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  161 Chapter 10 The Zen of Memory Loss Living in the Moment Nora is immobile and, we suppose, demented. She cannot talk or move, though her eyes radiate alertness and joy. Sometimes she smiles and makes musical cooing sounds. Sometimes she laughs softly for no apparent reason. Surely it’s her unrelenting contentment and profound happiness that convince us that she must be out of her mind. —Tom Gass, Nobody’s Home: Candid Reflections of a Nursing Home Aide I’ve learned an awful lot—like how to take care of people with dementia. I’ve learned a lot more patience with everybody. I had no idea how to approach somebody with dementia. In fact, I was almost afraid of them. But you treat them with respect and love like anybody else, and they come around to tender loving care. —Ida Cummings, Green House shahbaz My visit to Arbor Place in Rockville, Maryland, was a revelation. As I entered , I heard Latin jazz throbbing. Before me, in the living room, the household was in full swing. A gentleman in a plaid shirt dipped into a romantic embrace with a regal woman wearing a full skirt, her hair tucked into a ballerina’s bun. Others held their partners’ hands and bobbed to the beat. Some who were in wheelchairs hand-danced with their partners. When the song ended, everyone laughed and hugged. It was hard for me to believe that every resident there had Alzheimer’s disease.1 “Here, from the time they get up to the time they go to bed, it’s about 162 Old Age in a New Age pleasure,” said Eileen Fanburg, who codirects Arbor Place with her husband, geriatric psychiatrist Walter H. Fanburg. The contrast to most other dementia-care facilities is so striking that family members have been known to burst into tears when they first set foot in the door. Stephanie Waldron, whose search for alternative living for her mother had left her feeling “desperate,” knew instantly that Arbor Place was unusual. “When I first came, I had so much fun here,” she told me. “The residents had me in stitches playing a gambling game. When I left here, I felt happy.” The Fanburgs have taken the most advanced thinking on dementia care and applied it to an assisted-living home they created from the ground up. Arbor Place is far more expensive than most families can afford—$261 a day in 2005. But other homes could learn a lot from the quality of life there. According to geriatric-care consultant Susan Johnson, Arbor Place is among the best dementia-care facilities in the country—a “beacon in a sea of mediocrity ,” as she put it. “If you read the brochures of other places, they all are saying the same thing: good activities, customized care. But they may not deliver on that promise. The Fanburgs deliver. They provide stimulating activities that are for adults, not childlike activities just to keep people busy.” Perhaps even more important, Johnson added, is the opportunity to form meaningful relationships. “That’s important for all of us, but especially for people with dementia,” she said. “Some of these other places provide shelter and food, but people are not having human interactions and relationships. That’s what I’m very impressed with at Arbor Place.” As discussed earlier, roughly half of those in nursing homes and 24 to 42 percent in assisted living have dementia. Some 4.5 million people have Alzheimer’s disease in the United States. In 2006, one in three Americans had a family member or friend with Alzheimer’s disease. Nationally, the direct and indirect cost of caring for people with Alzheimer’s is $100 billion a year.2 People with dementia face considerable, progressive losses, as do their families. Bit by bit, memory ebbs away, first in the short term—how to get from your house to the grocery, where you put your purse, when to go to a doctor’s appointment—and gradually more and more. Often the person is adept at concealing her confusion for years. If family members begin to question irrational behavior, the person may grow angry or frightened. Eventually, sufferers will not recognize their own spouse or children. They may begin to wander at all hours of the day or night, trying to get to a job they held forty years ago or searching for long-dead parents. Families find it harder and harder to manage. Yet they often delay...

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