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In this excerpt from Anne Basting’s “Creative Care: A Revolutionary Approach to Dementia and Elder Care,” Basting reveals what she has learned from over 20 years of work in creative care and how she hopes her stories will inspire and guide us all in how to connect and interact with those living with dementia.

It was opening day. Spirits were incredibly high. I had walked into Morgantown Care and Rehabilitation in Morgantown, Kentucky, that Saturday morning to a chorus of exuberant greetings, not what you’d usually expect at a nursing home. Now it was just about 2 p.m.—showtime. After two weeks of rehearsal and a year of planning, the elders, local actors, volunteers, and staff were about to perform their version of Peter Pan—one in which Wendy is in hospice care in her final phase of growing up. And the audience, rather than clapping to prove their belief in fairies, would meet the extended hand of an elder to prove that they believed—in one another. There would be song and dance, there would be a giant crocodile, pirates, and of course flying. These residents, several of whom had not been out of their rooms for months, were about to welcome an audience to see them and their nursing home in a completely new light. They were inviting the audience to see beauty and meaning in a place where most people see only overwhelming loss.

Ruth had been at every rehearsal. If I had to guess, I would say Ruth was in her late eighties, with a bob of gray hair framing her face. Riding a wheelchair, she was one of the dozen elders dancing in the finale to Frank Sinatra singing “Fly Me to the Moon.” As Shirley, a resident who had been the activity director in this very nursing home for forty years, offered a blessing on the performance, and the stage manager called out, “Places!” Ruth’s care partner wheeled her out onto the home’s front patio for the pre-show. The wind carried a chill, but every elder in the dance chorus insisted on going outside to greet the audience and listen to the live music. I looked around at the faces. Every one of them was wide-eyed and wonder-filled. Except Ruth. She was crying. Her eyes were bright, but tears rolled down her cheeks. Her mouth was twisted into a half-smile, half-grimace. I went to her straight away, kneeling down in front of her and taking her hands. “Ruth!” I whispered. “Are you okay?”

She nodded eagerly.

“Are they happy tears?” I asked.

“Oh, yes,” she said with a laugh. “Happy, happy tears.”

“Happy tears”—there’s no better phrase to capture a feeling of joy in a time of tremendous challenge, such as when we create and experience poignant beauty in, say, a time of dementia, or a time of profound physical changes, or a time of powerfully missing people who have gone on before you or who are too far away or too busy to visit. In my twenty-five years of bringing the arts to people in late life, almost no one believes me when I first suggest it is possible to feel joy in these moments. Or that joy and meaning can coexist in some of the hardest times of our lives, if we are lucky enough to live that long. The power of being invited into creating meaning, of working together to create art that has a lasting legacy, is an elusive thing to describe. But when people feel it, they understand it deeply. I’m fairly confident that in the beginning of their training, the staff at the nursing home in Morgantown didn’t believe in that power. Nor did the elders, or their families. But after the show, they sure believed—in themselves, in one another, and in the power of the shared creative experience.

I didn’t always believe either. I didn’t even know it was a thing that could be believed in. My journey toward the performance of Wendy’s Neverland in a nursing home in Morgantown was a long, slow discovery for me, a gradual accumulation of experiences rather than a lightning strike. I continue to learn every day, especially now, as the landscape of time shifts under my own feet, bringing changes to my own family. It is my hope that the stories I’ve gathered here, stories of how I learned to apply the insights from theater and creativity studies to the world of elder care and memory loss, stories of bringing joy and connection to those who thought these possibilities were gone, stories from my many encounters with elders and care partners, offer readers a similar journey toward discovery—a journey toward believing that beauty, growth, learning, and joy are all possible in moments that most people assume to be overwhelmed only by loss and sorrow. My hope is that by reading this book you can follow in my footsteps and transform your relationships with people experiencing dementia and other challenges that can accompany aging.

There’s an urgency to my hope of course. At this point, nearly everyone knows someone who is experiencing symptoms of physical and cognitive changes that can come with age. Some are mild, not much more than a nuisance and a topic for bonding laughter at dinner parties. Some progress cruelly in ways that bring dramatic changes to every aspect of our lives.

This person might be your neighbor. He might pause when he sees you, squinting to try to recall your name, then turning and hurrying back to close the door before you have a chance to offer your usual warm greeting. This person might be your wife of many, many years—an unfamiliar knot of worry growing behind her brows, a slight, haunting distance when your eyes meet. This person might be your father, in your mind always regal and confident, now hesitant and uncharacteristically cautious.

With the numbers as they are now, with successes in public health increasing life expectancy across the world, we are in a new era of adjusting to the realities of living into late life and the range of changes that might bring—whether physical or emotional. How will we navigate them? As sons and daughters? As spouses? As neighbors? How will we navigate these changes as communities? As cultures? As a species?

Excerpt from Creative Care: A Revolutionary Approach to Dementia and Elder Care by Anne Basting. Published by HarperOne. Copyright © 2020 HarperCollins.