My wife’s birthday was a few weeks away. Should I buy her a present?
The question felt strange because my wife has dementia. She is now at a stage where words are hard to summon, she doesn’t always seem to notice my visits, and there is no certainty she would understand if I told her her birthday was coming.
In the years after her diagnosis she still recognized events like birthdays. As a loving husband I would buy her things — earrings and scarves were favorites. I gave up on clothes long ago because it was hard to know if a garment would fit unless she tried it on.
I also used to get her CDs from artists she loved (I suspect she loved Bob Dylan even more than she loved me) and books — memoirs like Mel Brooks’s, and history books, which she adores. Now those choices feel less relevant.
She no longer wears earrings, and she has plenty of scarves. Books I could read aloud, but I couldn’t be sure she would follow. CDs are largely obsolete. Plus she has an Alexa in her room so she can ask for songs herself: “Alexa, play the Beatles.”
Because dementia erases memories, a partner could reasonably stop remembering milestone dates. I can’t ask Marsha whether she mindfully notices birthdays now, but I believe she likely wouldn’t. That would mean I could be excused from those small rituals of couplehood. My responsibilities have shifted: I visit almost every day, chatter about anything and everything, give back rubs, and take her in her wheelchair for walks because she can no longer walk on her own.
Still, I couldn’t give myself a full pass. Even in this sorrowful new phase, I want moments of joy that remind me — and maybe Marsha — of our past. Even without words of thanks, I want to believe she understands, in some way, when something is special.
In recent years I’ve gravitated toward gifts that evoke an immediate reaction: food. Marsha lives in a group home with home-cooked meals that follow kashrut. I can’t bring something made in my non-kosher kitchen, but if I find a kosher product, that works. Ice cream is her favorite. She taught me you can have a big bowl of ice cream for dinner now and then. Coffee is her favorite flavor.
Buying a container of Häagen-Dazs coffee ice cream was a small triumph. After dinner the staff served a bowl; the smile on her face when she tasted it was sublime — maybe even bigger than the smiles she sometimes flashes at me.
Watermelon is another go-to, even in winter I’ll hunt down a personal melon because she always enjoys it.
This year, walking past a clothing store, I saw a sweater that felt very “Marsha”: a trim cardigan with black and charcoal bands across the shoulders and a cheeky red stripe down by the buttons. I worried: would it fit? And should I even spend money on something she didn’t really need in a room already full of clothes, many chosen for comfort and ease by caregivers? I asked our two daughters; they agreed it was right for her. So I bought it.
They worried about the size. When they saw the sweater they said, “Dad, it’ll be too tight — look at those sleeves. It’ll never fit.” I held out hope and figured I could always return it.
On her birthday the three of us visited. “We have presents!” I said. My younger daughter saw a smile flicker across Marsha’s face. We helped her into the sweater. It fit. It was, in a small and very real way, 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 vacantly. Sometimes music reaches her and she reacts; sometimes she’s agitated, perhaps because she has a need she can’t express. But when she smiled in that new sweater, looking chic and content, she looked like the Marsha I’ve loved for decades.
Andrea says Marsha is no longer capable of faking emotion. That makes the smiles real in their own way. They are small, authentic moments amid loss.
What did this birthday teach me about presents? Objects are just things. Many people say, “The only present I want is your presence,” and for those of us facing dementia that rings especially true. I do give my presence — the visits that can bring tears as much as joy, and that underscore how much we’ve lost.
But the sweater also taught me something else. Even though dementia has taken so much, our family remains bound by deep love — and, in our case, a shared fondness for clothes. That sweater made Marsha, our daughters and me happy. For that one afternoon, it was the best birthday gift of all.