Games to Bridge the Gap
New Pastimes Help Connect Family Members to Relatives With Dementia

By Beth Baker
Special to The Washington Post
Tuesday, April 15, 2008

Generations of family members have bonded over a hot game of Old Maid or Monopoly. Now a handful of entrepreneurs and researchers are demonstrating that some newer games can be a bridge to family members who have dementia.

Researchers who have designed several of these games don't pretend that their use will boost memory in people with brain disease. The goal, says psychiatrist Gene Cohen, director of the Center on Aging, Health & Humanities at George Washington University and developer of the board game Making Memories Together, is to improve quality of life, rather than memory.

Equally important, some say, is the emotional link that game-playing offers younger, healthier family members to those with dementia.

In a study of 33 families, satisfaction was higher after playing Cohen's game with a relative with dementia than after a visit that involved no game-playing. The study was supported by the National Institute on Aging and has been submitted for publication in a peer-reviewed journal.

Some 5 million Americans have Alzheimer's, a progressive, fatal brain disease that often leaves people anxious and isolated. Caregiving is a challenge, as is maintaining meaningful ties between patients, who are often at a loss for things to talk about or do, and family members.

That's where the new products come in. Their developers aim to engage families in activities from scrapbooking to board games to computer exercises that allow players to simulate flying over Hawaii or see faces of loved ones by touching a screen.

One computer game, It's Never 2 Late, lets players pick from large, colorful, on-screen icons representing topics such as history, music and spirituality. When Ruth Spring, 84, who lives at the Westminster at Lake Ridge nursing home near Woodbridge, touched the music icon in a recent game session, photos of Elvis, Johnny Cash and other stars appeared. She selected Dean Martin, and an old video clip played of the singer crooning "Memories Are Made of This." Spring smiled, bobbing her head to the music. Soon she was singing softly along. (Even those with late-stage dementia retain memories of favorite music, according to the Alzheimer's Association.)

Joyce Howard says her mother, Ruth Farquhar, 83, who has cognitive loss from seizures and strokes, also enjoys using It's Never 2 Late. Through the program's e-mail feature, Farquhar, who lives in a nursing home in Fort Collins, Colo., was able to send birthday wishes to her son -- especially meaningful since she can no longer use a telephone, due to deafness.

In 2001, Maura Daly of Germantown and her family played Making Memories Together -- in which family photos are displayed on large laminated cards -- with her mother, who had Alzheimer's before she died. "The game was quite remarkable," Daly said. "She was much more responsive to the family photos as displayed in the game, as opposed to any other way of looking at photos." An added benefit, said Daly: Choosing photos for the game prompted her father to share stories. "It really did bring us closer as a family," she said.

Rhonda Anderson, founder of Creative Memories, a scrapbook company, retooled her business after customers began noting how much their loved ones with Alzheimer's were enjoying the scrapbooks. The company trained its in-home consultants to help families turn shoeboxes of photos, pressed flowers and playbills into personalized time-travel vehicles, with each page holding a simple caption, for example: "My favorite holiday is Thanksgiving."

Jane Priest, chief program officer of the Alzheimer's Association of the National Capital Area, now gives the scrapbooks to support group leaders. "When you have a scrapbook, you're stepping back in time into their memory bank," she says.

Even those with end-stage illness enjoy memory books, according to Michelle Bourgeois, a professor of communication disorders at Florida State University. Those who can't speak may coo or pat the pictures of loved ones. "I firmly believe the memories are still in their brains," she says. "It's an access issue." Memory books and scrapbooks are especially helpful for those who live in nursing homes and similar settings, as a way for staff and volunteers to get to know them.

Memories Squared is a modified word-bingo game developed by the nonprofit Myers Research Institute in Beachwood, Ohio. The game combines fill-in-the-blank challenges with cues for engaging people in conversation and reminiscence. "If you never finish the game but you've had a good time talking and connecting with the person, that's the whole point," said Cameron Camp, institute director and senior research scientist.

Camp also developed Reading Roundtable Stories for groups or families to read aloud together. Bourgeois recommends a series of "two-lap" books by Lydia Burdick, such as "The Sunshine on My Face." The books, also meant to be shared and read aloud, feature images of older adults engaged in familiar activities, such as watching television and dancing to music on the radio.

Marlene Sandhu, founder of Being With Being, consults with long-term-care facilities in the Washington area about how to best connect to residents with dementia.

"Pictures are great," she said, "but at some point two-dimensional images are not engaging enough. Rather than take a family wedding photo, take your wedding dress for them to hold." Sandhu is developing a new product that uses props to help people connect.

Back at Westminster at Lake Ridge, a group of residents gathered around a big screen for another popular activity -- the Wii video game simulating various sports. Lillian Warren, 95, who has mild memory loss and limited use of her left side following a stroke, was willing to have a go at bowling, an activity she used to enjoy. Even though she was a lifelong lefty, she moved the remote with her right hand to send a ball down the lane. A whoop went up around her. She rolled a strike. ·

Beth Baker is a frequent contributor to the Health section. Comments:health@washpost.com.