An elderly man grapples with whether to buy a birthday present for his wife who has dementia and no longer remembers her birthday. Despite her condition, he decides to get her a gift.
Key points
An elderly man questions buying a birthday gift for his wife.
His wife has dementia and struggles with memory.
He decides to get her a present despite her condition.
An elderly couple's hands pictured next to a wrapped gift
Maria Fabrizio for NPR
My wife's birthday was a few weeks away.
Should I buy her a present?
The reason I asked that question is that my wife has dementia. She is now in a stage where she cannot summon up words, where she doesn't always seem to respond to my visits. And even if I were to tell her that her birthday was coming up, there was no way to know if she could understand what I was saying.
In the first years after her diagnosis she was aware of events like her birthday. And as a loving hubby I'd get her a gift — earrings and scarves are two of her favorite things. I long ago gave up on clothing because it was hard to figure out if a garment would be a good fit unless she were to try it on.
I used to get her CDs as well from some of her favorite artists. I think she really does love Bob Dylan more than she loves me! And books I knew she'd like — the Mel Brooks memoir from a few years back, for instance. And books of history, which is her passion.
Q&A
What challenges do caregivers face when a loved one has dementia?
Caregivers often struggle with communication, emotional connection, and making decisions about celebrations like birthdays due to the loved one's memory loss.
How can you celebrate a birthday for someone with dementia?
Celebrating a birthday for someone with dementia can involve simple gestures like giving a gift, sharing memories, or creating a familiar environment to evoke positive feelings.
What are the signs of advanced dementia?
Advanced dementia may include difficulty with communication, loss of recognition of loved ones, and challenges in understanding or responding to conversations.
Why is it important to acknowledge birthdays for individuals with dementia?
Acknowledging birthdays can provide emotional comfort, maintain connections, and offer caregivers a chance to express love and remembrance, even if the individual may not fully comprehend.
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And even if I were to turn to my two favorite gift categories … she no longer wears earrings and she sure does have a lot of scarves already. I could buy her a book and read it aloud but there's no way to know if she would comprehend. And CDs are in the dustbin of history.
Plus she has an Alexa device for her room so someone can order up songs from one of her favorites: "Alexa, play the Beatles."
Now let me be blunt. Since dementia robs people of their memories, a partner really does not have to remember milestone dates: wedding anniversary, Mother's Day, birthdays.
I can't ask Marsha to confirm this. But I do believe that if I were to skip any of these occasions she would be unaware.
So it would not necessarily be a bad thing to disconnect myself from these joyful (and yes, sometimes stressful) responsibilities of couplehood. I have a new set of responsibilities now – I visit pretty much every day, jabber on about all sorts of things, give her back rubs, take her on walks (in her wheelchair because she's lost the ability to walk).
Yet, how could I give myself a pass? Even in this sorrowful new stage of our relationship, I still want moments of joy, moments that remind me (and I hope Marsha) of our past.
Even if she doesn't have the words to say, "Thanks, honey!" I want to believe that in some way she understands that this is a special moment.
In the past few years, I've turned to gifts that will evoke an immediate reaction. And that means food.
She lives in a group home for people with cognitive and other age-related issues. Her meals are home-cooked and delicious (sometimes I sneak a bite). The house follows the Jewish rules of kashrut, so I can't bake something in my non-kosher kitchen and bring it to her.
But if I can find a food product that has a kosher seal of approval, that's … well, kosher. Ice cream is her most beloved food. It was from Marsha that I learned that you can just have a big bowl of ice cream for dinner instead of after dinner from time to time.
So ice cream was an obvious choice. And coffee is her favorite flavor.
Humble brag; That turned out to be a stroke of genius on my part. I bought a container of Haagen-Dazs coffee ice cream. After dinner, the staff scooped out a bowl. The smile on her face when she tasted that deep, enticing coffee was sublime. I think it was bigger than the smile that she flashes when she looks at m e in a good moment.
Another go-to is watermelon — even in winter, when her birthday falls I'll make an effort to find a personal melon, which she always enjoys
But this year, something happened as I pondered her approaching birthday. I was walking past a clothing store and saw a sweater in the window. And I was struck: That sweater is so Marsha.
It was a lovely, trim cardigan, with bands of black and charcoal gray across the shoulders and upper chest, and a cheeky red stripe inching down by the buttons.
She would love that sweater.
I had two questions: Of course, one question was "would it fit"?
The other question: Should I even buy it? She has a complete wardrobe in her room, pieces that work well in a setting where she needs to be dressed by others and comfort is important.
So to be blunt: Why spend money on a sweater that she doesn't really need and that she may not even be able to fully appreciate, as her ability to focus visually has declined.
I asked our two daughters. They agreed this sweater was very Marsha. So I bought it.
The girls recommended a certain size. When they saw the sweater, they said, "Dad, it'll be too tight, look at those sleeves. It'll never fit and be comfortable."
I held out hope. And of course I could always return it.
On the day of her birthday, the three of us visited. "We have presents!" I said. My younger daughter says she saw a smile flicker across Marsha's face. Then we helped her into the sweater.
It was a birthday miracle. The sweater fit.
Dementia is a disease of moments, says Andrea Kohn, the wise and supportive nurse practitioner who provides care for Marsha's dementia-related issues.
I've learned that you can't predict how someone with dementia will be from moment to moment. On some of my visits, Marsha dozes most of the time. Sometimes she just stares vacantly. Sometimes she seems to respond to music, sometimes not. Sometimes she is agitated and her face shows it -- perhaps she has a need and cannot find words to express it.
But at this moment, with her two daughters and husband by her side, wearing a stylish new sweater, she gave us a beautiful smile. Her face lit up. She looked … well, she looked like the Marsha I have known and loved for decades, decked out in a chic new garment.
I have talked with Andrea about Marsha's smiles. I want to believe they reflect a genuine moment of happiness in spite of everything. Andrea agrees – she's not capable of faking an emotion at this stage.
What did this year's birthday teach me about presents?
I do know that presents are just physical objects — they're just things. Many birthday celebrants will hold a party and tell invitees: "The only present I want is your presence."
That is completely true for all of us who have too much stuff and really don't need more.
I do give my presence – even though visits can be so hard, can bring up tears — before, after and during. A visit reinforces how much we've both lost due to this cruel and implacable disease.
But on her birthday, this moment of gift-giving gave me another insight. Even though we'd lost so much to dementia, our family is still bound together by our deep love — and, in this case, our love of clothes! That sweater made Marsha, our daughters and me happy. Which is the best birthday gift of all.
