"I'm going to put on my dress and go dancing."

A lot of time when people talk about memory loss and Alzheimer's or other forms of dementia, they talk about losing your memory backwards - losing what is most recent first and holding on to earliest memories the longest. We usually use this simple explanation to talk about short term and long term memory. But when we do this, we often ignore the fact that there are many types of memory (or many components to a single memory.) There is body memory, sense memory or emotional memory, working memory, episodic memory and more.

As I continue to work with this population, I keep reading and learning about memory. Two books that I found very helpful are John Zeisel's I'm Still Here and Forget Memory: Creating Better Lives for People with Dementia by Anne Davis Basting. But book learning only takes you so far. Much more of my learning is experiential and comes from spending time with my patients.

Every time I think I understand dementia, I have an encounter with someone that teaches me that I only know a little bit. I meet a woman and say, "It's nice to meet you." She responds, "I'm happy to meet you." This is going well, I think, and I continue, "My name is Chana Sorel." She says, "Chana. That's a nice pumpkin. I go walking. My stone is my daughter, my friend. And you? Who did the plant go?" And she continues. It sounds like speech. There are words I recognize. She looks like what she's saying makes perfect sense. And I have no clue. So I respond to the tone or to a word or phrase that maybe makes sense to me. And she smiles. And I smile. And we talk. Finally I say, "Thank you for talking with me. May I come visit you again?" And she says, "It was nice to meet you." Her social memory is intact (at least in the moment) even if her words are incomprehensible.

One woman's words are clear, but not responsive. "Hello. I'm pleased to meet you," I say. "Oh," she says. "You play the piano? Play something for us." And I'm dumbstruck, without a response.

Someone else mostly hums. Some days she says a word or two, or she laughs. I start singing "Michael Row the Boat Ashore" and suddenly she's humming "Michael Row the Boat Ashore." I search my brain for every song I know that might get a response. Soon the whole room is singing. Other patients are asking, "What are we going to sing next?" And my patient is humming along to every song we sing.

I walk by a room and a gentleman has a sewing machine. In other room a woman pulls out her knitting and another crochets an afghan just like dozens she has already made for her children and grandchildren. The commonality: they all have dementia. And they are all human beings making connections with us any way they can.

As I visit with a woman, she looks down the hall at something only she sees and says, "I'm going to put on my dress and go dancing." I hope when my turn comes I'll be going dancing too.