It certainly can be challenging finding a gift for the spouse, parent or grandparent with dementia. Yet you think about all the gifts you have received from this person and you want to find something really special. Something nice, well made, fun and most of all comforting. The Twiddle Cat or Dog fill the bill on all counts.

Rose had advanced dementia and had suffered a debilitating stroke years earlier. Rose was unable to walk or use her left arm. This combined with her declining vision as well as dementia left her few options for activities.  That is until she received her Twiddle Cat. Now Rose had not only something to hold, but an opportunity for visitors and staff to stop and engage her in conversation about her cat. While Rose’s right hand used to search all over her blanket for something to hold on to or do, she now could reach out for her cat.

The Twiddle Cat is made in the shape of a muff, for the elder to put their hands into.  Activities are attached to the muff to give the elder some variety of things to hold, beads, ribbons, items that are easy for old fingers to hold onto.

Rose took to her cat from the moment he was put into her anxious arms. She called him “Chuck” after a cat she had had as a child. Soon Rose and Chuck were inseparable.  Instead of being known in the nursing home, for always calling out for help, the staff now knew Rose as the lady with that cute little cat, Chuck.  Rose was less anxious       and was calling out for help, less and less often. She was just too busy now, now that she had Chuck.

The Twiddle Cat is made of a soft comforting fabric that launders beautifully. The muff provides a place to keep old hands warm, while the attached items give the elder something to twiddle with, entertaining the hands. The muff being a cat or dog is appropriate and provides a welcome distraction for the elderly man or woman.

The Twiddle Cat, something really special for the holidays.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing



Every year the average nursing home will have between 100 to 200 patient falls. The people who fall the most often are men, and patients who are confused. Men fall almost twice as often as women because they are less likely to call for assistance, because it is more difficult for them to admit needing help. Patients with Alzheimer’s disease or another form of dementia fall frequently, because they no longer have safety awareness.  Statistics tell us that 35% of those patients who fall are unable to walk, yet they try.

Most patient falls happen in the patient’s room, when the person is attempting something without assistance. Few falls happen in places like a dining room or at a nurses station where many staff members are available to monitor for unsafe behaviors. The majority of those falls in patient rooms have to do with needing to go to the bathroom. Being incontinent of urine, having diarrhea, and having to urinate frequently at night all contribute to the high number of falls.

Added risk factors are poor vision, going bare foot, clutter on the floor, poor lighting and possible a slippery/wet floor from the patient becoming incontinent. As well as the patient forgetting to reach for their cane or walker in their rush to the bathroom.

A nursing home fall prevention program includes assessing each and every patient for their fall risk. All of the above mentioned problems are identified. A plan of care is developed and all staff members are informed of the plan. Safety devices are put in place, most of those devices are in the form of alarms. A good web site for safety devices is Their site is very user friendly and they have a large selection of safety alarms.

Looking at the environment, follows the assessment. Are the grab bars placed correctly? If the patinet is getting out of bed, is the bed in a low position, with an alarm? Is the lighting adequate, are there motion sensors in place? Is the patient on a regular toileting schedule before bed? How often does the staff check on them during the night?

A big deterrent for falls is a busy, engaged patient, a patient who has activities to go to that they enjoy. A patient who is really tired when it is time for bed, that they enjoy a good nights sleep.

Virginia Garberding RN

Certified in Restorative Nursing and Gerontology


Adult coloring books are everywhere, from the internet to your neighborhood craft or book store. The choices are suddenly endless from floral, to animals and even the chance to color the masters of the art world. In this fast paced, goal driven, digital age, opening a fresh new coloring book and colors is soothing in itself. Taking any individual to a place of quiet and relaxation, but especially so for the senior with dementia..

For the person with Alzheimer’s disease, or another related disease causing dementia, coloring brings many benefits.  Coloring is among other things, an activity of reminiscing. Everyone remembers the wonderful feeling of opening a new box of crayons. And if you were the fortunate child who had the set of 64 with the built in sharpener, the feeling was quite amazing.

Coloring, gives the senior with dementia an opportunity to be successful. When you color it gives you chances to make decisions about which picture to color, where to start and which color to use. For a person with dementia who makes many mistakes all day long, due to memory loss, coloring is very safe. Art is in the eye of the beholder and there is no way to be wrong.

Find a quiet place, avoid a cluttered kitchen table, instead pick a place where the supplies can be spread out and enjoyed as well. Do not have the distraction of a TV, or even a radio unless it offers soft background music, preferably without lyrics. Even if the person with dementia never cared for art or crafts before, this is an area where they can do well now. This activity doesn’t require remembering facts, people, places or use any language skills. Just the ability to hold onto a coloring pencil or crayon.

When a person does an activity mainly engaging the right side of the brain where art, music and the softer side of life resides, it becomes a little vacation for the mind. As almost a form of meditation it can bring mindfulness to the person and make them more focused. Distraction is a major problem with dementia and developing activities which bring greater focus are worth the effort.

Having many coloring books and colored pencils or crayons around is a great way for the senior to do an activity with a child. The child knows instinctively how to get to the right side of the brain where there is only color, choices to be made and those spaces to be filled in.

Not only is coloring a great activity for the senior with dementia, it is also great for his caregiver. Time can fly when you are engrossed only in choosing which page to color next or what color to use. And the companionship created while you compliment each others work of art creates a pleasant feeling of friendship for both. Feelings that can last long after the crayons are put away.

Virginia Garberding RN

Certified in Restorative Nursing and Gerontology



Boxing and Parkinson’s Disease

I recently saw a news show on television that highlighted the benefits of boxing, for persons with Parkinson’s disease. While everyone interviewed identified positive results, all the way from; moving better, to being motivated and at times being pushed to participate.  Those who strongly recommended boxing never really hit the nail on the head, and told us why this sport would work so well.

Boxing and Crossing the Mid-line

Picture an imaginary line from your head to your feet cutting your body in half. Every time you do something with your right hand and arm, swinging to your left and therefore crossing your mid-line you also increase the right-left connection in your brain. Watching the show and seeing the participants either hitting a punching bag, or in a ring hitting an instructor, you can easily see the therapy involved. When they punched with their right hand they frequently crossed over their body and hit the opponent on the right side of his body.

The brains two sides coordinate with their opposite side of the body. All of the connections happen in the middle of the brain called the limbic system. Exercises that cross the mid-line, reinforce and support  the connections in the limbic system. The limbic system is also the site of emotional intelligence, explaining why people feel happy after exercise.

Creating exercises that cross the mid-line

A simple balance exercise turned into a brain exercise can include swinging arms across the body. Kicking a leg across the mid-line while holding on to a chair is a simple brain movement. Bouncing a ball in front of you, with your right hand and then switching to your left hand, crosses the mid-line. Starting with a larger bouncing ball and then scaling down to a smaller and smaller ball also improves balance.

Great games with small children such as a bean bag toss when done crossing the mid-line, is a fun way to exercise the brain. Older children enjoy playing catch, and can start by just bouncing a large ball back and forth. Till they then can catch a ball in midair and switch up to a smaller ball.

Take that even further by hitting a tennis ball, volley ball, anything that provides that movement of crossing the body. Especially so for the confused elder who enjoys just throwing a beach ball around the family circle, or maybe a wild game of balloon toss. The easiest mid-line exercise for just about everyone, is to cross your arms and give yourself a big hug. The limbic system, is why that feels so good!

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing


Many people only think of activities in the large sense. Activities like; painting a great picture, a trip to the circus, working with clay, throwing a party or seeing live entertainment. All of these things are great, but day to day activities are just that, normal things you do every day. These activities are called “normalization activities,” and these are the activities of good dementia care.

Normalization activities help the confused elder with dementia feel that they are participating in daily life.  Participating in normal chores; dusting, setting the table, folding wash, gardening, washing dishes, raking, vacuuming, all of these are everyday activities. Activities that take the elder back in time are especially good. Instead of using the dish washer, let the elder wash dishes by hand. Polishing and shining shoes is a great activity for a man, especially if he served in the armed services.

Normalization activities give purpose to the elder’s life. Many years ago when the destitute elderly were housed in “poor houses” or “poor farms,” they were given jobs to “earn their keep.”  And as always seems to be the case, the pendulum swung much too far in fixing that issue. In today’s nursing home communities, it is very much frowned upon to “make residents work.” And so residents of nursing communities are to be cared for and occasionally entertained.

Normalization activities give the elder in the home, or the nursing home, an opportunity to have social interaction with others. They can have that special feeling of satisfaction doing a job together, and being part of something. Normalization activities provide a routine to the day, opportunities for pleasure, improved self-esteem and improved quality of life.

Some time ago I asked the activity staff of a nursing home, what gave them work related stress. One brave young woman said she felt that she wasn’t doing her job, if she wasn’t providing a three ring circus all the time. Three ring circuses aren’t the stuff of everyday life, washing dishes is, and washing dishes can also be, just great.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing











In The Monk Who Sold His Ferrari, by Robin S. Sharma, one of the enlightening rituals he shares is to stare at the center of a rose.

When you start this practice you find it hard to concentrate for more than a few minutes, without becoming distracted. However with daily practice you get better at focusing and develop a more disciplined mind.

This is the same benefit you receive from learning to draw. However if you are going to draw that same rose you will look even closer. You will see where each petal intersects with the next as you see every subtle difference in shadow from each petal. This concentration teaches you to switch to the right side of your brain. When you are on the right side of your brain, you have no sense of time and experience really being in the moment.

After a time you realize that you are now seeing so many things so much clearer than you ever did before and without even trying. It is a major gift you have given yourself. Your vision isn’t better, yet you now seem to see so many more things.

My mother had her stroke eleven years ago now and since that time I have taken the hour and a half drive to see her once a week. Early on I decided that this would soon become a chore if I didn’t learn to enjoy the “journey.”  So I got off the interstate and started taking the lesser traveled country road. I now find that even though this trip does take a chunk of time out of my weekend, I enjoy the trip almost as much as the visit with Mom.

When the seasons change and the first new leaves of spring arrive, I love to see the trees with their new bright green growth, while you can still see every branch and twig of the tree. Learning to draw gave me a gift that I carry with me whether traveling down a country road or just looking out the window while I use my treadmill.

I do recommend The Monk Who Sold His Ferrari, it provides some very positive life advice in an entertaining way. Yet to achieve the really full and rich life he promises a person needs to take bigger steps than he suggests. I don’t know why people assume that monks who live a very isolated, self-centered life in the Himalayas have an answer for others. The answers in life continue to be what Jesus taught almost 2,000 years ago – be of service to others.

And if you have a choice, take that road less traveled with your elder and enjoy the scenery.

A Thank You to all the readers who are recommending this blog on their Twitter and Facebook sites – You are making it grow – God Bless You and Keep You.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance


Part I

I remember in the late 60’s when the Beatles were all over the news during their trek to Rishikesh, which sits in the foothills of the Himalayas, to learn meditation. It all seemed so foreign and mysterious, now we call a lot of those principles “new age.” The search for enlightenment seems to impact every generation.

My Mother gave me the answer in the form of a book years ago, the book Drawing on the Right Side of the Brain. (still available by Dr. Betty Edwards, but most people like the original edition -1979 -the best – check your library) I was all over it because I will read pretty much anything about the brain. But this was no new theory or break through to study and accept and or reject, this book was anything but.

This book gave the secret to drawing – practice and concentration. But the practice and learning the skill of concentration taught me much more than how to draw.  It seems that most of us stop trying to draw at the age of about six. So if you drew stick people at six, you very may well continue to draw stick people when you are sixty-six.

At the age of six your brain makes a significant shift from right side dominance to left sided dominance. The right side of the brain is where your arts and touchy feely skills are and your left is your word skills and analytical strengths. So at the age of six when your left side becomes more dominant – your internal voice, the most influential voice in your life, tells the child “You’re no good, your drawing stinks,” and you no longer try. So your ability is stuck at that age.

The beautiful thing about the small child working on a drawing, is seeing them clearly working with the right side of their brain. When you call their name – at first they can’t answer because they are right there, in the right side brain activity. They need to switch to the left side to answer because that is where the language skills are.

Reading that book took me to a drawing class at the local community college for only one semester. Drawing takes time, discipline and concentration. The discipline to give up time, to sit quietly, study lines, shadows, and reflections. But most of all learn how to once again go to that right side of your brain – which is such a full, calm and happy place.

Part II

What does that have to do with the Himalayas?

A Major “Thank You” to all the readers who are recommending this blog on their Facebook and Twitter sites – you are making it grow – God Bless You and Keep You.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance


Carl never really studied art, but that doesn’t hold him back these days from painting. Sometimes he paints for hours, over and over on the same tree, grass, sky or clouds. He is so engrossed that he rarely speaks and forgets to eat as well. His wife Barb just interrupts with the suggestion of a meal.  Because Carl is very confused now, it is much simpler to say “How would you like some meat loaf?” than “What would you like to eat Carl?” Giving a suggestion is so much more effective that expecting Carl to come up with an idea on his own.

Barb doesn’t want Carl to come out of that “place” he goes to when he paints. So Barb tries not to stress him with too many questions or choices. Participating in art is an opportunity to do something that is neither right or wrong. It just is, you may like it or not. This makes it a perfect activity for someone who is confused or has early dementia. You can’t be wrong.

Art nurtures the well-being of the confused elder, and in many cases brings to the elder a connection with the past. Over the years school districts have added or reduced art programs depending on the districts budget. But for the elders of today, they would have had some instruction in art in grade school.

Instead of this being a totally new experience the elder is really relearning a pleasant activity from the past. Relearning is so much easier for an elder, especially an elder who is also confused, than learning an activity that is brand new to them.

Painting doesn’t make Carl more appropriate in social situations, or in any way fit in better in group conversations. At a recent family event, as people were discussing an afghan someone had just made. Carl joined in with “that blue is in my picture.”  When the group knows what Carl’s challenges are, his observations are very much welcomed.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance



Natural disasters, tornados, hurricanes, flooding, drought, extreme heat, wildfires, blizzard and more tornadoes, 2011 has really been something and it’s not over yet. Roads and highways that have all but disappeared, being broken up by flood waters. People stranded, and now whole communities stranded with roads and towns that have become lakes.

That isn’t even counting all the news footage of terrorist strikes, marches, angry crowds, war, revolutions – and we get to see it all on TV, on some stations all day long.

Even a little of this is too much for the confused elder. The confused person cannot tell that what is being televised could be hundreds if not thousands of miles away, or right outside the door. When people are hurt the confused elder could think it is a family member being hurt or that the danger is to them.

Negative TV, negative news and dramas of killing, danger and mayhem need to be avoided by the elder who is having a problem telling the difference between the TV and their present situation.


Good TV for the confused elder? The current trend towards competitions- the best singer, the best dancer, how much do you think this costs – are shows the confused person can enjoy with the rest of the family. The elder can give their opinion if the singer/juggler/dancer is good or bad. The confused person can laugh along with the family even if they don’t always know what the joke is.

These shows are in the moment right with the elder. No need to remember a plot, or characters or follow a story line.  Just sit back have a little snack and enjoy the show.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

Natural Disasters – When Watching TV is Bad for the Elderly with Alzheimer’s Disease

When the TV is always on!

Some people live with the TV always on, like background music. The caregiver may  start their day with turning on the TV to catch the morning news and then just leave the TV on. A few years ago my husband and I owned but didn’t operate a small assisted living home in Florida. We had residents up to age 102 years, but they all had some level of confusion or dementia. Our biggest challenge was caregivers. Even though the home had a large beautiful four season’s room over looking the backyard pool. The residents spent their days getting up, getting dressed, eating and then sitting in the living room in front of a TV all day with all of the drapes closed so they could see the picture better.

This wasn’t the way I wanted to care for the elderly, so we had to close that home. I pictured a home where the drapes were open, people moved around the house helping make lunch – not only eating, sitting in the four seasons and enjoying nature and maybe a simple board game. And most of all soft music playing, not the constant drone of the TV.

Negative TV!

Bad News! Sad News! That is repeated over and over throughout the day. When news breaks that is frightening, like an earthquake or flood, some major disaster, the confused person might think it involves a loved one or themselves.

Crime dramas – soap operas, stories of personal tragedy where people are crying, yelling and angry or screaming in fear. People with Alzheimer’s disease no longer see the difference between the picture on the TV and reality.

Positive TV!

Shows from the past that the person always enjoyed. Lawrence Welk Show, always the favorite. Wheel of Fortune hasn’t changed its format for years and so remains very familiar. Re-runs of shows from early TV days, Andy Griffith, Dick Van Dyke and always I Love Lucy.

Make it a happy day – turn off the TV.

Virginia Garberding, R N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance