s a figure of touch that will release emotions people didn’t know existed.

It was a simple request, “Why don’t you give me a hug before you leave.” That was from daddy as I prepared to leave after one of my last visits. He’d never said that before. There was no hesitation on my part. Even in the touch of his frail, thin body there was strength and meaning. It was a slow, shy hug at first that became warm and strong, from both of us, one to another. We’d done that once before when I was 17…and in trouble!

You may have heard the story of Dan Peterson and Nora Wood of Augusta Georgia. A seemingly simple hug from a stranger changed lives, it opened hearts. If you haven’t heard the story, Google search the names.

Now use Personal History to reach out to a dementia patient. Like a hug, it can help discover lost emotions. It also helps to calm many fears.

First review past posts on How To Use TalkShare and Learn to Relax and Listen I & II. That will get you started…and remember the meaning of the word patience.

Remember these words also:    Compassion and Acceptance

Be aware of a patient’s feelings, be with them.

Be patient, don’t prejudge. This unique person has knowledge and wisdom to offer. Give it a try…listen.

Be accepting and honest.

Give them a HUG!

You never really understand a person until you consider things from his point of view… Until you climb inside of his skin and walk around in it.”

Atticus Finch/Harper Lee – To Kill a Mockingbird

 

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Christmas Stories 2016

Here it is Christmas Eve 2016…a good time for stories. There’s always a Christmas memory or favorite story to be told. This year, be sure to make new ones and share old ones.

Here’s my contribution….

HOLIDAY FOOD MEMORY…

Growing up mother’s Cranberry Nut Bread was always a favorite. It was best lightly toasted, which allowed melted butter to drizzle through the nooks and crannies and eventually surround the nuts and berries.

She made it every year for as long as I remember. Her mother made it too…a family recipe of sorts. When I got married, mother wrote the recipe out line by line on an index card for my new recipe box.

Myself, as a young mother and air force wife traveling around, mother’s Cranberry Nut Bread became a great holiday ‘food gift’…and always a hit. Over the years there were many requests for the now Christmas Cranberry Nut Bread recipe. Once after a neighbor tried her ‘gift’, she came over, excited and asked… ‘What is this? It’s delicious! I didn’t know what to think when you said ‘cranberry nut bread’. I was thinking something terrible…but I need the recipe!”

Christmas Cranberry Nut Bread took on the shapes of mini loaves, muffins and even a Christmas wreath.

One Thanksgiving I tasted ‘real cranberry sauce’.  Not the jellied stuff in a can…until then, that’s all I knew about cranberry sauce. I asked about the recipe and was told to look on the back of the Ocean Spray Cranberry bag…and there it was…

…right above the Cranberry Nut Bread recipe!

Could it be? Mother’s Cranberry Nut Bread was the company recipe on the plastic cranberry bag! Not a family recipe passed down from my grandmother! A few minor adjustments had been made but it was the same recipe.

The one consolation…it is a great recipe passed down from my grandma Cunningham to mother then me…Janell will have it too…it’s on mother’s index card and the Ocean Spray cranberry bag!

Do you have a similar story? Let’s share and see how many we find. Be sure to keep your story, pass it along AND write it down.

Wonderful wishes to everyone for a great holiday season and a memory making 2017!

Elaine

 

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November 2016…a year later

There’s been a lot happening the last couple months.

It was about a year ago my sister Ginny and I met in Augusta to see daddy (1st post Nov 2015). For me, it was our last face to face visit.

On Dec 16 this year he would have been 97. That’s a lot of years. I still see ‘Daddy’ listed in my phone contacts. It will stay there. There will be a sad sigh next June as I pass the aisle filled with Father’s Day cards. He’s not here, but what we have are his stories and his voice. Those 19 audio tapes he recorded about his life are even more precious now. Thank you daddy.

For me what’s become an even greater treasure, the reminisces of the last 15-17 years. While on visits to see him and mother, he’d talk about his life, our family, and his thoughts and views about things. The more he talked about himself, the more I learned about myself. Our similarities were the most surprising.

Besides sharing historical family information, it was a time of reflection for him, his personal story, his accomplishments. It was fun to see him relive his grade school days in Ben’s Creek, the pride in his military career and his attraction and love for mother.

It was wonderful to witness.

THE POWER OF PERSONAL HISTORY

So, the next time mother, dad, grandma or uncle Joe begin to talk about the ‘good ol’ days’, ask uncle Joe to tell you what he did for Halloween tricks. Listen to the story…again! Ask yourself, do I sound like grandma when I laugh or is my curly hair like hers? Use this time to discover and share with them.

It’s an opportunity to learn something new. Ask more questions! Be sure to video, audio or document the experience. It’s fun!

Dementia patients benefit from the simple experience of telling their story. It’s not a drug, but it can calm an excited patient or client. It’s not a cure yet the moment is positive and  will come back again. Let them talk. Listen for the value of who they are and what they accomplished. It doesn’t matter if they drove a Sherman tank for General Patton or took care of the kids while daddy worked.

The fact that you show an interest in them makes a connection on a personal level. It won’t be forgotten. It builds trust and recognition. Set the same time each day or each week just to talk. Tuesday at 2:00. They will look forward to it. A special time they will understand and remember. It becomes a habit.

Give them a hug. It’s a time for everyone to feel good. And it feels good to be hugged… at any age.

At the same time, besides family history we learn about ourselves.

Our lives revolve around stories. What we did at work, at school. High school reunions are full of ‘old stories’…and why…it feels good telling them. It’s the communication with others.

As we age, our stories, good, bad and sad are part of who we are. It’s one connection that pulls us ‘out of the present.’ A time to daydream about ourselves. It includes talking about what could have happened… ‘then your mother came along’, or at another time ‘you came along! That changed everything.’

Each life has a pattern. Each life is an experience that has meaning. Each life can be re-discovered. That’s the goal of Remembering When/TalkShare.

DURING THE HOLIDAYS…

…A perfect time to share and record stories. Do it now so there’re no regrets later.

Remember, every time a life ends it’s like a library burned down and there’s no way to rebuild it. Because of technology, future families 20, 50, 200 years from now will know their ancestors. Whether on DVD or written in a scrap book they will know their story… if time is taken to record it.

Let us know how your holiday recording turned out. Has time been added to the calendar for regular visits to let someone know you care?

Be sure to sign up to receive updates and new blog information.

Thanks and have a wonderful holiday season…Elaine

 

 

 

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How to Use TalkShare

A couple years ago for a Toastmasters project I decide to compile my experience, research and knowledge about Personal History and dementia into a speech titled TalkShare.

Read on to see how it works.

Good evening members and guests:

  • Over the past couple of years, several of my speech topics have been about Personal History
    • How to start it and share it with family members
    • And why it’s important

 

Now, think of Personal History as a conduit to a TalkShare. Let me explain:

At the turn of another century….1899-1900

  • Senility was considered a normal part of aging
  • By the 1970s it was known as dementia – a disease related to aging
  • Currently, dementia is an umbrella term for several types of memory loss and aging is one risk factor
    • Alzheimer’s, Parkinson’s, vascular dementia, head trauma, a tumor, Lewy Bodies and Huntington’s disease all have a place under the dementia umbrella.
    • The first and most important step is to find the correct diagnosis for memory loss
      • The treatment for vascular dementia,  or Parkinson’s is different than treatment for Alzheimer’s

Then:

No matter how hard we try, the phenomenon of aging won’t stop

  • Common aging battles include
    • Gravity
    • Gray and/or thinning hair
    • Things begin to hurt that never hurt before
    • Eyesight and hearing diminish
    • Our brains aren’t the same
  • “What’s that name/that word…it’s on the tip of my tongue”
  • “Where are my keys? I’ll be late picking up the kids!”
    • That’s not always memory loss, it’s more like information overload or stress.

The word Alzheimer’s began to creep into mainstream vocabulary around the 1980s or so.

  • In the last 30-35 years it’s become more common
  • More research dollars are being spent
  • Much has been learned, but many questions remain

What does this mean to each of us?

  • Some form of memory loss will touch our lives
  • It could be a relative, friend or a co-worker’s neighbor!
  • In some way it will touch us
  • Possibly as individuals

Situations differ yet some facts are the same

  • With early on-set Alzheimer’s
    • The disease can take over the lives of young people in their 50 & 60 or earlier
      • In these rare occasions there’s a more rapid decline
      • Being young isn’t necessarily better
        • The metabolism is faster so everything accelerates
        • It’s more gradual in an aging person
  • It doesn’t end with the memory loss of what happened yesterday…
    • Awareness of communication usually breaks down first
    • Writing ability diminishes
    • Language is lost
    • All stages vary but eventually walking, sitting, even eating is difficult
      • In time the individual is bedridden
    • A family could watch this decline for up to a decade

It will affect us. What do we do about it? How do we cope?

While waiting for a medical answer, there are ways to turn this declining time into a meaningful experience. To touch lives in a way that will enrich related generations… HOW?

 Begin to TalkShare – using Personal History

The following ideas will help lay the foundation for everyone to discover forgotten memories. Once revived, these memories resurface as renewed moments to be remembered by everyone in the present family and future generations.

 First:

  • Be consistent, it’s best to set a time to TalkShare
    • Each Tuesday at 2:00 or mornings at 10:00 for two hours
      • Whatever time works best
    • Establish an easy going mood
    • Be at eye level to talk with the individual
    • Use pleasant words and add compliments
      • “I love what you’re wearing today…did you pick it out?”
      • Even if it’s terrible!

Next:

  • Use Personal History to reach for those hidden memories that will produce a smile or even laughter
  • Look into their eyes, the answers will be there

Begin with broad easy questions:

  • Where were you born, name family members and any pets
  • Describe the house where you were raised
  • If no answer, move on to another question
    • Eventually circle back to a previously unanswered question
    • Slowly the answers will become more detailed
  • Laugh and be amazed each time they tell the same story.
  • For them, it’s the first time to tell it.
  • Act as if it’s the first time to hear it!

 

Another ice breaker is to organize pictures

  • Ask for their help to identify people in a picture
  • What was the occasion?
  • Figure the date/time-line
  • Encourage their participation
    • Let them know they’re the best person to help do this
  • Does the picture or story spark emotions?
  • Which is their favorite story and why?
  • Reinforce the need for their wisdom and knowledge to compete the task.

Listen for the story. Remember it and use the information again later

  • Acknowledge difficulties with past issues, present concerns and share similar experiences
    • But don’t dwell on negative or difficult situations
  • Play mind exercises to stimulate memories
    • Name the presidents during their life time
    • How many cars did they own? Name them
    • Use easy words
    • Ask simple questions in short sentences
      • An involved question can become frustrating and cause withdrawal
  • Watch the pitch, loudness and tone of your voice…allow for pauses. Use vocal variety
      • This begins to sound like goals from the Toastmaster Competent Communicator manual – Vocal Variety
      •  It works!

Make them feel important

  • Use Touch – When listening to a story, gently place a hand on their elbow or gently hold a hand
  • Smell – If possible bake, cook or talk about favorite aromas to connect a memory and story
  •  Music – a great use of ITunes
    • Discover their favorite music period – big band, rock and roll, classical, jazz
    • Make it toe tapping, dance, sing
  • Watch – your facial expressions and gestures
    • Don’t make them too large
      • It can be frightening
    • We want pleasant memories

Using Personal History as a guide will help make these connections.

Everyone knows the saying, “Walk a mile in another man’s shoes”…well…

Consider entering their mind for awhile. See how Personal History can dig deep and arouse a sleeping memory and capture an emotion. A smile will broaden on the lips or a tear can moisten the eye. The thoughts may not last long but they’ve been captured and can be released again and again. These personal memories will continue to be cherished by loved ones and future generations.

You’ve experienced a TalkShare…using Personal History.

This was a 6-8 minute speech. Expand on the ideas and make it fit your situation.

The speech provides helpful information to be used as a guideline to begin communication with a loved one or a caregiver’s client.

Let us know how it works. Share your experiences.

Here’s one example:

After meeting Bill each Thursday at 1:00 for 24 hours (12 weeks) it was time for a review and to put his thoughts on paper. Instead, he didn’t want to stop. When asked why, he said. “While doing this I started to think of things I haven’t thought about in 70 years. There’s more to tell!”

Don’t wait for dementia to cloud the mind to explore a personal history. It can be done at any time. The sooner the better.

An easy start is to set time aside each week to identify pictures and connect them to a story. Ask grandma or whomever, to help with names and places, you’ll enjoy the time together.

Listen and learn their stories through pictures. Their long term memory is very good. Let them make the connection. Let them recall what THEY enjoyed. NOT what WE feel it SHOULD be.

Besides actual photo albums, edit all those pictures on phones and computers. Can everyone be named, is there a location or special memory of the occasion? Make picture ID a TalkShare experience with the kids. Discover their memories of the wedding, reunion or birthday party. Video their answer holding the pictures, write it down. You’ll be glad you did. And be sure to make it fun.

Enjoy the time together and let us know how it went. Also if you have any questions just ask.

Be sure to sign up to receive future updates…

Thanks for your time and may God Bless…Elaine

Other connections:

Association of Personal Historians – http://www.personalhistorians.org

Alzheimer’s Association – www.alz.org/dementia/types

Toastmasters International – www.toastmasters.org

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Learn to Relax- Part II

Learn to Relax: Part II

Being a good listener is a ‘best practice’ in any situation. It’s a learned skill and very beneficial.

Simple breathing relaxations is a good place to start. Don’t snicker, it works! But it takes practice. The more practice, the easier and more natural it becomes.

That’s how the brain works. The prefrontal cortex is the large gray matter across the front of the brain. Just like exercise builds stronger muscles. Relaxation exercises strengthens the brain.

The prefrontal cortex controls personality, expression, decision making and social behavior, to name a few. It helps us relate to conflicting thoughts and to decipher the future consequences of our immediate actions.

It’s beneficial and  well worth the try to include dementia patience’s too!

So let’s be in the moment

  • Plan on five to ten minutes to begin (add more time as you appreciate the process)
  • Get comfortable lying or sitting on the floor in a quiet place (only use relaxing music, if helpful)
  • Don’t let the mind wander, take deep, gentle, controlled breaths, focus
  • Don’t think about what should happen in the next hour or what you did an hour ago
    • Be mindful of the immediate moment
    • This time is about you
  • Quietly THINK about your breathing
    • Slow it down
  • LISTEN to each breath:
    •  IN 2, 3, 4
    •  OUT 2, 3, 4
    • Gradually take longer breaths IN, 2, 3, 4, 5, 6, 7, 8, OUT 2, 3, 4, 5, 6. 7, 8
      • Breath IN through the nose
      • OUT through the mouth
      • Fill the lungs to capacity (include the lower lung)
        • Hold for a few seconds
      • On exhail, push all the air out using stomach muscles
  • Come back to the moment and repeat several times
    • If lying on the floor you could fall asleep

With practice, relaxed, deep breathing becomes second nature. Stressful situations become easier to handle. Listening becomes natural.

Over time, it becomes easier to deal with a confused relative or a memory care patient. Not better, but easier to handle on a daily basis.

Do you make time to really relax?  Don’t let the moments slip away.

What do you do to relax? Share what works for you.

Also, pass this information and blog along to others who will benefit.

“The most basic and powerful way to connect to another person is to listen.  Just listen.  Perhaps the most important thing we ever give each other is our attention.”

Rachel N Remen

Next:

Listen…To Personal History Part III

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Listen & Learn

Listen & Learn: Part I

Listening to the same story, comment or question over and over is the most common frustration when dealing with dementia patients. One way to cope… listen!

An Example:

It’s been a long day at work, dinner will be late. Mother is in the kitchen willing to help. Within 30 minutes she tells the same story three times. As she begins version four you cut her short.  “Mom, you’ve told me that!”, or “I know that story I don’t need to hear it again.” All normal reactions.

As she begins version four anyway, try this…before reacting, pause to listen. Take a deep breath if necessary. Considered it a form of multi-tasking.

It’s the fourth time you’ve heard the story, but Remember it’s the first time for mom to tell it. With each rendition, act as if it’s the first time you’ve heard it. The advantage, you know the story, it’s easy to make comments and know what to say, at the right time.

Next, gently turn the situation into a mental exercise for mom while you continue to make dinner. It’s more pleasant than a pointless argument. If possible, ask her to help set the table or toss the salad. Some sort of busy work. Give her something to do.

Then, if she still insists, let her tell the story about Joe being in the Navy. But ask the question, ‘I thought Joe was in the Army.” Continue to prepare dinner. Give her another simple dinner task if possible. Another distraction.

By asking the question, you’ve changed her routine story…the challenge…make mother think deeper. Slowly develop a new conversation. It’s beneficial for both of you.

Use this time to exercise her brain. Avoid an argument. Keep her calm with other simple questions that make her think. Avoid an argument. Follow her lead, listen to what she wants to talk about. Not what you think she should say or do. If confusion is the response, reach out to gently hold her hand, calm her thoughts. Agree, “Maybe Joe was in the Navy”. Avoid an argument. You are in charge, guide the conversation to sooth any discomfort. Listen to find out what is puzzling her. Find ways to build confidence and understanding. It works for both of you.

If the dementia patient is ‘dad’, use the same Listen & Learn procedure.

Remember …put yourself in their confused mind. How must it feel? Always be aware, the real person you know IS in front of you, just not all the time. At different stages, a patient will realize they’re losing you too, which adds to their confusion. The personal challenge is not to be upset during difficult times. Become the calming influence not the agitation and listen for clues that help.

In time, a new relationship can be established. It’s important to build a new and final relationship. It’s time to release whatever happened in the past. The ‘now’ is what needs to be Remembered, not long ago issues.

Is your story similar? Share helpful experiences. What are your challenges?

Remember:

“The most basic and powerful way to connect to another person is to listen.  Just listen.  Perhaps the most important thing we ever give each other is our attention.”

Rachel N Remen

Relax and Learn Part II will be next….

 

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Japanese Lover/North Andover Book Club

The North Andover Book Club is reading Isabel Allende’s new book, The Japanese Lover. A timely selection. One part of the story takes place at the Lark House nursing home which holds extraordinary secrets.

Telling these ‘secrets’ or stories, gives new life to the story teller. It’s especially revealing for someone hearing the story for the first time. Life stories are what we are all about…literally. They make us who we are.

The exercise of telling life stories promotes understanding, which in turn eliminates fear. This brings people closer. Teaching the importance of sharing life stories is Talk Share. One way to confront the confusion of dementia is learning who we are and where we came from.

Alma is telling her story so others will understand.

This is the time and place to recommend other books that tell a story. What is your favorite?

Ginny, my sister is a member of the North Andover Book Club. Scroll down to the first post to see how she is part of ‘our’ story.

Thanks for your visit, come again

Elaine

 

 

 

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