A woman in a peach-colored sweatsuit sits in a sunlit hallway at the Silverado Senior Living Center in Calabasas. Once she was a professor at a California State University campus, teaching English literature. Now, because of the effects of Alzheimer's disease, she barely has a word to share, only a bemused smile for people she thinks she recognizes.
Can someone like this former professor possibly care that it's Passover, much less enjoy a seder? The staff at Silverado answer with a resounding "yes." The center will hold its second annual Passover seder for its Alzheimer's patients on March 29. Last year's seder attracted more than 60 people, including residents, day-care patients and their families. The Jewish members of the Silverado staff who planned the event said they were amazed by the response.
"Last year, we had so many families come up and say how wonderful it was to see everyone acting appropriately, like there was no dementia in the room at all," said Cheryl Stollman, director of Silverado's day program. "Many people talked about how their loved ones hadn't been to a seder in years because it just wasn't possible in their condition."
Stollman said the center put together an abbreviated version of the traditional seder, about two hours long, replete with everything from matzah ball soup to Maxwell House haggadot. Family members of patients and day-care visitors were encouraged to bring mementos of holidays past to share. The effect on the patients was profound and encouraging, Stollman said.
"Some people had not been to a seder in so many years we thought they would not care, but this turned out to be one of the things they remembered," she said. "It was good for the families, too. One resident died about a week after the seder. He had been a very religious man, and the family all commented on how wonderful it was to have one last seder with him."
Alzheimer's disease and dementia disorders affect approximately 4 million people in the United States, according to the Alzheimer's Association. The number is expected to grow as the world population ages -- in particular the Baby Boom generation. Given these facts, the Jewish community will need to find ways to help families support affected loved ones during holiday celebrations.
Elizabeth Farr, a psychologist with a certificate in gerontology from Boston University, said Passover is a fitting time to work on including people who have memory problems in a family celebration.
"When we come to the seder, what we're trying to do is regain a collective memory of what our forefathers and foremothers went through, and unless you've gone through some kind of past life regression, none of us really has that memory," she said. "So it's kind of an even playing field."
She said she advises families of dementia patients to be creative in helping their relatives connect to the holiday.
"One idea is to have the loved one do an art project with a caregiver, to create something they can share at the seder, perhaps a memory of a past seder," Farr said. "They could also bring an object from a seder from their past, such as a seder plate or matzah cover, and place it where they going to be sitting so they have that as a reminder."
Safety issues are also key. Farr said to think about foods that could present a danger to people in the middle or later stages of dementia, who might see horseradish, not recognize it and try to gobble a large mouthful. Matzah can also be hard to swallow. Consult your rabbi to find out if it is halachically acceptable to serve frail guests egg matzah, which is softer.
Farr said people in the early stages of dementia could be asked to tell a story from a past seder. Many people with such disorders can remember the past more vividly than the present and would enjoy sharing these memories.
"Even a person in late-stage dementia can be guided to participate," Farr said. "The key is preparation. You need to give as much time to planning how to make people feel comfortable at your table as you do to planning your menu."