Maayan and Ena

Friday afternoon – the quiet hours between the last bites of lunch and the welcoming of Shabbat – finds many of our seniors enjoying a siesta. But for a Spanish-speaking Rashi student and a Cuban-born patient at Hebrew Rehabilitation Center at NewBridge on the Charles, Friday afternoon is the perfect time for leisurely conversation and cross-cultural connection.

The Rashi student, 8th grader Maayan, began facilitated visits with Ena Polak Teichberg at NewBridge in January 2017. These sessions were initially designed as academic enrichment opportunities for ongoing conversational engagement with a native Spanish speaker. With the support of staff from Hebrew SeniorLife’s Multigenerational Program and HRC Nursing, Maayan and Ena connected through Spanish conversation, simple crafts, and music — including a recording of a Latin jazz “Hava Nagila,” complete with shofar stylings.

Each time Maayan arrived at the NewBridge Health Care Center for a visit, she found Ena at her chosen spot at the dining room table. From her designated post, Ena greeted visitors with mayoral warmth and affectionate, grandmotherly needling about friends and study habits. Ena’s memory was ebbing, so at the beginning of each visit, Maayan patiently reintroduced herself.

During their earliest visits, Ena often drifted into English, then Spanglish, then back to Spanish. But with each visit, and with the onward march of dementia, Ena was inclined to speak less English and more of her native language. This shift was a marker of her cognitive decline, but it also presented an opportunity for deeper shared experience between them. As is common in many people with dementia, the oldest memories are often the crispest and best-preserved. And Spanish had a special power to reveal the corners of Ena’s heart: the cholent with extra spice, the lilting sounds of La Bayamesa, Cuba’s national anthem, and the rhythms of her Jewish household, which was a striking anomaly, in their small, primarily Catholic town.

Poignantly, Ena spoke of her Cuban surroundings in the present tense. “She’s in Cuba right now,” Maayan commented during one of their visits. “But no matter where she is in her mind, she’s telling you her experiences.”

When we train youth to engage with seniors in our memory care communities, we encourage a communication strategy that is creative rather than corrective.

On one of Maayan’s early afternoon visits, Ena was particularly agitated. She wasn’t sure she had time to visit because it was getting late — her mother was expecting her to come home for dinner and she couldn’t be late. And besides, she had un montón (a lot) of biology studying to complete before school the next day. She was sorry, but there simply wasn’t time for a visit.

Instead of insisting on the facts – that Ena’s mother had passed long ago, that she didn’t have any biology homework – Maayan responded with great curiosity and empathy. She took a step into Ena’s world with a single question:

¿Cómo es su mamá? What is your mother like?

Maayan effectively opened a doorway into Ena’s world. Before long, Ena was chiming in on topics ranging from the weather to politics. She remembered boarding the train to Guantánamo with her sister to attend school, packed lunches in hand. She shared her family’s Jewish traditions, which Maayan compared to her own, and regaled us with tales from the Universidad de la Habana, where she launched her pioneering career as a pharmacist.

Maayan’s question drew us closer to the contours of Ena’s world: the simple dining room table we gathered around was transformed into a patio set on el porche of her childhood home in Cuba, Ena’s wheelchair became a wooden rocker, and the container of flexi-straws and paper napkins vanished, a bouquet of girasoles (sunflowers) taking its place. In this dreamlike tableau, Ena gracefully assumed the role of hostess. Would Maayan like algo para beber (something to drink)? Was she hungry? Ena hoped very much that Maayan would stay for dinner. Maayan accepted the invitation without missing a beat.

Maayan understood that the truth can be a funny, shapeshifting thing where memory loss is concerned. In our quest for a sense of common ground, dementia often bedevils our notions of truth and reality. For Ena, the sights and sounds of Cuba were just as real and immediate — if not more so — than the dining room table where we were gathered on that winter afternoon. How, then, do we establish common ground?

When we train youth to engage with seniors in our memory care communities, we encourage a communication strategy that is creative rather than corrective. Creative engagement benefits both dementia patients and caregivers. Why? It encourages us to understand dementia as a shift in a person’s capabilities rather than a loss of functioning. It attunes us to what remains — namely, capacity for connection, love, and joy– and deemphasizes what has faded. Neuroscientist and author Lisa Genova, borrowing from improvisational comedy, calls this the “yes, and” strategy. This method encourages us to (1) affirm the reality of the person with dementia as he or she is experiencing it (the “yes”) and (2) continue to explore that reality (the “and”). How might this look in practice? Among people with dementia, concerns about being tardy for appointments and visitors are quite common — and feel quite real. An affirmation of the person’s concerns might be simple: “Yes, of course you wouldn’t want to be late for dinner, but I’ll keep an eye on the clock while we visit.” The further exploration might involve a playful twist: “I wonder what your mother is preparing for dinner? I can almost smell the onions and spices on the stove…”  

In broader context, Maayan’s relationship with Ena is one touchpoint along a rich continuum of intergenerational learning experiences built into every level of the Rashi curriculum. Throughout her time at Rashi, Maayan has engaged with NewBridge seniors in various contexts, from holiday-based celebrations with Independent and Assisted Living residents to music and art programs with long-term chronic care patients in the Health Care Center. As a Middle School student, Maayan participates in the Making Memories program, which trains and supports 6th, 7th, and 8th grade students for more sustained connection with seniors in memory care communities across NewBridge. The skills she has developed through this program have helped her to develop the flexibility, playfulness, and empathy that are so critical to building relationships with people with Alzheimer’s and other forms of dementia.

At NewBridge on the Charles and across Hebrew SeniorLife, the Multigenerational Program supports youth of all ages in building these mutually beneficial relationships with seniors. Through this work, we are preparing the next generation of caregivers and compassionate citizens, ready to support our aging population with grace, wisdom, and the sweetness of a Cuban cafecito.

About the author

Marianna V. Mapes is the Multigenerational Program Associate at Hebrew SeniorLife, working to develop and implement programs that support youth and seniors in building mutually beneficial relationships. Marianna’s primary focus is the implementation and management of multigenerational programs at NewBridge on the Charles in Dedham, including NewBridge’s partnership with the co-located Rashi School. She also oversees the training, placement, and support of a growing portfolio of individual youth volunteers across HSL.

Marianna graduated Phi Beta Kappa from Smith College with a Bachelor of Arts in Philosophy and Classical Studies.

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