A Birthday Present Despite Dementia

My wife's birthday was coming up, and I found myself asking a question I never thought I'd have to ask: should I buy her a gift?

Marsha has dementia. She's at a stage where finding words is hard and she doesn't always seem to register my visits. In the years after her diagnosis she still marked occasions like birthdays, so I kept giving things she loved — earrings, scarves, books, the occasional CD. Over time I stopped buying clothes unless she could try them on, and I gave up on physical music as formats changed. She now has an Alexa to play whatever she wants.

Dementia erases memories, so some partners let milestone dates pass without fuss. I can't know whether Marsha would notice if I skipped a birthday. My days are full of new responsibilities — daily visits, conversation that sometimes goes nowhere, back rubs, and trips around the garden in a wheelchair. Still, I wanted to create moments of joy that harked back to our life together. Even if she couldn't speak, I hoped she'd sense something special.

Lately I pick gifts for immediate reaction: food. She lives in a kosher group home with good meals, so I look for kosher treats. Ice cream has always been her favorite — she once taught me that a bowl of it for dinner is sometimes the right thing to do — and she loves coffee flavor. I brought a container of Häagen-Dazs coffee ice cream. After dinner the staff served her a bowl and the smile that spread across her face at that first taste was pure and unmistakable.

Watermelon is another reliable favorite; I hunt for a personal-sized melon even in winter. And this year, while walking by a store window, I saw a sweater that felt like Marsha: a neat cardigan in black and charcoal with a cheeky red stripe near the buttons. I wondered if she needed another sweater and whether she'd notice, but our daughters agreed it was perfect, so I bought it, comforted by the thought I could return it if it didn’t work.

On her birthday the three of us visited. 'We have presents,' I said. My younger daughter later told me she saw a flicker of a smile. We helped Marsha into the sweater. It fit — a small birthday miracle — and for a moment her face lit up in a way that was unmistakably her.

Andrea Kohn, the nurse practitioner who helps care for Marsha, puts it plainly: dementia is a disease of moments. You can't predict how someone will be from one visit to the next. Some visits she dozes, some she seems absent, some she responds to music or a familiar touch. But when she smiles now, Andrea says, it's genuine.

What this birthday reminded me is that a gift is more than an object. Presence matters — I give mine, even when it's hard — but a simple thing can create a shared, bright instant in the middle of loss. That sweater made Marsha, our daughters, and me happy. For all of us, that was the best present of all.