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Karla Elling wanted to show her appreciation to the nurses at Scottsdale Village Square who had treated her father with dignity during his final days, as he struggled with dementia. Most people would have sent a fruit basket. Elling sent poets.
Elling -- a spirited woman with hippie-long gray hair and an ancient orange van -- had been running community poetry workshops in schools and homeless shelters for years as coordinator of Arizona State University's creative writing program.
But she'd never thought of doing it in a place where fathers don't even recognize their own daughters, a place where people with Alzheimer's disease and other forms of dementia come to live until they die.
Elling and Joy Phillips, then the director of nursing at Scottsdale Village Square, had a hunch it would work, though, because of a patient named Alice Mae Lisi.
The late stages of Alzheimer's had stolen Alice's ability to talk, but she could still walk, and she wandered constantly around Vistas, the locked ward at the nursing home. One day, as Alice paused at the nurses' station, on a whim Phillips handed her a piece of paper and a pen, and Alice began to write. She wrote a few lines, then walked, then returned to write more. The scribblings made no sense to Phillips, but Alice seemed more at peace, relieved to be expressing herself.
So Elling and Phillips gathered a few Vistas residents, and once a week, three ASU-trained poets prompted them with questions, stimulated their senses with props and acted as scribes for those who could not write. They added line breaks to make the writing look like traditional poetry, but the words came directly from the dementia patients themselves.
That was 1992, years before Ronald Reagan's family admitted that the former president was losing his mind because of Alzheimer's, turning the disease into a household term overnight.
Long before researchers proved that dementia patients are much better off reminiscing in an imaginary world than listening to the daily news read aloud in the real one, Karla Elling and her poets knew it intuitively.
"I knew my dad," Elling says. "And I knew that when I talked to him, even though he didn't know me, I could talk the old stories, the old names, the right towns, and he would come up with connections that just blew me away. . . . He was happy when we could go through these old stories."
As a daughter, Elling knew too well the struggle family members go through to communicate with a loved one who just doesn't make sense anymore. Who better, she thought, to help draw out these connections than poets, who strive for what often comes naturally to a person with dementia: expression that is nonlinear, emotion-packed, inhibition-free. And who better than people with dementia to teach poets to write more freely?
"It's like every person is a treasure, and you have to figure out how to get in there, even if it's briefly," Elling says.
Alice proved her right. In that first workshop, Alice created a jewel that was published nationally and hung on a wall at Juniper Library in northwest Phoenix. It is called "Cloves":
A little girl think year
with some grass amid the house
and dark vegetables getting
further away in the year
for a green thought.
In the spare time,
in the house next
to the spruce and the wheat.
In the urgent house,
the house of cleaning,
the house in the trees
in the time of the heart
amid the fish.
In that place is
a good trip
on this paper.
Alice had died by the next semester. But Kara Elling kept sending poets.
Elling hand-picked topnotch nursing homes whose staff understood the value of activities. And she hand-picked the poets, sending them into the nursing homes with only the briefest facts about dementia and virtually no teaching instruction that might inhibit trying something new. With props ranging from real flowers to fake bugs, they have recorded poetry in bound notebooks, on video, in performance art pieces. A $6,000 grant this past school year sent six poets to three nursing homes.
This summer, at Elling's behest, two of the poets, Argie Manolis and Trish Murphy, are working on a book explaining the techniques used over the years, with the hope that caregivers, family members and other poets can apply this loosely conceived model.
Terry Lisi, Alice's son, thinks that's a great idea. He didn't learn of his mother's poetry until after her death, but he is delighted to have it now, and recalls that cloves were her favorite cooking ingredient; growing up, the Lisi house always smelled like cloves. Lisi also believes teaching families how to write poetry with Alzheimer's patients would be valuable.
"When they get to that stage that my mother was in -- and let's face it, they all get to that point, some sooner than others -- as a loving family member, you don't know what to do [when you visit]," he says. "You just kind of stand there and look at your feet."
In writing the book, Manolis and Murphy face the challenge of explaining why anyone should run poetry workshops for people who don't know what they are creating and can't appreciate it once it's finished. Does it matter that creative intention is lacking?