Hour to hour, David got excellent care at The Meadows.  Unlike the staff at the assisted living memory care facility, The Meadows staff talked with residents, joined them in games and activities, and watched for situations that helped them relax or made them light up.  Some residents relaxed when staff members combed and curled their hair, others when the whole group played bingo or trivia games or batted balloons around the room with pool noodles.  The activity director for memory care was particularly attentive and perceptive; she understood that David saw himself as working in the college library, so she set up a desk near the nurse’s station with a name plate and a keyboard.  He was at ease there.  Everything fell into place.  The CNAs were his students; the staff were his colleagues; the other residents were people who wished to use the library resources. 

Staff members had learned that David liked to have a mug of coffee filled no more than one-third full.  Having a coffee cup at hand, too, put him at ease.  It often sat there untouched.  As time went on, he tended to pick up an invisible cup next to his coffee cup and sip from that.  When he did pick up the mug, he still tried to set it down where there was no table – but he didn’t let go until he felt something solid under the cup.  It was nerve-wracking to watch, but he never actually set a cup down in thin air, and in any case the coffee was almost always cold. 

At the quarterly care conferences, staff members reported on changes I couldn’t observe.  They told me how much of the food on his plate he consumed (usually 76 – 100%) and how often he joined in activities.  They described changes in weight, vital signs, and mobility.  They also reported any changes in mood or behavior – changes I might not see because my visits and our video calls with Fiona both comforted and him and perked him up.  I learned that the dietician had ordered more finger foods for him because utensils were so difficult to use.  I often visited after meals, so I already knew that there was many a slip – 76 – 100% of the food left his plate, but some of it landed in his chair.  I appreciated the emphasis on independent eating, though I didn’t yet realize how important that was: when staff feed the residents, l learned later, they sometimes stop eating.  There were many eyes on David, and creative, thoughtful people were easing his way.