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Pat Kaplan, of Palm Desert, is determined to make a difference in the lives of Coachella Valley residents suffering from dementia—and the loved ones caring for them.

The oldest of six girls, Kaplan, 71, remembers her father, an attorney, ran the household “like a courtroom. I think he was afraid of making wrong decisions, having six girls to raise. He did teach me that anything I wanted, I could have it, but I’d have to work for it. He’d say, ‘Nobody’s going to give it to you,’

“My mom was a physical therapist who always told me that regardless of what I did growing up, she knew I was a good person—that even if she might be disappointed in what I did, it was only ‘because I know you’re better than that.’

“My folks were both devout Catholics, and I went to Catholic schools all the way through my first two years of college. I then spent my last two years at a public university, majoring in sociology.”

Born and raised in San Jose, Kaplan met her husband while she was attending school in Santa Barbara. Her husband at the time was a helicopter pilot, working for private companies.

“I started out working in the insurance industry, working a day shift and going to school at night,” she says. “My husband was working the night shift. He used to work on a ‘time on/time off’ schedule, and we were both used to having time apart and enjoying the time we spent together. It’s the same now: We do different things that we each enjoy doing, and we enjoy our time together as well.”

They married in 1970, so the arrangement has worked well.

“We settled in Seattle, my husband’s home turf, but eventually got tired of nine months of rain,” she says. “We kept our house in Seattle but spent summers here in the desert. We came back each year, and after three years, we sold our house and have been here permanently since 1989.”

The couple invested in two homes in Palm Springs that had been built for elder care.

“Once we came to Palm Springs,” says Kaplan, “I envisioned that we’d just be taking care of people who couldn’t live at home anymore—but I was told we needed to take care of people with Alzheimer’s and dementia. I started doing research, and what I really learned is that the first residents you get will teach you everything you need to know.”

Kaplan went on to study gerontology at UC Riverside.

“We sold the homes in 2004, and I became a consultant at Vista Cove in Rancho Mirage. I also do a lot of volunteer work now with Alzheimer’s Coachella Valley, a nonprofit organization that began in 2017,” she said; Kaplan was a co-founder and serves on the board. “We had a group including registered nurses, social workers, therapists, activity directors and even a chef to brainstorm ideas about what was needed in the Coachella Valley.

“We felt it was important to establish a local place that could offer the kind of programs people really need. The national Alzheimer’s Association raises money and focuses on research to find a cure, but caregivers—primarily spouses and children—need help with what they’re facing on a day-to-day basis. We began offering programs in January 2018.”

ACV offers an eight-week program that meets each Friday, “Traveling the Journey Together,” where patients and caregivers spend one hour together, and then spend an hour apart. Patients get stimulating activities while caregivers learn skills that can improve their adjustment to what is possible rather than what is lost. Another program, “Club Journey,” meets each Tuesday for three hours and is focused on social interaction, as well as activities like music, games, sing-alongs, exercise, bingo, conversation, crafts and more; it includes snacks and lunch. ACV also trains caregivers and offers support groups. There is no cost to participants.

“Even if someone hasn’t been officially diagnosed,” says Kaplan, “the person living with them can see what they are going through, and needs help coping with the changes they’re encountering.”

What is the best way to find out if a dementia diagnosis is warranted?

“The first stop should be a neurologist,” says Kaplan. “A regular internist or primary caregiver can then follow up to monitor related medical care and oversee medications. There are drug-trial programs where companies are researching drugs that can delay or minimize symptoms, but those drug trials have stringent requirements about who can participate, and there’s a lot of oversight needed, (like) keeping records (and) monitoring ongoing testing. It’s not easy for the caregivers, and it may or may not help.”

Kaplan says state and federal policies need to adapt to an aging population. “We need to enact medical programs that cover stay-at-home and long-term care,” she says. “Under Medicare, you get 21 days in a skilled nursing facility after a surgery or accident, but we need coverage for at-home care, and for day-care programs where a patient can get skilled care while their caregiver gets some time off knowing the patient is in a safe place. There are only two such places in the Coachella Valley, and lots of people just can’t afford it.”

Pat Kaplan’s advice to anyone dealing with a loved one with symptoms of dementia: “You have to think creatively, and realize you don’t speak the same language the patient does. Obviously, you need a lot of patience, and there is a lot to learn about how to communicate effectively. Don’t buy into the stereotypes and negativity about people with cognitive impairment.

“When someone has cancer, we know they didn’t choose that. It’s the same with dementia. Focus on the opportunities that are still there. Is dementia a horrible disease? Yes. But there’s still a person inside, and that’s what you need to focus on.”

Pat Kaplan is focused on making a difference in the Coachella Valley—and she is succeeding.

Anita Rufus is also known as “The Lovable Liberal.” Her show That’s Life airs Tuesday-Friday from 11 a.m. to noon on iHubradio, while The Lovable Liberal airs from 10 a.m. to noon Sundays. Email her at This email address is being protected from spambots. You need JavaScript enabled to view it.. Know Your Neighbors appears every other Wednesday.

Published in Know Your Neighbors

Barbara Fosse, 81, has been in the desert for more than 17 years. After selling pharmaceuticals for 30-plus years, the Sun City Palm Desert resident is now program coordinator for Tunes for the Memory, a subsidiary of Los Angeles-based Music Mends Minds, an orchestra and music program targeted to those with Parkinson’s disease, Alzheimer’s disease, other dementia-related conditions, traumatic brain injury and stroke, as well as veterans with post-traumatic stress disorder.

Carol Rosenstein, a Los Angeles resident and 2018 CNN Hero, founded Music Mends Minds after what she describes as a “freakish moment” in 2014 involving her husband, Irwin, a person living with Parkinson’s.

“I walked in and heard him sitting at the piano,” she recalls. “He had previously played piano and saxophone, but hadn’t made music for the eight years since his diagnosis. I noticed how he seemed to resurrect while playing, responding like a plant that had needed nourishment. A doctor told me that I was watching music change brain chemistry. It’s absolute magic. Playing the piano had caused him to release dopamine. I realized that no medications seemed to be more powerful than the music.

“I got a few of his buddies to come and jam to have fun musically, and I had a big banner made up that said ‘The 5th Dementia.’ We had about 30 people at our launch. Within just a few minutes, some of them were gathered around the piano and starting to also make music. We now have 17 bands nationwide along with five global groups, including many in affiliation with Rotary International groups. We have band kits for those who want to start their own band, and we offer mentoring, all free as a community service. We’re now looking for music therapists to be able to expand our help to those who want to participate.”

In spite of disease progression, the ability to play music and recollect lyrics is often maintained. Participation can increase a sense of self-worth, confidence and identity. People can feel whole again.

“Science does show us today that playing a musical instrument is like a full body workout for the brain,” says Rosenstein. “It pushes natural neurotransmitters. Until science gives us a cure, we have a kind of natural medication available by playing music.”

Music Mends Minds’ website indicates that music directly affects neuroplasticity, the ability of the brain to change, repair and reorganize itself. It cites research studies showing that:

• Music improves mood by helping one feel happier and less anxious.

• Music may play a protective role against cognitive aging.

• Music improves pain control and reduces pain severity through activation of the brain’s reward centers and by lowering stress hormones such as cortisol.

• Patients with Alzheimer’s may forget certain melodic content of songs, but their ability to play their instrument seems to be unforgettable.

• Music can enhance cognitive functioning and neural processing more than any other art or hobby, allowing people to react and creatively process things more effectively.

Each Music Mends Minds location has its own band name: The aforementioned 5th Dementia in Los Angeles, the Band of Heroes in West Los Angeles, and the Beverly Hills Treble Makers, where Rosenstein says they get about 100 people every week.

Here in the Coachella Valley, Barbara Fosse saw an article in the paper about the Music Mends Minds program.

“I’m an organizer,” says Fosse, “so I called and asked, ‘Do you have anything for me to organize here?’ I had previously worked with Songshine Singers, a group targeted to Parkinson’s patients, and I always believed in the concept of how music can make a difference. But I felt it needed to go to memory issues as well.

“Music Mends Minds (started in) Sun City three years ago. … The Braille Institute in Rancho Mirage agreed to let us meet there. We call our group ‘Tunes for the Memory,’ and famed local pianist Bill Marx helped us kick it off. Now we meet every Friday afternoon from 1:30-3 p.m. from October through April. You’d be surprised how many people have backgrounds in making music. We have some really great musicians and singers.”

Fosse was born and raised In Illinois, and she graduated from the University of Illinois with a degree in education, specializing in biology. Her first marriage to a high school sweetheart yielded two sons and a daughter. After living in Northern California for two years, they moved back to Illinois, where Fosse taught for three years and then “retired” to raise her children, working only part-time. After 17 years, the marriage ended, and Fosse began a new career.

“I took a job as education curator for the local zoo,” she says. “Then I became acting director, but when I applied for the director position, they hired a man. I thought, ‘What else can I do?’

“I became the first female sales rep for a pharmaceutical and veterinary medicine company. My by-word was, ‘If you don’t know more than the doctor, you’d better get out!’ I also became a trainer, teaching things like rape prevention.

“I loved working with the doctors … mostly. I do remember one office where one of the doctors asked me, ‘Why isn’t a man doing this job?’ And I said, ‘I’m a divorced mother with three children. Do you want me to go on welfare instead?’ That stopped him. He said, ‘By all means, keep on working.’”

Fosse’s affiliation with Tunes for the Memory has taken on an even more personal importance since one of her sons was diagnosed with Parkinson’s.

“I’ve reviewed the literature about the impact of music on patients and their caregivers,” says Fosse. “They all benefit, and that also includes family, friends and the community. The musical environment not only lets people make music together, whether they tap, hum, sing or play an instrument, but it’s a way for them to express themselves, often when they don’t communicate in other ways.

“After participating in making the music, people are more connected, even more conversational. Their mood is elevated; functionality improves, and the impact can last for weeks.”

The impact of Barbara Fosse and Carol Rosenstein will last for a long time.

Anita Rufus is also known as “The Lovable Liberal.” Her show That’s Life airs Tuesday-Friday from 11 a.m. to noon on iHubradio, while The Lovable Liberal airs from 2 to 4 p.m. Saturdays. Email her at This email address is being protected from spambots. You need JavaScript enabled to view it.. Know Your Neighbors appears every other Wednesday.

Published in Know Your Neighbors

Rob Lyman of didn’t know what to do.

The Redwood City resident was helping his aunt, Sharron Evans, who had early-onset Alzheimer’s disease and needed constant supervision. A former teacher, she had run out of money and had no income. She qualified for government health-care assistance, but it appeared she’d need to go to the only setting that would be covered: a nursing home.

“Basically, that’s a hospital setting, and that was our only choice,” Lyman said.

To him, that didn’t make sense.

“My aunt just needed a safe place to be; there was nothing physically wrong with her,” Lyman said. “She didn’t need that level of care. It’s inappropriate. It costs the state a lot of money. But this is what people do. That’s the default choice.”

The baby boomers are aging. By the end of the next decade, 11.1 million Californians will be 60 or older, and the number of people 85 and older will jump 37 percent, to the 1 million mark, according to state officials. One in six Americans is expected to develop dementia, and care can be expensive enough to force even middle-class families into poverty and onto the public payroll.

For low-income seniors who can’t afford care at home and don’t need the full medical services of a nursing facility, the state’s few options aren’t enough to meet demand. A middle-ground choice—assisted living—requires special permission under government rules and is available to fewer than 4,000 Californians, although state health officials and lawmakers are both proposing increases. Taxpayers currently pick up the more-expensive nursing-home tab for more than 20,000 people who may not need it, by one advocate’s estimate.

Evans, now 69, was lucky enough to land a permitted spot in a Sacramento-area assisted-living home after nearly a year’s wait. The cost didn’t matter much to her or Lyman, because it was paid by Medi-Cal, the state’s version of the federal Medicaid program. The lower price tag for assisted living saves the state money, while also providing a more home-like setting and the right level of care for Evans.

For more than a decade, the state Department of Health Care Services has been trying to address the need for more-appropriate, less-costly care. But Medicaid pays only for what is “medically necessary,” such as nursing-home care, unless states ask for waivers. The state budget deal struck last week would provide administrative costs for a waiver to cover an additional 2,000 assisted-living slots.

That’s not enough, said Assemblyman Ash Kalra, a Democrat from San Jose. Kalra’s Assembly Bill 2233 proposes adding nearly 13,000 more, to cover a total of 18,500 people over the next five years. That would basically triple the number of Medi-Cal recipients with access to assisted-living care—assuming waivers, which last five years, can be secured.

“We’re hitting a crisis point with our senior care,” Kalra said. “It costs us twice as much for skilled nursing care.” His bill, which has no organized opposition, passed the Assembly and is now in the Senate.

The federal and state governments each pay roughly half of Medi-Cal expenses. A legislative staffer pegged savings for the state’s share at slightly more than $23 million over the five years, once all 18,500 patients are placed in assisted living. According to the Department of Health Care Services, which oversees Medi-Cal, the state’s share of the average cost for assisted living is about $22,000 a year per person—roughly half the $42,000 annual cost of a nursing-home.

“I have visited skilled-nursing facilities, and the nurses … told me that many of the patients don’t need that level of care. So we could be saving money for the state dramatically,” Kalra said.

According to the Department of Health Care Services, California has about 53,000 Medi-Cal patients in long-term institutional care, such as skilled-nursing facilities. A legislative analysis shows an estimated 11,000 of them have lower-care needs and could be fine in assisted living.

That figure could actually be twice as high, said Mark Cimino, who runs assisted-living homes in the Bay Area and around Sacramento, including the one where Evans lives. He said assisted-living facilities provide a wide range of care that could serve upward of 20,000 Medi-Cal patients who are now in nursing homes.

California’s first waivers, approved in 2004, covered about 1,000 people. That figure doubled in 2009 and nearly doubled again to about 3,700 in the most recent period, which runs out in March 2019.

“There’s a huge trajectory here,” Cimino said. “The question is: Is the expansion of the waivers enough?”

And there’s the human side of the equation, he added: “The assisted-living community is more home-like,” he said. “No one wants to spend much time in a (skilled-nursing) unit.”

The state “has specifically worked to expand access to assisted-living services,” said Department of Health Care Services spokeswoman Carol Sloan.

It’s hard to go any faster, she said by email, because the state has to check for “requirements, monitoring and oversight responsibilities, staffing, adequacy of available provider network and other resource limitations” before requesting more waivers.

As for the nursing-home industry: “If a resident can be shifted to a lower level of care, we think that’s a good thing,” said Deborah Pacyna, spokeswoman for the California Association of Health Facilities, a trade group. “We always support people getting the appropriate level of care for their needs.”

That won’t hurt business, she said: “The boomers are coming.”

For Rob Lyman, a move toward assisted living is a no-brainer.

“If the state, and we as a community, are going to provide assistance, we have to do it in a cost-effective way,” he said. “Putting people in skilled nursing when they don’t need it—that’s not good stewardship of public dollars.”

CALmatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics.

Published in Local Issues

They say you should write about what you know—and I know that as I age, a lot of my friends are beginning to worry that they have Alzheimer’s disease.

A few of my friends have talked to their doctor about their fears, or taken a test. Two friends have been diagnosed; they are being treated and so far have not lost control of their lives.

I can relate. I’ve given up on remembering names, constantly make lists, forget the word I’m looking for in the middle of a sentence, and occasionally can’t find things that I always keep in the same place. Memory lapses can be both aggravating and frustrating—but they may only be due to the overwhelming amount of information that is being taken in by an aging brain, and not a brain disease.

Some people I know assume the inevitable because of a family history: a grandparent, father, mother or siblings who developed some form of dementia. However, researchers claim that you are at a greater incremental risk only if both a mother and father had dementia. Between 6 and 13 percent of the general public will develop Alzheimer's after age 65. Of 111 families studied, in 22.6 percent of people with both a mother and father affected, Alzheimer’s developed—a greater risk to be sure, but still not an overwhelming statistic.

Pharmaceutical companies have taken advantage of our fears by advertising drugs that supposedly slow the progression of dementia or even prevent symptoms. Studies and research are always dumping new data to either frighten or reassure us.

Because I’ve been involved in the local attempt to de-stigmatize dementia, including almost three years of sponsoring the Dementia-Friendly Café (about which I’ve written several times), and because I worry about my own memory lapses, I decided to look into the difference between age-related memory impairment (AMI) and dementia, of which Alzheimer’s is merely one of more than 40 types.

Perhaps the most important takeaway is that while Alzheimer's disease or other dementia becomes more common with age, it is not a normal part of aging.

My mother used to call me, frantic that she could not find her keys. “Mom,” I would flippantly answer, “it’s not when you can’t find your keys that we worry; it’s when you don’t know what keys do.” It turns out I was right!

As we age, our ability to process information, either incoming or outgoing, slows down. Normal AMI means you have a harder time recalling new pieces of information, such as the name of a person you only recently met. I liken it to a kitchen sponge which, when soaked through with water, cannot hold any more: For more to go in, something has to dribble out.

The good news is that AMI is not generally progressive. Many of us are actually better able to do memory-related tasks as we age, like crossword puzzles, than younger people, whose brains can be overloaded with newly learned information. We often find the younger generation has trouble focusing on a single task because they are so accustomed to constant multi-stimulation.

Here are some AMI issues that do not indicate the onset of dementia:

• Occasionally forgetting names or appointments. I have to look at my calendar every day to know what I’m doing; if I write it down, I don’t need to remember it!

• Needing help setting the microwave, working the cable remote or, in my case, using the computer. This is where having grandchildren can be a blessing.

• Forgetting what day it is, but remembering it later. I use my pill dispenser to remind me what day it is when I get up each morning.

• Having trouble finding the right word in the middle of a sentence. This is particularly upsetting when I’m doing my radio show, but I generally come up with a substitute word or find a way to describe what I mean.

• Misplacing something but being able to retrace your steps to try to find it. I must admit I spend a considerable amount of time retracing steps, but at least I remember where to look.

• Developing a routine and being upset when that routine is disturbed. I have a good friend who has lunch every day, in the same diner, at the same table. I think he even orders the same thing every day. He does get upset when his routine is interrupted. He does not have dementia.

Dementia-related memory issues don’t just upset your day; they disrupt your life: Suddenly realizing you don’t know where you are or how you got there; not remembering whether you’ve eaten; forgetting to put shoes on before going outside; requiring others to handle things you’ve always done for yourself, like making appointments or paying bills; having to ask for the same information over and over and over again; not knowing how to play a favorite game; not recognizing family or close friends; being unable to follow or join in a conversation.

The Alzheimer Society of Canada suggests a telling indication that you are experiencing AMI is when you’re worried about your memory, but those close to you are not—as compared to when your family expresses concern, and you’re oblivious to any problem.

If you’re concerned, talk to your family doctor, and then find a doctor who specializes in testing and diagnosis. People in their 40s can develop early-onset dementia, while people in their 90s may be sharp as a tack.

Meanwhile, I’ve developed some coping mechanisms that might be helpful:

• When you get up to do something, say it out loud so you have a chance of remembering why you got up when you get where you were going. Seriously, this works!

• Write things down as you think of them. Don’t expect to remember something that just flitted through your mind.

• Repeat information to make it easier to remember: “Let me make sure I heard you.”

• Always put things in the same spot. For me, it’s the small dish into which I toss my keys when I step inside my front door.

• Get enough sleep. A tired old brain is nowhere near as useful as a rested one.

• Finally, don’t be afraid to talk about this with your loved ones, your doctor, or your friends—but don’t obsess. Let those close to you know that you are experiencing normal AMI issues, and encourage them to let you know if they get concerned it’s more than that.

Then let it go—and get on with your life.

Anita Rufus is also known as “The Lovable Liberal,” and her radio show airs Sundays at noon on KNews Radio 94.3 FM. Email her at This email address is being protected from spambots. You need JavaScript enabled to view it.. Know Your Neighbors appears every other Wednesday.

Published in Know Your Neighbors

Occasionally, you meet someone who seems to have been destined to do the work they do—someone who not only is good at their job, but who also loves doing it.

Dierdre Wieringa—better known as Dee—is one of those people.

Wieringa, 60, a Palm Desert resident for the past seven years, serves as administrator/executive director of Caleo Bay Alzheimer’s Special Care Center, a residence facility in La Quinta dedicated to serving those coping with a form of dementia. Built in 2013, Caleo Bay is designed to provide comfort and security to those who can no longer be cared for by family or who can no longer live independently. It includes 24/7 nursing staff, motion sensors in each room to ensure no guest is left on their own, and specialized training for staff to deliver “patient-centered care” with attention to building relationships with clients. 

“The layout is designed to provide a sense of security and continuity,” says Wieringa, “so that no guest ever feels disoriented. As they move freely about, they find continuity in living rooms, dining rooms and activity rooms no matter which corridor they’re in. They never feel like they’re lost.”

Each guest room has a collage of pictures posted outside the door, including a current photo, and pictures from their past supplied by family and friends.

“Guests can find themselves in the pictures as they often see themselves, somewhere in the past,” says Wieringa. “It’s also a great way for us to recognize who they are and what their past history is, so we can better relate to them on any given day.”

The facility also has display cases with artifacts from past decades—from World War II memorabilia to wedding mementos to an old typewriter—because these are things with which those with memory issues can relate.

Wieringa was born in Johannesburg, South Africa. She met Ben, her husband of 30 years, and had three children before moving to the United States in 1996.

“We wanted a better life for ourselves and our family,” she recalls. “Ben was offered a chance to work here, so we decided to make the move.”

Wieringa’s educational background was in public relations. Her first job was in property acquisition, then she did paralegal work, and finally she opted to be a stay-at-home mom while her sons and daughter grew up. Once in San Diego, Dee, whose daughter had just gotten married, “wanted to be out there doing things.”

A senior living facility was being built nearby. It was an unfamiliar concept to her—she doesn’t remember any such approach to senior living in South Africa—but she asked if they had any jobs available.

“They hired me as the assisted-living director and then I became executive director,” she says. “Eventually, I was offered the chance to manage the desert facility of Segovia, a high-end independent and assisted-living country club environment.  So, Ben and I came to the desert in 2009.”

Wieringa also served as executive director and administrator at Stonewall Gardens Assisted Living in Palm Springs before moving into her current position at Caleo Bay.

“We strive to find the lighter side of Alzheimer’s,” says Wieringa. “Our staff training includes teaching how changes can cause frustration or turmoil in people who need a sense of stability and continuity. People with dementia often act out or lash out with agitation when they get confused or are faced with the unknown. There are communication skills, like diversion, that can really make a difference to those whose short-term memory is so fleeting. You have to live in their reality and realize that every day is different. I believe in ‘meaningful moments,’ and the staff is trained to facilitate that philosophy. We celebrate something each day, no matter how small, for each resident.”

Caleo Bay also utilizes volunteers from church groups and students, as well as animal therapy, music and dance. Wieringa is also involved in other volunteer activities on her own: She runs a Parkinson’s disease support group and participates in the Dementia-Friendly Café (which I help organize), held monthly for the past two years. 

There are several different types of senior living facilities: independent living; assisted-living, where guests need some help with daily activities; and memory-care facilities dedicated to supporting those in various stages of dementia-related illness.

“The problem,” says Wieringa, “is that people aren’t prepared for the cost of long-term care. Medicare doesn’t cover it, and even skilled nursing facilities limit how many Medicaid beds are set aside. Families always ask, ‘What happens when Mom or Dad runs out of money?’ There is no good answer. Unless the younger generation invests in long-term care insurance (which often include caps on expenditures), especially with dementia diagnoses rapidly increasing and people living so much longer, the baby boomers and millennials are going to be faced with an impossible situation. Even if Medicare did cover long-term care, the cost would certainly break the bank.

“Families often are the only recourse, and they don’t realize that … many caregivers die before the person they’re caring for. Plus, there are so many dysfunctional families or people with nobody to care for them. Whenever a guest dies, even in the middle of the night, I make sure I’m there. I saw them come in through the front door, and I see that they leave the same way.”

With a high-stress job, what keeps Wieringa going? “You can’t teach passion. I love my job. It just makes me feel good to know I’m really helping others and making a difference. There are a lot of lonely old people out there with no one to turn to. One person can make a difference. Working with dementia is hard, but a moment of making people feel good about themselves makes me feel as if what I do was meant to be.”

How many of us can truly say that?

Anita Rufus is also known as “The Lovable Liberal,” and her radio show airs Sundays at noon on KNews Radio 94.3 FM. Email her at This email address is being protected from spambots. You need JavaScript enabled to view it.. Know Your Neighbors appears every other Wednesday.

Published in Know Your Neighbors

A number of plays have moved me while I’ve been doing theater reviews in the Coachella Valley—but none have pierced my heart and shaken me to the core the way Dezart Performs’ The Outgoing Tide did.

That’s due, in large part, to its subject matter: Alzheimer’s disease. It’s a hideous, devastating illness—one which took my mother’s life nearly five years ago. She spent her final years in an assisted-living facility on the East Coast, so I was spared the daily trauma of seeing my mother wither into a mere shadow of who she once was. That pain fell to my dear, devoted father, who drove to the facility and fed her lunch every day for years. When I did visit, it was deeply painful to observe this once-vibrant, articulate woman rendered nearly speechless following two strokes and the dementia. Nothing scared her more … the thought of ending life in an institution, incapacitated and in a wheelchair, feeling helpless and alone.

It’s something we all fear. Many of us studiously avoid talking about the possibility that it could happen to us. But talk about it, we must.

Written by Bruce Graham, The Outgoing Tide tackles this tough subject matter head-on. The play centers around Gunner (Michael Fairman), who is battling the scourge of Alzheimer’s; his wife of 50 years, Peg (Judith Chapman); and their son, Jack (Scott Smith). Gunner is aware that his disease is rapidly progressing, which makes him grumpy and fearful. The situation is often humiliating, as when, after a tirade over a broken television, Peg points out that Gunner is trying to watch Cops on the microwave.

Things are really going downhill: Peg has begun securing the gates at night so her husband can’t wander, and he almost burned up his newspapers after placing them on the stove. Peg is considering an assisted-living facility where both she and Gunner can take up residence; they can be together, and she can still care for him as long as possible.

Both Peg and Jack (visiting at his father’s request) think it’s a good idea—but Gunner won’t hear of it. After touring the place and noting the condition of some of the current residents, Gunner quips, “It’s like a roach motel. You check in, but you don’t check out.” Gunner adamantly refuses to consider selling his house and moving to such a place, even though he admits to Jack that his condition is worsening: “I feel like it’s starting to show.”

Instead, Gunner has an alternative plan—one that would end his suffering and set up his family financially. It’s radical and controversial, and Peg is totally against it. Jack (currently going through a divorce) is often stuck in between his two strong-willed parents, and doesn’t know what to do. When Jack asks Peg if she really wants to spend the rest of her life taking care of her husband, she responds: “What else am I good at?”

Though the play’s theme is gut-wrenching, there’s plenty of humor as well. Peg dismisses the possibility of a suicide pact with Gunner: “He’d probably shoot me and then forget to shoot himself!”

The acting is absolutely superb across the board. As Gunner, Michael Fairman is flawless. We feel every bit of the fear, anger and frustration his deteriorating mental condition triggers. Though he’s made some mistakes as a father, he’s funny, charismatic and lovable, yet ultimately tragic. His Gunner makes us wonder about our fathers, grandfathers or uncles…what would they do in this situation? Could we support their choice, even if it meant we’d lose them?

The amazing Judith Chapman does not disappoint. As the long-suffering Peg, she is the glue that keeps the family together. She’s strong and level-headed, and seems to be able to keep it all together despite the gradual loss of her husband. But Chapman lets us see the heartbreak just beneath the surface. Does she love her husband enough to let him do what’s right for him … or will her fear of being alone stand in the way? There is not one false note in her performance.

Scott Smith is terrific as the returning son who loves his parents, but feels he’s in a no-win situation. Beyond the drama of Gunner’s advancing Alzheimer’s disease, Jack’s visit home reveals some long-held family secrets.

Once again, artistic director Michael Shaw proves his mettle as a director. He moves his cast members around ably on Thomas L. Valach’s outstanding set, and draws out award-worthy performances from each of them. Clark Duggar’s sound was spot-on, as was Phil Murphy’s lighting (after a couple of brief glitches early in the play).

I have seen a number of very good plays from Dezart Performs, but The Outgoing Tide is in a league of its own. The opening-night audience gave the show a well-deserved standing ovation. The play forces us to think about end-of-life issues and personal choice. Most of us, at one point or another, will be touched by the tragedy of Alzheimer’s disease. A parent, a spouse, a friend or even we ourselves will experience the mind slowly slipping away. What would you do?

The Outgoing Tide is the most profound theater experience I have had in quite a long time.

The Outgoing Tide, a production of Dezart Performs, is performed at 7:30 p.m., Friday and Saturday; and 2:30 p.m., Sunday, through Sunday, May 8, at the Pearl McManus Theater at the Palm Springs Woman’s Club, 314 S. Cahuilla Road, in Palm Springs. Tickets are $24 to $28, and the show is just more than two hours, with a 15-minute intermission. For tickets or more information, 760-322-1079, or visit www.dezartperforms.org.

Published in Theater and Dance

My father’s recent death was not beautiful, and neither were any of the other deaths I’ve witnessed of late. This has left me wondering about a better path.

Death is not easy, to be sure, but these were made particularly painful by medical interventions—or perhaps I witnessed the confusion between saving a life and prolonging the process of dying.

So I threw a party. Or rather, I held my first Death Café—and it turned out to be a lively, invigorating affair.

In Europe, there’s a tradition of gathering to discuss important subjects—a café philo, for a philosophical café, or café scientifique, a scientific café. Now there are café mortel, or death cafés. A death café isn’t an actual place; it’s a temporary event in various locations, such as my home, complete with decorations and, for example, a cake with DEATH: THE FINAL FRONTIER scrawled on top.

My gathering included spunky friends, all in our middle years, all of us healthy. As it turns out, this is the segment of population that most seems to care about shaping the end of a life. A Pew Research Center study found that less than half of people older than 75 had given much thought to the end of their lives, and incredibly, only 22 percent of them had written down wishes for medical treatment. The same study, though, found a sharp increase in all adults putting something in writing (six of 10 of us), which indicates that percentage-wise, it’s the slightly younger folks who are preparing for their inevitable deaths.

This does not surprise me. For the last 14 years, I’ve been one of the 28 million Americans currently watching as someone dies. Baby Boomers and GenXers are caught in an unprecedented tide of taking care of both children and parents (not to mention ourselves and our own aging bodies); we are the first generation to be caught in this particular kind of care-giving-and-slow-death crisis. With medical intervention and technological wizardry, we’re forced to make decisions about procedures and medicines and ethics as never before. And we find ourselves without much guidance in a culture that’s conflicted and confused about dying.

Which is why we’re willing to talk. At my Death Café, I encouraged us not to focus on the deaths we had witnessed in the past, but instead to speak of the deaths that we want for ourselves in the future. Various results emerged. Half were afraid of the suffering that can precede death; half were afraid of death itself. A few of us had practiced death (“pretend this next breath is your last; what does that feel like?”), but all of us were convinced that doing so would only intensify and enlarge our lives.

The zeitgeist of this new movement is just now gaining momentum, but I can feel its strength and power. An unprecedented 66 percent of Americans now think there are instances in which doctors should allow a patient to die instead of doing everything possible to save that patient’s life. People would like to die—and sometimes would like others to die—and this doesn’t make us morbid or crazy or unethical or mean. No. We are merciful and kind. We are as moral as we are mortal. We just want to know how to gracefully do that is going to happen anyway.

What lies ahead is unexplored territory, much like death itself, really. Here in California, “Death With Dignity” legislation recently became law, and the state representative in my Colorado hometown is reintroducing a similar bill in that state. Don’t get me wrong; I am all for funding research, finding cures, and offering respite to caregivers. But it’s also our ethical duty to try for a chin-up, heart-steady end.

My father contracted pneumonia after 14 years of suffering with Alzheimer’s. He was given antibiotics; I was not in a legal position to object, but I’d have asked for comfort care only—not because I didn’t love him, but because I loved him enough to want him to have as natural and relaxed a death as possible. Instead, I saw him grimace in pain and fear. I saw tubes and syringes and the sores on his body. I saw the family he’d worked so hard to create break apart under the pressure. I saw his blue eyes fade, and they taught me well: This could happen to you, too.

Death is perhaps the greatest mystery we face, and the actual act of dying is the last physical act of our lives. We can strive to do it our way and to do it well. If anything deserves preparation, or some renewed clarity, death might be it. Which is why I suggest throwing a lively party.

Laura Pritchett is a contributor to Writers on the Range, an opinion service of High Country News. Her novel Stars Go Blue is based on her experience with her father.

Published in Community Voices

How do you start up something new? No matter how worthy the cause, you need individuals who see a need and are willing to volunteer a substantial amount of time to satisfy that need.

A local coalition has cropped up committed to creating a “Dementia-Friendly Coachella Valley,” composed of individuals who represent local nonprofit organizations, those diagnosed with or caring for someone with a dementia-related disease (like Alzheimer’s), medical professionals and interested citizens.

The DF-CV group recently sponsored the first Dementia-Friendly Café as a way to expand awareness that those living with a diagnosis of a dementia-related disease are still able to enjoy life, socialize and be in a public setting without fear. They wanted to create a “safe space” in which people could come together for a purely social event.

What is a safe space? To me, it’s a place where one can be truly oneself, relaxed and able to be fully expressive without fear of ridicule, judgment, embarrassment or stigmatization based on sex, race, ethnicity, orientation, religion, age, physical disability or any other arbitrary characteristic.

Cathy Greenblat, author of Love, Loss, and Laughter—Seeing Alzheimer’s Differently, was the catalyst for the coalition after the exhibit in Palm Desert of her remarkable photographs of patients with dementia-related diseases in state-of-the-art treatment facilities.

Dee Wieringa, executive director of the new Stonewall Gardens in Palm Springs, made the arrangements for the café with Albert Morales, manager at PF Chang's China Bistro at The River. Morales was enthusiastic about the idea.

“Our company is always telling us to get involved with our community,” he said.

A dining room at the restaurant would be set aside from 3:30 to 5:30 p.m. Those attending could order off the menu if they chose to, get drinks at the bar, or just socialize with others who could relate.

Rupert Macnee, a filmmaker who lives in Rancho Mirage, did the first draft of a flier. With minimal tweaking, it was ready to distribute online, at hospital rounds and on counters and bulletin boards at businesses and organizations throughout the Coachella Valley.

Pat Kaplan, of Palm Desert, one of the honorary co-chairs of the 15th annual Alzheimer’s Association Walk to End Alzheimer’s, came up with the idea of coalition participants wearing purple ribbons, typically an Alzheimer’s disease symbol, so those attending the café would know whom to ask if they had questions or concerns. She greeted attendees warmly, and generally acted as the unofficial hostess.

Other coalition participants who worked the room included Anne Gimbel, regional director of the Alzheimer’s Association; John Wisor, of Palm Springs; Kae Hammond, executive director of the Dementia Help Center and the author of a definitive book, Pathways: A Guidebook for Dementia and Alzheimer’s Family Caregivers (if you need answers and guidance, this is THE book); Soo Borson, a geriatric psychiatrist; and yours truly, who prints nicely and thus did the name tags.

The expectation was that if we could turn out 15 to 20 people on our first outing, that would be a good start. We wanted to learn what the community needs—and what the community will respond to—when it comes to the potentially touchy subject of dementia. Imagine our surprise when more than 50 people showed up! The staff at Chang’s brought in extra tables, added another waitperson, and generally made it a good experience. People were sitting with others they didn’t already know, making new acquaintances, sharing stories and laughing. There was a lot of laughing.

Two women who attended came alone, without their husbands who are living with dementia-related diagnoses. The wives, being sensitive to what their husbands might require, wanted to make sure it would be a safe space. They were thrilled and plan to bring their husbands to the next café. Other attendees included people from all over the valley, ranging in age from their 40s to their 80s—daughters and sons, caregivers, spouses and live-in partners, gay and straight, long-time and new desert residents. It was a noisy, fun, purely social couple of hours with good food, good company and the comfort of a safe space. One attendee described it as “warm and fuzzy.”

The next Dementia-Friendly Café is scheduled for Wednesday, Dec. 3, from 3:30 to 5:30 p.m. at Chang’s. Morales is eagerly looking forward to making everyone comfortable, and the coalition members are planning to spread the word far and wide.

How do you start something new? You come together with people who know how to get things done—people who genuinely care about the issue you’re addressing, people who make time in busy schedules, people who are your neighbors. When’s the last time you got involved in something new?

Anita Rufus is also known as "The Lovable Liberal," and her radio show airs Sundays from 11 a.m. to 1 p.m. on KNews Radio 94.3 FM. Email her at This email address is being protected from spambots. You need JavaScript enabled to view it..

Published in Know Your Neighbors

It’s funny how seemingly unrelated events can coincidentally coincide.

I recently wrote about Cathy Greenblat and her stirring book, Love, Loss, and Laughter, featuring photographs of people with various types of dementia and reminding us that “someone is in there.” Cathy has inspired a local coalition of individuals and organizations to make Coachella Valley into a “dementia-friendly community,” patterned on similar projects around the world.

And now for something seemingly unconnected: The Board is a group of men, mostly of a certain age, that gets together monthly for lunch to gab, exchange stories, listen to speakers and generally socialize. They also occasionally have an event where womenfolk are invited. I recently attended just such an event, the day after attending a meeting of the “dementia-friendly” group, where one of The Board’s members, Larry Delrose, showed a film he wrote and co-produced, called Night Club.

Delrose’s film includes such film stars as Mickey Rooney, Sally Kellerman and Ernest Borgnine, in a story that centers on a residence facility where many patients have dementia. The film shows both the compassion and care given to such patients, as well as the callousness often encountered. It includes scenes that members of the audience laughed at nervously—possibly because the film showed many people in a situation in which we’re afraid we’ll one day find ourselves.

Delrose is a Rancho Mirage resident who has been in the Coachella Valley for 34 years. At 63, he has been married for 40 years, and has two daughters and five grandkids. He previously was a real estate investor, wrote a book called Directions to a Happy Life, and began acting and movie-making later in life in an effort to “pursue what you love to do in life.”

Why a movie on this subject? “I thought the movie business needs more mainstream movies that address social issues (instead of) extreme violence, dysfunctional families, horror and action,” says Delrose. “I thought I could present socially aware subjects to the moviegoer in a way that they could learn something about life, without being preachy, corny or too depressing.”

In her pursuit of photographs of people with dementia-related illnesses, Greenblat was determined to capture what makes them laugh, sing and dance. Delrose affirms that “music, dancing and being around younger people can help all older people feel better, especially music, (which) is like a free anti-depressant drug.”

This conclusion led Delrose, in part, to Night Club: “I want to make movies that expose a social issue for thought, make it a great script, get some well-known skilled actors, and bring in lots of kids and music. Night Club was a test for me to see if my idea was right, and based on how I saw people react, I now know that I’m on to something.”

What would it take to de-fuse the stigma attached to a diagnosis of “dementia”? We had a president, Ronald Reagan, who may have already been experiencing the early stages of Alzheimer’s while still in office. Singer Glen Campbell went on tour after his diagnosis, and only recently had to cancel performances due to escalating memory issues—although he is continuing to speak out about his condition.

Other famous people have gone public with their diagnosis and have helped de-stigmatize Alzheimer’s: actors Charles Bronson, Charlton Heston, Rita Hayworth, Burgess Meredith, Peter Falk, Estelle Getty; renowned composer Aaron Copeland; boxer Sugar Ray Robinson; singer Perry Como; and basketball coach Pat Summitt.

I can remember when the word “cancer” struck fear even in those who had not received the diagnosis. We whispered the word. We didn’t talk publicly about it. Then first ladies Betty Ford, Rosalynn Carter and Nancy Reagan shared their own experiences with us, along with many others. Now cancer is recognized as a disease that can be detected and in some cases cured, or at least somewhat controlled; we have learned not to shun or fear people who have it. We speak out about it and walk with signs to raise awareness. Although we still fear hearing the diagnosis, we no longer worry about “catching it.”

A similar transformation took place around HIV/AIDS. None of us want to be told we have it, but we no longer fear being around people who have been diagnosed, as when people were afraid to send their children to school because they might “catch it.”

That is one of the goals of a “dementia-friendly community”—to not only de-stigmatize those with the condition, but to educate ourselves and our communities to understand that “someone is in there.”

The next time the person in front of you in line at Starbucks is confused by too many choices, or someone at the checkout counter at the market has trouble counting out change, instead of getting impatient and huffy, offer to help. That is the first step toward the Coachella Valley being a dementia-friendly community—and we all have an investment in that.

You can make a difference.

Published in Know Your Neighbors

Cathy Greenblat is a newcomer to the desert; she’s now settling in Palm Springs after living in Nice, France.

Greenblat earned her Ph.D. in sociology at Columbia University. She has published numerous books and papers, and has lectured in South America, Europe, India, Africa, Israel, the Far East and throughout the United States. She is soon heading for Indonesia and Australia.

In 2002, Greenblat gave up a tenured professorship at Rutgers to pursue her labor of love: photography and its ability to depict the sociology of aging.

Through the Coachella Valley Regional Office of the Alzheimer’s Association, Greenblat has been presenting her work locally. Her photographic display and its accompanying book, published in 2012, is called Love, Loss, and Laughter: Seeing Alzheimer’s Differently.

Initially focusing on person-centered care facilities in the United States with her 2004 book, Alive With Alzheimer’s, Greenblat’s photos now depict not only Alzheimer’s patients in the United States, but also in Mexico, France, India, Japan and the Dominican Republic. Her intention is to challenge stereotypes.

“People with Alzheimer’s are not, as they are often depicted, ‘empty shells,’ completely lost,” says Greenblat. “I believe (photography) to be the most effective vehicle to open people’s eyes … a better way to ‘face’ issues that are generally avoided.”

Greenblat’s photos capture the sheer joy, free laughter and loving interactions people with Alzheimer’s can have, in images documenting the impact of competent care and exposure to music and the arts.

One patient had been all but bedridden for several years—basically warehoused in a nursing-home facility. After his family had him moved to a place that features a person-centered approach specifically for Alzheimer’s care, his demeanor completely changed. Greenblat shows the once-inert man is clapping, smiling, moving along to music and even getting up to dance.

Cathy Greenblat’s pictures are worth seeing for the joy they evoke—the laughter between a grandparent and grandchild, for example, and the genuine affection between caring staff and their patients. Her photos allowed me to fully experience the reality that she describes: “Someone is in there … Quality health care allows people with Alzheimer’s to sustain connections to others and to their own past lives.”

According to HBO’s Alzheimer’s Project, 70 percent of people with Alzheimer's live at home, cared for by family and friends. In addition to hoping to preserve some personal dignity and a sense of connection to home, many family members may not be able to afford a care facility for their loved ones. Unless one is basically impoverished and eligible for Medi-Cal, the cost of such long-term care is not covered by Medicare or most health insurance, and few have prepared for their own situation by investing in long-term care insurance. This is an area long overdue for re-thinking by policy makers.

Phyllis Greene, a Palm Desert resident, had to make the difficult decision to move her husband to a local group-home care facility. They had prepared for this eventuality by purchasing long-term care insurance.

“I realized that when he had no independence left, had become incontinent, and would wander away, it was time,” says Greene. “I couldn’t care for him myself. I couldn’t watch him all the time. I thought I would feel guilty, but to be honest, the impact on me at that point was relief.”

Greene visits her husband several times a week. He doesn’t always know who she is, often mistaking her for his own mother. “He speaks his own language and lives in his own internal world,” says Greene. “He can get very agitated when I don’t know what he’s saying. The main thing is, I know he is getting good care and is in a safe environment.”

Bill Couturié, director of HBO’s Alzheimer Project, says the decision to place a loved one in a care facility can be wrenching.

"Not only is it very expensive to pay for care in a nursing home, but the patient is someone you love a lot—a mother, father, spouse, someone who has taken care of you—so it's only natural to want to take care of them," he says.

But Alzheimer's takes a great toll on the physical and emotional well-being not just of the patient, but of the caregiver as well. “It's not uncommon for the caregiver to die before the patient,” says Couturié.

There is a tremendous cost to the public as well. The Alzheimer’s Association says that “in 2012, nearly 15.4 million caregivers provided more than 17.5 billion hours of unpaid care valued at $216 billion.”

Alzheimer’s is the sixth-leading cause of death in the United States. In 2013, statistics showed that 5.2 million Americans have Alzheimer's or some other form of dementia. (All Alzheimer’s is dementia, but not all dementia is Alzheimer’s.) Those numbers are expected to increase to almost 14 million by 2050 as Baby Boomers continue to age.

Anyone with concerns about memory loss or other possible symptoms of Alzheimer’s can take Ohio State University’s Self-Administered Gerocognitive Exam (SAGE), which is designed to detect early signs of cognitive, memory or thinking impairments. There is no answer sheet—you just follow the directions and then take the test to your physician for an evaluation.

The local Alzheimer’s Association office has helpful tips for caregivers and family, and sponsors caregiver support groups where people can share their stories and solutions.

“My goal is to change minds and hearts, to have this work be a catalyst for education, cultural understanding, and social action,” says Cathy Greenblat. Seeing her photos has expanded my consciousness not only about Alzheimer’s disease, but about the need for a change in public policy regarding long-term care.

My mother used to call me from her retirement apartment in Florida totally hysterical because she couldn’t find her keys. “I know I put them exactly where I always put them, but they’re not there. I’m afraid I’ve got Alzheimer’s.”

“Mom,” I would reply, “stop worrying. It’s not when you can’t find your keys—it’s when you don’t know what keys are for.”

Although it’s good to keep your sense of humor, I’ve learned that Alzheimer’s disease is not something to joke about, no matter how that may alleviate our fears.

Get the facts. Talk to your family and friends about your concerns; reach out for support; lobby for informed public policy, and see Cathy Greenblat’s photos if you get the chance. (She will be featured on Saturday, Feb. 15, at 9 a.m., at the Annenberg Auditorium on the Eisenhower Medical Center campus, 39000 Bob Hope Drive, in Rancho Mirage.)

There IS someone in there.

Anita Rufus is also known as "The Lovable Liberal," and her radio show airs Sundays from 11 a.m. to 1 p.m. on KNews Radio 94.3 FM.

Published in Know Your Neighbors