My wife’s birthday was coming up and I found myself asking a question I hadn’t expected: should I buy her a present?
It felt odd because Marsha has dementia. She’s reached a point where words don’t always come, she can seem unaware of my visits, and I couldn’t be sure she’d understand if I told her her birthday was near.
After her diagnosis she still marked occasions like birthdays. I used to delight in finding things she’d love — earrings and scarves were reliable hits. I gave up on buying clothes years ago; without fittings it was a gamble. I used to bring CDs from artists she adored (I suspected Bob Dylan ranked above me in her affections) and books — memoirs, history — which she always loved. Those choices feel less relevant now.
She no longer wears earrings and she’s buried under scarves. Books could be read aloud, but I couldn’t be sure she’d follow. CDs are nearly obsolete; she has an Alexa in her room and can say, “Alexa, play the Beatles.”
Because dementia erases memory, it’s tempting for a partner to let milestone dates slide. I can’t ask Marsha whether she notices birthdays anymore, but I suspect she generally does not. That would excuse me from the rituals of our former couplehood. My role has already shifted: I visit almost every day, chatter about anything and everything, give back rubs, and push her wheelchair on walks because she can’t walk alone.
Still, I couldn’t grant myself a complete pass. Even in this painful new phase I want small bursts of joy that echo our past. Even without a clear thank-you or a coherent reaction, I want to believe she understands, somehow, when something is meant to be special.
Lately I’ve leaned toward gifts that create an immediate reaction: food. Marsha lives in a group home where meals are cooked to kashrut. I can’t bring in something prepared in my non-kosher kitchen, but I can buy kosher treats. Ice cream is her favorite — she taught me you can have a big bowl of it for dinner sometimes — and coffee is the flavor she prefers.
Finding a container of Häagen-Dazs coffee ice cream felt like a small victory. After dinner the staff served her a bowl; the smile that spread across her face was radiant, maybe even bigger than some of the smiles she reserves for me.
Watermelon is another dependable delight. Even in winter I’ll hunt down a personal melon because she always lights up when she tastes it.
Then, walking past a clothing shop, I saw a sweater that felt completely right for Marsha: a neat cardigan with black and charcoal bands across the shoulders and a playful red stripe near the buttons. I hesitated. Would it fit? Should I buy something she didn’t need in a room already full of comfortable clothes chosen by caregivers? I asked our two daughters and they said it was perfect. So I bought it.
They worried about the size. When they saw the sweater they warned, “Dad, it’ll be too tight — look at those sleeves. It’ll never fit.” I clung to hope and figured I could return it if necessary.
On her birthday the three of us went to see her. “We have presents!” I announced. My younger daughter watched a tiny smile flicker across Marsha’s face. We helped her into the sweater. It fit. For a small, bright instant it felt like a birthday miracle.
“Dementia is a disease of moments,” Andrea Kohn, the nurse practitioner who cares for Marsha, told me. You can’t predict how someone with dementia will be from one visit to the next. Sometimes Marsha dozes; sometimes she stares into space. Music can reach her; other times she’s unsettled, perhaps because she can’t express a need. But when she smiled in that new sweater, looking put-together and content, she was unmistakably the Marsha I’ve loved for decades.
Andrea also said Marsha can no longer fake emotion, which made that smile feel especially real. Small, authentic moments stand out against the steady grief.
What did the birthday teach me about gifts? Objects alone are just things. Many people say the only present they want is your presence, and that rings truer than ever for those of us living with dementia: my visits — the conversations, the tears, the ordinary closeness — matter.
Yet the sweater revealed something else. Even though dementia has taken much of who she was, our family remains bound by deep love — and by small shared pleasures, like a fondness for clothes. For an afternoon that sweater made Marsha, our daughters and me genuinely happy. For that few hours, it was the best gift I could have given.