With the help of a care manager, Howie and Billie Palmer made a seamless move from their assisted living community in upstate New York to their daughter’s
house in Maryland.

Betsy and her husband invited her parents to come and live with them in their home in Maryland. To her surprise, her father not only accepted their offer but also was ready to move the following day.

“When I asked when he wanted to move, he said tomorrow, and I knew I needed to go back and make arrangements immediately,” Betsy recalled. With no experience with elder care and no idea where to start, she quickly became overwhelmed planning for her parents’ impending move.

When one of her acquaintances recommended that she contact Jill Rosner from Rosner Healthcare Navigation for help, Betsy quickly made the call. “Jill came over and met with my parents, and she clearly knew her way around the medical field,” Betsy said. “She recommended the home care agency we are still using, made suggestions on doctors, and helped troubleshoot any problems we had along the way.”

Since the Palmers have settled into their daughter’s home, Jill has continued to help the family work through various challenges. She visits monthly to perform an assessment and review their care plans.

In addition to her monthly visits, Jill is always available for emergency consultations. “She is there whenever anything comes up,” Betsy explained. “She also always stops by whenever I am out of town to make sure everything is going well. That really provides peace of mind for me.”

As the primary caregiver for her parents, Betsy is extremely grateful to have the assistance and expertise of Rosner Healthcare Navigation at her disposal. She concluded, “Jill’s always there if I need her; all I have to do is pick up the phone.”

John and Anne Eakin are no exception. “We have lived here, in this residence, since 1978, and we just love the community and are happy to be here,” John said.

The Eakin's are still able to enjoy their summer retreat in Camden, Maine thanks to a supportive team led by a Geriatric Care Manager

Of course, as the years have passed the Eakins have needed a little more help to remain at home. After Anne got sick while traveling, John turned to Care Options, a geriatric care management firm offering many services for aging adults and disabled individuals. Those services include a senior care visitor program, a private duty home care agency, a nurse practitioner house call program, relocation services and a specialized activity program for individuals with dementia. From an initial assessment to ongoing care monitoring, Care Options has managed both John and Anne’s changing healthcare needs for almost four years.

John, a native Washingtonian, always knew he wanted to remain in the area. After he married Anne, they moved to their family home in McLean, Va., where they raised their three daughters.

As a young man, John attended Strayer Junior College but longed to get started in his career. He joined the family business early in his life and took over the company when his father became ill. The company, called Eakin Properties, is a commercial real estate and management firm that was founded by John’s grandfather.

John is immensely proud of his family’s business legacy and has only recently passed the torch on to the next generation. “I’m still involved in the business a bit,” he said. “It would run without me, but if they need me, I just want them to know that I am there.”

It is the security of knowing that someone is always there for them that has allowed the Eakins to continue living in their family home and enjoying an active lifestyle. Not too long ago, that lifestyle appeared to be in jeopardy following Anne’s health crisis.

Anne was making her way back home from the couple’s summer retreat in Camden, Maine, when she suddenly became very ill. She needed acute medical care and had to remain in the hospital in Boston, Mass., for several months.

After visiting his wife in Boston, John, who has chronic health issues of his own, knew he would need help managing her condition once she returned home. He called Care Options, and they arranged a home visit to assess the family’s needs. The assessment included an evaluation of legal, financial, medical, spiritual and social needs. This holistic approach led to the creation of a road map to guide care to meet the couple’s needs that can be updated as necessary.

Diana Gilbert, a geriatric care manager with Care Options, explained how the company helped Anne and her family make the transition from the hospital to home. “Anne had so many doctors in Boston, but now she needed duplications of all of them down here,” she said. “I began pulling in resources, coordinating the care that she required and setting up appointments.”

Diana also started going to all of Anne’s appointments. “It was important for me to discuss her care with the doctors, so I could understand what was needed to continue with her care and recovery,” she said. John recalled feeling an immense sense of relief when Diana was present. “She’s always there when we need her,” he said. “Things have worked out very well since my wife and Diana got together.”

After working with Care Options and her new medical team for several months, Anne’s health status stabilized and she was able to return to Maine for her annual visit the following spring. While Anne was enjoying the summer in Maine, her care management services were placed on hold until she returned. During that time, John had a health scare of his own. “He called me from a hospital bed in Fairfax,” Diana recalled. “He had a severe diabetic wound on his foot.”

Care Options and Diana stepped in and helped John navigate his recovery, which included several hospitalizations and a stay in a skilled nursing facility. After about five months, the wound healed. Care Options and Diana have continued to work with John to make sure that he keeps his health conditions under control by managing his medications, attending medical appointments and coordinating all home services.

As the couple’s needs increased, Care Options arranged to have a caregiver in the home and a senior care visitor to help with transportation to appointments and other activities. Josephine Aikens has been helping the couple with daily tasks since 2009. Josephine now provides assistance with everything from grocery shopping to medication reminders. “She just oversees everything; she’s a wonderful help,” John said.

With the help of Care Options and the professionals they have enlisted, the Eakins remain both happy and safe in their long-time home. They have also been able to continue working, participating in activities, and traveling back and forth to their summer home in Maine.

As a seasoned real estate expert, John knows a good location when he sees it, and he spotted his perfect place in McLean more than 30 years ago. Today, both John and Anne are proud to still be able to call that prime location home.

At first, Linda* just seemed a little forgetful, according to James*, her husband of 43 years. Then, her employer started noticing some problems and suggested she take a yearlong sabbatical. During that time, Linda’s memory deteriorated and her increasing confusion eventually led to a car accident. Fortunately, no one was hurt, but the family knew they needed to act.

“After many diagnoses and mis-diagnoses, she was finally diagnosed with early onset Alzheimer’s,” James said.

As Linda’s diagnosis was complicated by vision problems, her medical issues and the resulting treatments were becoming increasingly difficult for James to manage.  When a bad medication reaction led to a psychotic episode, he had no choice but to admit her to a psychiatric ward.

“When she leaves [the ward], she has lots of doctors and lots of medicine,” said James. “I’m dealing with four different doctors and not one of them talks to the others, and I was getting really frustrated.”

James shared his frustration with a hospital administrator, who suggested he enlist the help of a geriatric care manager. She referred him to Golden Pond ElderCare Strategies. After meeting with Megan Descutner, MS, RN, about how she could help him and his wife, James was hopeful.

He immediately knew he had made the right decision when the family friend who stayed with Linda during the day was unable to come one morning. James called Megan and asked for help. “She knew who to call, and we had someone that same day who came in and stayed with my wife,” he recalled.

When James decided it was time to get Linda off some of her medications, Megan found Copper Ridge, a facility that offered Linda specialized Alzheimer’s care. After six weeks, Linda was feeling better and only taking three medications. During that time, Golden Pond helped James find Great Falls Assisted Living, where Linda has since continued to receive the appropriate medical care.

“Through all this, Megan was there. Whenever Linda had a medical change, I’d call her,” explained James. “For someone like me, with little or no experience with anything like this, she was a lifeline.”

Through the difficult decisions and challenging transitions, James is relieved that both him and his wife now have a sense of stability. “When it comes to medical issues, you always hear, ‘Get a second opinion,’” he said.  “Well, the care manager is the person who helps you ask the right questions for the first and second opinions. They are the voice of reason.”

*Names have been changed.

With the help of Elder Clean Pros, Jack and Fran Lish, along with their loved ones, learned Jack had a serious medical concern. The couple now receives home care assistance through its partner company, Advanced Home Support.

When it comes to deciding where to spend their future years, an increasing number of seniors are choosing to remain in the comforts of their homes.  It can be difficult, however, for their family members or care managers to keep a close eye on the household.  Fran and Jack Lish are among this growing niche, preferring to remain in their Gaithersburg, Md. apartment.  Fortunately, with the unique services provided by their son’s companies Elder Clean Pros and Advanced Home Support, they and their loved ones rest assured knowing that their safety will always be a top priority.

A Brooklyn native, Jack graduated from Columbia University with a B.A. in economic geography.  Just a short time later, World War II broke out.

“I was a patriotic American and went to inquire about becoming a Navy Officer,” he said.  “I served a little over 3 ½ years, two of those were spent in French Morocco on the Atlantic.”

With this experience and having received his M.A. in statistics, he was eventually recruited to teach advanced communications and cryptology.  While this may seem complex and challenging to others, Jack would say with a smile that his career was a walk in the park compared to pursuing Fran.

Born in New Jersey, Fran attended the University of Georgia, leaving after her first year to work as a secretary in the government when the war started.  She had actually met Jack when she was on the verge of graduating high school as he was working for the government and renting a room with her aunt.

“He was coming home from work when I was outside on the porch babysitting.  He saw me and thought he was at the wrong house,” Fran said with a laugh.

While they enjoyed a courtship before she left for Georgia, she was not ready to get married.  Jack, however, never gave up and was delighted when she finally said ‘yes.’  They were married in 1945 and later welcomed Sam, their only child.

Over the years, they maintained busy lifestyles as Fran transitioned from being a homemaker to reentering the working world helping Jack who had become an attorney running a practice out of their home.  Aside from his career, he has also been involved in a great deal of community work, including serving as international president of the Federation of Jewish Men’s Clubs.

Like many of their peers, the Lishes eventually found their apartment was becoming difficult to maintain.  As a result, they enlisted the services of Elder Clean Pros, Sam’s unique company that ensures the cleanliness and safety of a home but also provides oversight and observation of the individual.

Nearly 20 years ago, Sam Lish started the home healthcare company Advanced Home Support, one of the few private duty agencies providing skilled nursing along with personal care throughout the Washington, D.C. Metro area.  The organization’s thoroughly screened and trained professional caregivers offer assistance with activities of daily living, transportation, homemaking, and medication management, among many other services.

Within the past five years, however, Sam and his wife, Jody, noticed a trend of seniors needing help but not necessarily skilled nursing or personal care.  They noted how basic housekeeping services are not what the senior needs or what their loved ones had in mind.  Instead, they want the knowledge a nurse comes with and that additional help around the house.

Therefore, they started Elder Clean Pros, through which individuals can either receive a monthly or twice-monthly full home deep clean.  Additionally, the elder clean specialists offer a weekly safety check along with linen changes, room wipe downs and vacuuming and tidying.  Most importantly, since many of the specialists are Certified Nursing Assistants, they provide, as Sam and Jody often refer to it, ‘undercover care.’

“So many seniors will not tell their family what is really going on.  If we notice something needing immediate attention that nobody knows about, like a bruise or injury, we can at least let the family or care manager know what we’ve seen,” said Jody. “We bring attention to those issues before they become a crisis.”

As a result, children and family members rest assured knowing there is another set of attentive eyes on their loved ones.  For this among other reasons, care managers such as the Director of Aging Network Services in Bethesda, Md., Barbara Kane, LCSW-C, understand the importance and need for this type of service.  “It fills a niche for seniors who are not ready or who are resistant to home health care. Seniors are more likely to want housekeeping help, but these housekeepers have an eye on things,” she said.

And Jack Lish is just one of many clients who have proven why this undercover care is so essential.  During a visit, the cleaning specialist noticed Jack’s leg was swollen and reported back to Sam who took his father to the doctor.  They learned Jack had a blood clot, and he was immediately sent to the emergency room.

According to Jody, many individuals, like her in-laws, have started out using Elder Clean Pros, finding it provides an easy transition for seeking the services of Advanced Home Support.

As the cleaning specialists visit twice-monthly, Jack now has a caregiver that comes every weekday and will even make him himself available on weekends and holidays if needed.

“Our caregiver is such a caring and nice person; we feel lucky to have him,” said Fran.  “These services have certainly helped me a great deal and we’re very satisfied.  We feel well taken care of and completely covered.”

“I kept making strikes that day,” he said with a laugh. “I went over and showed her and her friend how to score for two strikes in a row.”

Eventually they were put on the same summer league team while Kay became Hal’s personal cheering section as he umpired for baseball games.

And ever since, it has been an uphill ride for the Elys with three children and five grandchildren and five great-grandchildren.

For the couple, retirement could not have come sooner. While he worked as an accountant and she a retirement plan specialist, they looked forward to the extra time they could spend on their favorite activities.

The Elys knew, however, that they would need some help along the way. As they evaluated the different housing options in the SourceBook, they noticed an ad for Senior Supportive Services, Inc.

“It sounded too good to be true,” said Hal. “But we found they really could offer us all the assistance we needed.”

For the past three years, Michael Mastroieni and Jeanette Mastroieni-Cave have helped the couple with their retirement funds, long-term care insurance and income taxes while enabling them to navigate the Medicare system. They were also able to offer expertise on various surrounding retirement communities when the Elys were planning to move.

“They had a lot of experience with different communities and made several suggestions to us,” said Hal. “They’re terrific, very much people-oriented and efficient in what they do.”

With their worries behind them, the Elys are busier than ever. Enjoying the scenic views of their new home, Tel Hai Retirement Community, they are devoting their time to their favorite pastimes: music and baseball. The couple sings in the choir and Kay, who plays the French horn, has started a band within their community. Hal, who helped start the Norristown Community Chorale, works with staff to put on various musical programs while singing for chapel services and at baseball games.

And of course they make sure to spend time with Michael and Jeanette, two individuals they cannot thank enough for helping them find a home and solve their financial questions.

“They are much more like personal friends than associates or advisors,” said Hal. “Or I should say very helpful friends.”

It was in 1967 that Tony Coruzzi joined his brothers Pete and John in America to assist with Pizza John’s, located in Essex. John came to America from Italy in 1950 and founded the Italian restaurant in 1966, becoming a well-respected figure in the community. Three months later, Pete followed their brother’s footsteps, and was eventually joined by Tony. As a trio, they continued to build the success of the restaurant.

Nowadays, Tony still visits Pizza John’s for his favorite meal of ravioli with his Ivory House Aide, Kim Gresham. What makes moments like these so remarkable is that Tony has Multiple Sclerosis (MS). For the past three years, Ivory House Health Services, consisting of a team of nurses, Geriatric Care Managers and Certified Nursing Assistants, has provided him with total chronic care management in addition to nursing home care. Helping families make their loved ones’ wishes a reality is a specialty of the organization, and Tony is certainly very well loved by his brothers and his lady friend, Pat.

As evident in the case of Tony and his loved ones, Ivory House staff regards the focus on wellness and on the support of family relationships as pivotal. Ivory House’s Model of Care Management has evolved from years of applied specialized nursing and hands-on service to the geriatric population. It is holistic and centers on total involvement in the needs of a client and his/her loved ones. The care model consists of an initial in-depth assessment of all aspects of life, including medical records and treatment history, physical abilities, cognitive status, environmental conditions, social needs, relevant legal documents, and is followed by discussions with the family. Ivory House serves as the intermediary/advocate for Tony and other clients with physicians and key parties.

From the beginning, Ivory House engaged Tony as an active participant in his care management. Nurses came aboard during a health crisis and the first goal was to stabilize the disease medically. Early on, their success was attributable to the very slow pace at which progressions were undertaken — six months to help Tony move from the hospital to sub-acute rehabilitation to home. With the exception of two occurrences, Tony has been able to remain in the comforts of his home.

In addition to the physical changes that have complicated Tony’s daily life, he also has to deal with memory challenges. Yet, he delightedly receives friends and family, and, of course, all the caregivers and nurses that provide him with 24/7 nursing home care in all of its dimensions. One of these individuals is Ivory House Medical Director Dr. Thomas Lansdale, a respected internal medicine physician and educator who makes home visits to Tony as needed.

*Sandy Cooney — A Dutiful Daughter in Spite of it All*
Another situation that exemplifies Ivory House’s care model through wholly evaluating the needs of the involved loved ones and providing instruction is that of Sandy Cooney* and her family. Sandy’s parents, Sue and Bill, were married for 53 years, but were not especially close with their son and daughter. When a gas leak threatened the couple’s lives, however, it was time for their children to take charge with the help of Protective Services.

With one spouse having cardiac issues and dementia and the other diagnosed with Alzheimer’s, the couple was forced to separate due to house relocation from assisted living to hospice. In the midst of all the turmoil, Sandy’s brother was killed tragically in an automobile accident, leaving her to intervene and provide care despite the difficult relationships with both parents.

Even with the support of her loving husband, Sandy felt very alone and overwhelmed. Fortunately, she soon had the guidance of Ivory House nurses, who at every step provided her with options, understanding, teaching and resiliency. Eventually Bill moved in with Sandy and her husband and although the challenging times continued with feisty bouts, the stresses of role reversal and loss of control, Sandy found she was at peace when he passed. With the support and encouragement of Ivory House, she was comforted knowing she had done her best.

It is with the guidance, assessment, expertise and overall family-oriented practices of Ivory House that the clients in these stories have found the individualized help they needed. Whether it is Tony’s enjoying ravioli surrounded by his brothers and friends, or Sandy’s finding peace after troubling times, these individuals and their loved ones are all thankful to the team that has played a large role in their lives.

_*Indicates name has been changed._

Emma Alford's family turned to Rosemary Allender, founder and owner of Family Eldercare Management, who offered her aid and assistance and provided Emma and her sister with helpful information regarding their mother's care.

Emma Alford moved her mother Annie Davis, also affectionately known as Ms. Daisy, from Mt. Vernon NY to care for her. For Emma, it was the best option after her father had passed away, especially with all of her siblings living outside of New York.

It was only nine months after Emma moved her mom into her home that Ms. Daisy wanted to live on her own and be as independent as possible. She then moved into an apartment building for senior citizens conveniently located just around the corner from her daughter.

In order to further enable her mother to continue living independently, Emma had also found a day care center that Ms. Daisy could attend 3-4 days a week. Emma remained her mother’s sole caregiver as she continued to frequently visit and check on her.

As time went on, however, Ms. Daisy’s health began to change and living on her own became a major challenge when she ultimately had a stroke. Emma proceeded to call her sister, a Geriatric Nursing Assistant, who moved her family to Maryland to assist in the care of Ms. Daisy. Her health continued to decline and Ms. Daisy was also diagnosed with Alzheimer’s.

At what was an extremely difficult time, the family turned to Rosemary Allender, founder and owner of Family Eldercare Management, who offered her aid and assistance and provided Emma and her sister with helpful information regarding their mother’s care.

Over the course of the next few years, Rosemary provided her expertise as a care manager on invaluable resources, such as how the family could get additional health care assistance through though the Special Low Income Medicare Beneficiary Program. She also informed them of local support groups where they could find additional support and insight.

In August 2008, at age 88, Ms. Daisy’s Alzheimer’s progressed to the late/end stage. With the continued guidance of Rosemary, they were able to provide in-home Palliative/Hospice Care throughout the following year, when Ms. Daisy closed her eyes and peacefully transitioned.

As of Jan. 1, 2010, all current and renewing members must hold one of these certifications and since January of 2008, it has been required that all new applicants for Care Manager membership be certified.

The approved certifications include Care Manager Certified (CMC), Certified Case Manager (CCM), Certified Advanced Social Worker in Case Management (C-ASWCM, and Certified Social Worse Case Manager (C-SWCM).

More information can be obtained on each of the certifications at the following:

Care Manager Certified — CMC
National Academy of Certified Care Managers (NACCM)
(800) 962 — 2260
www.naccm.net

Certified Case Manager (CCM)
Commission for Case Manager Certification (CCMC)
(651) 789-3744
www.ccmcertification.org

Certified Advanced Social Worker in Case Management (C-ASWCM)*
Certified Social Work Case Manager (C-SWCM)*
National Association of Social Workers (NASW)
(800) 683-8799 ext. 409
www.socialworkers.org/credentials

*These are the only certifications from NASW that fulfill NAPGCM certification requirements. The Gerontology Specialty Certifications, Clinical Social Worker in Gerontology (CSW-G) and Advanced Social Worker in Gerontology (ASW-G) do NOT fulfill NAPGCM Certification requirements.

*_To learn more about the NAPGCM, visit www.caremanager.org._*

That is most likely what one client would say of Arlene Saks Martin, LCSW-C, CCM, whose services span Baltimore City, Anne Arundel, Baltimore, Carroll, Frederick, Howard, and Harford Counties. This client is 67 years old and lives independently in her home. Growing up as an only child and having never been married, this particular client has no immediate family as her parents have passed away.

After being in and out of different psychiatric hospitals in Maryland and other states since she was 18, she was recently on the verge of being hospitalized again. That is when her guardian and the lawyer managing her trust found out about Arlene’s service, Armel, Inc.

With the help of her new care manger, the client, who suffers from paranoia and hears voices, has started attending a support group for people with a mental illness. She has also been taken to the local senior center.

The client has several resources in the community and Ms. Saks-Martin has arranged to have an aide attend doctors’ appointments with her. The aide has been trained by Arlene and diligently reports back with information from the doctor. A pharmacist has also been hired to review all of her medications to avoid medication interaction since she is taking many different meds for different diagnoses.

Most importantly, however, the client has found comfort knowing she can call Arlene 24 hours a day, seven days a week, especially during those times in which she feels anxious or hears voices. Taking care of common tasks such as getting her car inspected is now made simpler with the help of a geriatric care manager.

For this client who has also endured a mastectomy and suffered from severe anxiety, having this support system has been a great relief. Her geriatric care manager, who has felt like a friend, has helped her in several ways to remain independent in her own home while encouraging her to tap into her strengths and potential. If at any point the client needed to obtain a Social Security Disability, Supplemental Security Income or Medicaid, she knew she had the right person to turn to.

With the help of her guardian and care manager, this woman has overcome difficult times in her life and has certainly found the light at the end of the tunnel.

That’s why communicating with AD sufferers effectively has become a “linguistic science,” one in which caregivers and families must modify their manner of speaking. AD patients can only absorb so much within a few minutes of conversation.

Caregivers and relatives must also adjust their rhetoric as the patient advances through the three stages of Alzheimer’s – mild, moderate, and late. And often a caring family member will say something he or she shouldn’t, and stands to be corrected.

For example, I visited my wife Maxine daily after I placed her in a residence specializing in memory care management. (She was clinically diagnosed with Alzheimer’s in 1990 at the age of 74.) On one occasion, I told Maxine how much I “depended on her.” A hospice nurse overheard me.

“That’s a no-no.” she said. “Maxine might misunderstand the meaning of your statement and think you were criticizing her for failing to do something. In her troubled mind, this would create more anxiety, confusion, and worry. Better just to say what a big help she is in your work.”

Dr. Kathryn Bayles and Cheryl Tomoeda of the University of Arizona have conducted extensive research in the area of cognitive communicative disorders connected with dementia, particularly AD. Their two books, The ABCs of Dementia, published in 1995 by Canyonland Publishing, and Cognitive Communication Disorders of Dementia, Plural Publishing, 2007, are excellent reference sources for the “dos and don’ts” of conversing with those afflicted with AD.

The U of A pair also produced a two-part instructional video tape (VHS) titled Understanding the Communication Problems of Alzheimer’s Patients and Improving the Ability of Alzheimer’s Patients to Communicate. Both are excellent educational tools on strategies that can be used by anyone who interacts with AD patients.

I’d engage Maxine in reminiscing, even though she had no recall. I always used simplified syntax. Complicated syntax will greatly increase the demands on memory. A slow rate of speech, pleasant tone of voice and simple vocabulary are the best techniques for eliciting positive responses.

It’s also desirable to supplement words with pictures. One of the first things I did for Maxine was to develop her own personal “memory book,” a large album filled with photos and short captions showing significant events in our lives. If she misidentified a subject, I’d explain it. And if she was at a loss for words, I’d supply them.

Before the onset of Alzheimer’s, Maxine, a 1938 journalism graduate from the University of Illinois, edited virtually all of my writing. (We even did a book together, Stunt Flying In The Movies.) After she contracted AD, I’d show her a draft of something I’d written and thank her for polishing it. It pleased her to know she still had a role in my important business projects.

Authors Bayles and Tomoeda tell us the average rate of speech is 160-170 words per minute. The more words spoken per minute, the more concepts the AD patient must comprehend. By reducing the number of concepts to be processed, the load on the memory is also reduced.

“The brain damage associated with dementing disease results in slower information processing,” say Dr. Bayles and Ms. Tomoeda. “Even many normal elders benefit from a slower-than-average speaking rate because the processes of normal aging have resulted in them being slower information processors.”

Although it went against my grain, I learned the necessity of “therapeutic lying,” a standard practice in the healthcare industry in the presence of AD patients. If I needed to take my wife to the doctor, which she always rebelled against, I’d say we were going to the post office and then McDonald’s. Entering the doctor’s waiting room, she’d usually say, “Is this the wellness clinic?”

Little white lies are ways of avoiding upsetting a loved one with Alzheimer’s. When it was time to leave Maxine after one of my visits, I’d simply say, “Well, I’ve got to go back to work now.” And whenever she’d inquire about “my husband” or “that man,” the caregivers would tell her, “He’s working today.”

Invariably she’d ask, “Why does he have to work so much?” And the caregivers would follow my script and answer, “Because he wants you to enjoy this lovely apartment.” Maxine’s response: “That’s nice of him, but why isn’t he here to enjoy it with me?” If my precious had ever addressed that question to me, I think for once in my life I’d have been speechless.

Jim Greenwood is the author of Alzheimer’s: Medical Science and Families are Still Asking Why?. His website is www.jimgreenwoodauthor.com