I’m often asked how I got into the work I do: “How did you start your career in Alzheimer’s disease care?” or “Did you have a family member with dementia?”

Like many people I know, my career choice happened, in a sense, by accident. I had finished up a Master’s degree in Public Health in 1986 when my first job offer came from the then brand new Alzheimer’s Disease Research Center at the University of Kentucky. I knew nothing about the field but they hired me anyway. But my future boss saw something in me, “Sometimes knowing nothing is a good thing…you won’t know what not to do!”

As I began working with hundreds of families throughout the state of Kentucky, I learned by doing, by spending time with persons with dementia and their families. We had so little awareness about the disease and didn’t know how to improve lives. Sometimes I felt very frustrated that I couldn’t offer any solutions to the overwhelming problems. However, I did know one thing: in my heart, I knew that staying in a negative space that victimized persons with dementia and families wouldn’t accomplish anything. We had to find some better ways of providing care.

It was during this time that I began developing my own model of care with the social worker at our center, Virginia Bell. Virginia and I called our model the “Best Friends” approach or philosophy of care. We realized that it was possible to create a therapeutic environment for persons with dementia and that there were techniques families could use to foster cooperation, reduce challenging behavior, and create a better caregiving experience for all. I’ll write more about our philosophy of care in future columns.

The next decade was a productive one for me, working in Kentucky and California, writing my first book, working in adult day centers and working for the Alzheimer’s Association in Santa Barbara, California. I have to say that I loved my job every day—it was really more of a calling than a profession.

But then Alzheimer’s disease hit home. My own mother, Dorothy, began having memory problems. We had taken a family vacation in London and several times during the trip she asked, “What city are we in?” My mother was always a “clothes horse” and loved dressing in her trademark two-piece wool suits. One day I came home and discovered her favorite suit hanging up in the laundry room, completely ruined. Mom had put the dry-clean only, expensive suit in the washer and dryer, something she never would have done in the past.

Mom’s journey ended when she passed away in April of 2008. We were fortunate in many ways that she kept her wonderful, upbeat spirit and remained “pleasantly confused” through much of her journey. Still there was much loss and sadness. I well recall the time she asked to borrow some money from me. I asked her how much she needed and she replied, “Do you have a nickel?” She was back in a much earlier time. It was heartbreaking, but I reached into my pocket and gave her that nickel and she smiled and said, “Thank you.”

In these series of columns I will look forward to answering your questions, and sharing my professional and personal experiences. I’ll also keep you abreast of new developments; our field of knowledge is constantly expanding. Let’s hope 2012 is a breakthrough year.

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