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Thirty years ago,
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I walked into a nursing home,
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and my life changed forever.
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I was there to visit my grandmother Alice.
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She was a very powerful woman
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who had lost a battle with a stroke
that stole her ability to speak.
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Alice had just three forms
of communication left.
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She had this sound
that was like, "Tss, tss, tss,"
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that she could shift in tone
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from emphatic, "no, no, no,"
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to enticing, "yes, you've almost got it."
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She had an incredibly
expressive index finger
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which she could shake
and point with frustration.
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And she had these enormous pale blue eyes
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that she could open
and close for emphasis.
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Wide open seemed to say,
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"Yes, you've almost got it,"
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and closing slowly
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was, well, it didn't really
need much translation.
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It turns out that Alice had taught me
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that everyone has a story.
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Everyone has a story.
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The challenge for the listener
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is how to invite it into being,
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and how to really hear it.
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Now, Alzheimer's and dementia,
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these are two words that,
when you say them in front of people,
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you can watch a cloud descend over them.
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You can imagine me at dinner parties.
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"What do you do?"
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"Well, I invite people with Alzheimer's
and dementia into expression.
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Where are you going?"
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(Laughter)
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Fear and stigma wrap themselves
so tightly around an experience
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that affects 47 million people
across the world,
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and they can live with this diagnosis
for between 10 and 15 years,
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and that number, 47 million,
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is supposed to triple by 2050.
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Family and friends can fade away
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because they don't know
how to be in your company,
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they don't know what to say,
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and suddenly,
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when you need other people the most,
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you can find yourself
really painfully alone,
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unsure of the meaning
and the value of your own life.
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Science is pushing for treatments,
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dreaming of cures,
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but loosening that grip of stigma and fear
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could ease the pain
of so many people right now.
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And luckily, meaningful connection
doesn't take a pill.
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It takes reaching out.
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It takes listening.
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And it takes a dose of wonder.
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That really has become my unending quest,
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set in motion by Alice
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and then later on by really
countless elders in nursing homes
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and day centers
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and those struggling to stay at home.
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And it comes down the question of how.
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How do you meaningful connect?
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I got a big part of that answer
from a long-married couple
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in Milwaukee, Wisconsin, where I'm from,
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Fran and Jim,
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whom I met on a rather dreary winter day
in their tiny little kitchen
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in a humble duplex over by Lake Michigan.
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And when I walked in,
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Fran and a caregiver and a care manager
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greeted me really warmly,
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and Jim stood staring straight ahead,
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silent.
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He was on a long,
slow journey into dementia
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and was now beyond words.
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I was there as part of a project team.
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We were doing what we called
"artistic house calls,"
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with a really simple goal
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of inviting Jim into creative expression,
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and hopeful in modeling
for Fran and the caregivers
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how they could meaningfully connect
using imagination and wonder.
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Now, this was going to be no small task,
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because it turns out
Jim had not spoken in months.
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Could he even respond
if I invited him into expression?
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I didn't know.
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Family members, when they try to connect,
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most commonly will invoke a shared past.
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We say things like,
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"Do you remember that time?"
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But nine times out of 10,
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the pathway for that one answer
to travel in the brain is broken,
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and we're left alone with a loved one
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in the fog.
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But there is another way in.
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I call them beautiful questions.
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A beautiful question is one
that opens a shared path of discovery.
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With no right or wrong answer,
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a beautiful question helps us
shift away from the expectation of memory
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into the freedom of imagination,
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a thousand possible responses
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for people with cognitive challenges.
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Now, back in the kitchen,
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I did know one thing about Jim.
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I knew that he liked
to walk along Lake Michigan,
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and when I looked around that kichen,
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I saw, over by the stove,
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this trunk that was just covered
in little pieces of driftwood.
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And I thought,
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"I'll try a question
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that he could answer without words."
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So I tried, "Jim,
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can you show me how water moves?"
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It was silent for a while,
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but then really slowly he took a step
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over to that trunk
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and he picked up a piece of the driftwood
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and he held it out,
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and then very slowly
he began to move his arm,
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leading with that driftwood.
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In his hand, it became buoyant,
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in sync with the motion of the waves
that he made with his arm.
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It began this slow journey
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across calm waters,
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this gentle rolling to the shore.
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Transferring his weight
from left to right and back again,
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Jim became the waves.
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His grace and his strength
just took our breath away.
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For 20 minutes,
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he animated one piece
of driftwood after the other.
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Suddenly, he was not disabled.
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We were not gathered in this kitchen
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for a care crisis.
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Jim was a master puppeteer,
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an artist,
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a dancer.
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Fran later told me
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that that moment had been
a turning point for her,
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that she learned how to connect with him
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even as he progressed
through the dementia.
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And it really became
a turning point for me too.
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I learned that this creative,
open-ended approach
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could help families shift,
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expand their understanding of dementia
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as more than just tragic
emptiness and loss
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into also meaningful connection
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and hope
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and love.
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Because, creative expression in any form
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is generative.
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It helps make beauty and meaning and value
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where there might have been
absolutely nothing before.
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If we can infuse
that creativity into care,
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caregivers can invite a partner
into meaning-making,
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and in that moment care,
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which is so often associated with loss,
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can become generative.
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But so many settings of care
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offer bingo
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and balloon toss.
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Activities are passive
and entertainment-oriented.
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Elders sit and watch and applaud,
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really just distracted
until the next meal.
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Loved ones trying to keep
their partners at home
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sometimes don't have anything to do,
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and so they resort
to watching television alone,
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which compounds the symptoms of dementia
with what researchers now tell us
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really are the devastating impacts
of social isolation and loneliness.
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But what if meaning-making
could be accessible
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to elders and their care partners
wherever they lived?
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I've really been totally
transformed and captivated
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by bringing these
creative tools to caregivers
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and watching that spark
of joy and connection,
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discovering that creative play
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can remind them of why
they do what they do.
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Bringing this creative care to scale
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could truly shift the field.
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But could we do it?
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Could we infuse it
into a whole care organization
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or an entire care system?
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The first step towards that goal for me
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was to assemble a giant team
of artists and elders and caregivers
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in one care facility in Milwaukee.
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Together, over two years,
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we tackled reimagining the story
of Homer's "Odyssey."
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We explored themes.
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We wrote poems.
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Together, we created a mile-long weaving.
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We choreographed original dances.
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We even explored and learned Ancient Greek
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with the help of a classics scholar.
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Hundreds of creative workshops we embedded
into the daily activities calendar
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and invited the family members
to join right along with us,
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and had caregivers and staff
from every single area of care
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collaborating on programming
for the first time.
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The culminating moment
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was an original,
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professionally produced play
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that blended the professional performers
right alongside the elders
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and the caregivers,
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and we invited a paying audience
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to follow us from scene to scene,
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one in the nursing home,
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in the assisted living dining room,
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and finally in the chapel
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for the final scene
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where a chorus of elders
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all playing Penelope
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lovingly welcomed Odysseus
and the audience home.
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Together, we had dared
to make something beautiful,
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to invite elders, some with dementia,
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some on hospice,
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into making meaning over time,
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to learn and grow as artists.
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All this in a place where people
were dying every day.
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I find myself now in a place
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where I'm having to tackle this challenge
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of meeting a person with dementia
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across that gap
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in a more personal way.
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At a family dinner over the holidays,
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my mother, who was seated next to me,
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turned to me and said, "Where's Annie?"
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My funny and beautiful and feisty mother
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had been diagnosed with Alzheimer's.
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And I found myself in that place
that everyone dreads.
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She didn't recognize me.
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And I had to figure out fast
if I could do what I'd been coaching
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thousands of other people to do,
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to connect across that gap.
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"Do you mean Ellen?" I said,
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because my sister's empty chair
was just right across the table from us.
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"She just went to the bathroom."
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And my mother looked at me,
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and then something deep inside sparked,
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and she reached out and smiled
and touched my shoulder
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and she said, "You're right there."
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And I said, "Yes, I am right here."
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I know that that moment
is going to happen again and again,
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not just for me and my mom
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but for all 47 million people
across the world
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and the hundreds of millions more
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who love them.
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How will we answer this challenge
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that is going to touch the lives
of every family?
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How are our care systems
going to answer that challenge?
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I hope it is with a beautiful question,
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one that invites us to find each other
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and connect.
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I hope our answer
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is that we value care
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and that care can be generative
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and beautiful,
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and that care can put us in touch
with the deepest parts of our humanity,
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our yearning to connect
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and make meaning together
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all the way to the end.
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Thank you.
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(Applause)