Most days, Jane sits slumped. When alert, she shuffles her feet to propel the wheelchair forward. She wanders without purpose. People pass her in the hallway on their way to meetings or in their haste to give a pill. Sometimes Jane watches them.

“Good morning Jane,” the nurse says.

Jane looks up, and in about thirty second’s time, she responds, “good morning.”

The nurse doesn’t hear her. She’s turned the corner. Jane’s response is delayed. She has Alzheimer’s disease.

Every day, we have a small group activity for residents with severe dementia. We gather in a small circle in a quiet place at eleven o’clock in the morning. We take turns introducing ourselves. Sometimes members surprise us and say their name.
We offer rhythm instruments. Billy always takes the drum. He was a bass guitarist in an R&B band fifty years ago. Pete likes the vibrating sizzle of the cymbals, Beth shakes a tambourine, Mary rings a bell, and Jane pushes the box away. We turn on the CD player and an old familiar tune starts to play.

“You are my sunshine, my only sunshine. You make me happy when skies are gray. You’ll never know dear how much I love you. Please don’t take my sunshine away…”

These five people cannot put a coherent sentence together. If words come, they don’t fit together. Sometimes one word in a mouthful of sound is intelligible. Music makes a difference though. It comes from another part of the brain. Maybe music comes from the heart, because every one of these people with advanced dementia sings this song, every word of it. It’s the same with Amazing Grace, Don’t Sit Under the Apple Tree, Over the Rainbow and Will the Circle Be Unbroken. When the music is playing, they keep time. Heads are no longer bowed, eyes are open, and voices sing.

Jane dislikes this part of the program. Noise bothers her, and although she mouths the words to the songs, it’s easy to tell that she was not interested in attending the Municipal Band concerts in her home town. Acapella is more her style. She jumps when Billy comes down hard on the drum, and sends a disgusted frown in Mary’s direction when she rings the bell.

We turn off the CD and put the instruments away. This segment of the activity is always different. Sometimes we pass around a prop for everyone to see and feel. Yesterday, it was an old tin measuring cup. We handed it to each person and asked what it was, if they remembered using one, what they did with it.

Pete put the cup to his mouth. We reminded him about his years of drawing water from the well and taking a cool drink. Beth said, “baking cakes,” as she turned the cup over as if pouring measured milk or sugar. Mary held the handle, smiled, and closed her eyes. She likes coffee. Billy banged the metal cup on the table with a beat, like a drum. Jane said, “Stop that.”

This morning, we chose a close up picture of a three month old baby to share. He was smiling and his bright blue eyes sparkled from the page. His fat cheeks invited a pinch and drool was shiny on his chin. A wisp of hair stuck up on his round head. We offered Jane the prop first. She took the laminated photo, brought it close to her face, smiled, and with no hesitation at all, said, “baby.” Then, she kissed him.

Today, we found what Jane likes best.

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