This transcript was created using speech recognition software. While it has been reviewed by human transcribers, it may contain errors. Please review the episode audio before quoting from this transcript and emailtranscripts@nytimes.comwith any questions.

From New York Times Opinion, I’m Lulu Garcia-Navarro, and this is “First Person.” In America, one in three seniors dies with Alzheimer’s or another form of dementia — one in three — which means that if you don’t know someone who’s dealt with cognitive decline yet, you almost certainly will. And yet, it is so uncommon to hear stories about it.

When actor Bruce Willis stepped back from the public eye a few months ago because of his dementia, it felt like an incredibly rare disclosure. So why is it that we don’t talk about this thing that’s so common? It can be incredibly hard to know what to do when someone changes, especially someone you love, someone you’ve known for decades.

It can be tempting to turn away from the change, to ignore it, to cling more tightly to the person we knew. But maybe there’s another way. Anne Basting thinks there is. Ann is an artist. She’s spent her life developing a different approach to communicating with people who are experiencing cognitive decline.

She believes that we need to make a world that accommodates, and even celebrates, people who are dealing with dementia. And my conversation with her actually made me feel optimistic about how I can connect with the people in my life who are forgetting who they were. Today, on “First Person,” Anne Basting on a better way to weather one of the hardest parts of aging.

Anne, I’d like to start by asking what set you down this path. What were your early experiences around aging and the changes that can come with it?

I think I was one of those kids who — I was baffled by kids my own age, especially in middle school, which you can have a lot of — let’s see. How do you describe them — mean girl?— at times of your life.

That’s how you describe them — “mean girls.”

And I just spent a lot of time alone. It was not easy, and my mom tried her best and put me into art classes. I was the only kid in them. And it was older people — people in their 50s, maybe. And they became my friends. I developed an easy comfort with people much older than me.

And when did you first notice that aging can also come with limitations?

I think —

I think the first real profound disability I encountered that was aging-related was probably my grandmother on my mom’s side, who — I was — I didn’t see her a ton, but I was pretty close with her. She was — I’d call her a little bit of a bossy storyteller. Then, she had a stroke that really — she could no longer speak or read, and she was a really avid reader. And that was really, really tough on her.

How old were you at the time?

That was probably through high school, and then into college. And there was a particular moment in college when I visited her in the nursing home, and I had never been there before. So it was that alienating feeling of walking down the hallway, the empty hallway, and the antiseptic smell, and the smells that the antiseptic smell is trying to hide, and just being shocked, kind of, by a new reality for her.

And she started to, with only, like, her finger and her — this one sound she could make, kind of, guide me through a story. And the experience of that — of me guessing — is it something inside the nursing home or outside the nursing home? Is it somebody I know? Is it a family member?

It was to end up with a really specific story that we, essentially, built together — that really profoundly affected my understanding of my role as a listener. I used to think there was telling and listening. And now, I see it’s a co-creative act.

So you’ve seen cognitive change in someone close to you. What was the moment you got interested in working with older people professionally?

So I was a fiction writer, a playwright, and also simultaneously, doing a PhD in theater studies, performance studies. I realized that a lot of the representation that we were looking at in theater stopped at about age 40.

And here, I came to this with a deep understanding and love of people much older than me. And I saw that as a place where I could kind of exercise my own, I think, natural impulses as well as comfort and expertise.

So I started both looking at representations of older people in performance and theater, and then also continuing to write roles for people. And I followed around senior theater groups across the country and wrote about how performance itself, which is, literally, taking on a new role — when you do that in late life, it totally counters, sort of, the narrative of decline and increasing rigidity. You’re, literally, expanding your roles through performance.

Anne finished her dissertation on senior theater groups, but she kept wondering about the people whose illnesses were so advanced, that they couldn’t perform — like people in care homes. What could creativity look like for them? So after getting her PhD, she decided to volunteer in a locked Alzheimer’s unit in Milwaukee.

It was profoundly sad and disorienting to be in that space. There were alarms going off, triggered by wrist or ankle bracelets from people with dementia, Alzheimer’s — and very, very loud televisions. People in the common room really pharmaceutically restrained, kind of, slumped over. And it was a place nobody wanted to be, including the people who lived and worked there.

What was it like for you as a volunteer? I mean, it sounds demoralizing.

I — you know, I had the power of being an artist and of my memory of my grandmother opening to share a story. And I just kept trying. I didn’t want to quit. I didn’t want them only to have the TV, you know.

And really, the only thing out there at the time was kind of what’s called reality orientation or reminiscence therapy, which is really trying to find the trigger to kind of dislodge a memory. People will say, today is whatever day it is. It’s this time. You’re in this place, thinking that that’s going to really heal and help the person.

Basically, the idea being that if someone isn’t in touch with the reality that you and I share, that that’s something to be corrected. That’s what you mean by reality orientation.

Yeah, your reality orientation is kind of healing by bringing the person back to where you are, grounding them in time and place. You know, I call it a noble impulse. It’s like that’s what feels like it’s broken, and so to go there to try to heal it by supplying it to the person.

So was the reality orientation working?

Um, No.

Week after week after week, there was about five — maybe four or five people I was working with, sitting around a little table. And sometimes they would pick up their head and kind of look at me, pushing through whatever cognitive or pharmaceutical fog was clouding them. And there was just no connection.

I thought, I just got to change tactics here. This is — this is not working. And so I, pretty much out of desperation, just ripped a picture out of a magazine, and I said, let’s try to make something up.

And the picture happened to be of the iconic cowboy of the Marlboro man character, with, like, a big wide-brimmed hat and profile in that dusty Western light. And I said, what do you want to call him? You can name him absolutely anything.

You know, and I’m so out on an edge at this point, just like, please say something. You can name him anything you want, and I’ll write it down. And they said, Fred. And then, I said, Fred who? And they said, Fred Astaire.

And I said, where do you want this to be? Oklahoma. And then, this was always like — to me — the cracking-open moment. Somebody started to sing, “Oklahoma.” And other people joined in. I joined in.

One of those musicals — I was like, thank you, Dad, for being in musicals. I actually the song. And they were with me for 45 minutes, singing and laughing. And that was just, like, so amazing to feel a contribution and a trust, and to feel the beginning of that process of shaping something together.

After that moment with the Fred Astaire story, I just repeated that over and over and over again in different settings. Could this work in adult day settings? Could it work in skilled care? Could it work in individual people’s homes?

Can I train students to do this? Can I train family caregivers to do it? Can I — homecare workers can — and so the next 20 years, really, were about repeating it, trying to boil it down into the simplest-possible process, and then give it away to as many people as possible.

Can you walk me through how it actually works? I mean, what does your approach sound like in practice?

Sure. So one of the people I started working with in, just, somebody living in their own home was a gentleman named Bill. He’s passed, at this point. But at that time, he had really deep communication problems, and some cognitive challenges, too.

And so Bill was living in Milwaukee alone at a care community north of the city. And I would visit him once a week, and I actually taped those conversations, so we could turn our creations into things we could share publicly.

The homecare worker, very commonly, takes my presence as an opportunity to do something else. So it was usually just me and Bill. And I brought with me questions of the day.

They’re just a question that would open the moment, and kind of poetically phrased, so that there’s no right or wrong answer. And we can build a story based on it together.

He told me a story about him being obsessed with pulling rocks out of the ground at his family farm up in Charlevoix, Michigan, and just what a folly it had become in his family that he was obsessed with moving these rocks.

I asked him to describe the farm to me. He said, well, there were songs. And you know, singing — I will always invite someone to sing a song, especially after “Oklahoma.” Right? It was like magic, because you can connect through song right away. And I said, oh, my gosh, what song? And he started to sing.

With singing, his voice was probably 10 times the strength, and no hesitation whatsoever. It was a total transformation for him.

So then, the next time I came back, I had an idea. He had told me this very funny thing about rocks. I said, what is it with you and rocks, Bill? You know? And he said, well —

He said, there’s no such thing as a new rock.

I just thought, we got to turn that into something. I had an idea to invite him to rewrite a song. I asked him if there were any songs about rocks, and we thought of “Rock of Ages.”

But the lyrics, we wanted to change, so we, together, wrote a new song, with his stories about Charlevoix, Michigan, and the family farm — really, the poetry of his stories — as part of the song.

There is such a powerful force in knowing that you are making something that matters. And people in that curious part of life often feel like they have no capacity to make things of value or be of value anymore.

So it had this dual impact — the interpersonal communication, and then the sense that they were contributing something in making and shaping something valuable.

As you’re talking about how you worked with Bill, it strikes me that the shifts you’re describing intentionally require, sort of, little from the people with dementia and much more, maybe, from the people around them.

That’s the hardest part, I think, is the willingness to set down those — that burden of holding who the person was so firmly and supplying all the memories for the person who is losing the ability to hold them themselves. It’s asking a person to live in loss and creativity, simultaneously. I talk about it like it’s a cloud — it’s not a cloud that covers the sun.

You can’t see or feel the sun anymore. It’s more like wearing sunglasses. You can simultaneously feel the warmth and the joy of the moment and be experiencing the sorrow. It’s OK to do both.

And if you do both, you’re going to connect with the person that you thought was lost to you. You just have to let go and be willing to move into the moment and where the person is right now. And that’s — that’s hard.

After the break, Anne finds out just how hard, when dementia enters her own family.

We were at a very busy pizza restaurant, and a family holiday with, maybe, 12, 15 people sitting at the table. And my mom turned to me and said, where’s Anne?

Anne spent decades of her life helping caregivers and people with dementia figure out better ways of connecting. But for the most part, her work stayed out of her personal life — until about five years ago.

I remember it really vividly. We were up at the family cabin. And Mom and I were washing and drying dishes — and dishes we had put away thousands and thousands of times in the exact places where they go.

And Mom handed me a bowl that had been my grandmother’s and said, where does this go? And that would seem like a really innocuous thing to somebody who hadn’t spent 25 years working with people with dementia. But what I heard in that moment was, the map in my mind of this kitchen is gone, and I don’t know where this goes. And that’s a real — that was a sign that her brain was changing.

You’re, obviously, at a very unique position of being both an expert in this field and a daughter. And I am wondering if there have been moments where it feels impossible to hold both those roles at once when you’re interacting with your mother now.

I never know when I go to visit her now — you know, I turn the corner. She’s on a memory care unit, in a very — I’m very lucky — very close to my house, so I can go visit her easily. And I never know, when I turn the corner, what I’m going to find in the room, where she is in the moment.

I try to hold that improvisational impulse and to open myself to it as I turn the corner and as I — our greeting for each other is, I say, hoo-hoo. And if she’s in the room, she’ll go, hoo-hoo.

She knows it. And it sort of gives me a gauge of where she is and how she’s feeling.

And one time, I remember, I had to push through, because I went in the room, and it was, like, two in the afternoon, and she was just lying on her bed, staring at the ceiling. And I thought, agh!

Where are the activities? I was like — I have to go talk to someone. And I kind of had this little burst of being upset.

And then, she looked so peaceful. My sister bought this beautiful, bright bedspread and big flowers on it. And I went over to her and just touched her arm. And she opened her eyes, and she smiled, and I said, do you mind if I lay down next to you? And I lay down next to her.

And we just rested together, both staring at the ceiling. I was like, gosh, this is really relaxing, actually.

And then, she started to giggle and laugh. And I started to laugh. And she’s like, what if somebody came in here? What would they think?

And I thought, boy, that was improvisation right there — to say, yes/and to the nap, instead of fighting it and getting her up and taking her for a walk. And that — I’ll remember sharing that laughter with her for a long time.

It’s making me think about my own experience with people in my life who have dementia. And something that I’ve seen that is common is that people get so frightened by this change and shut people with dementia away. I’ve heard people talk about them as if they’d already died, because they are so different from the person that they knew, and that it’s easier for them to think of them that way, because it’s so painful to deal with how much they’ve changed.

I think people get uncomfortable, and they don’t want to say the wrong thing. You’re worried you don’t know how to be in their company. But the isolation makes both sides of the care partnership so much worse. And I also say, no good care happens in total isolation.

Both people feel abandoned. And you know, I’ve watched this field evolve, and the research in social isolation has gotten so good, that we now really see that that could even be causing some of the symptoms, you know. And that’s part of the work of mine on the systems level — is just to get these incredibly simple tools out into the water.

It can be incredibly enriching. So now, we’re really trying to do the same thing in the systems that are reaching people at home, and working at a transformative level with memory cafes, which are these informal gatherings that are just safe, nurturing, stimulating places for caregivers and people with dementia to find each other. And usually, there’s just coffee and talk and connection, and then maybe 30 to 45 minutes of creative programming, and then another chance to socialize before you go home.

And just to understand — it’s just people come together to reminisce? I mean, what is it that they do there?

So you’d walk into a memory cafe. Say, there’s one in my little village of Shorewood. The cafes and grocery stores — some of them are in libraries. One’s at a botanic garden.

One’s — it’s normal life, right? Normal places where normal people who happen to be having some cognitive challenges can go and find each other. And there’s, I think, currently, 900 of them in the United States.

And I’m like, we’re doing it.

We can send them in all the libraries. We can put them in all the arts and culture institutions. They can be in the cafes in grocery stores. There is no reason why that supportive infrastructure shouldn’t just be everywhere.

I mean, you sound really animated when you’re talking about this. Because it brings together all the things that you’ve been talking about, which is community, learning, creativity, and connection.

It’s that simple, right? And the other thing is, I am a firm believer in research, but I’ve gotten a little tired of hearing, we need more research on this, we need more research on this. Meaningful social engagement and a sense of purpose and joy in your life — we can research that for the nuances and details, but we should also know at this point that we’ll die and not thrive without that. And we should be making that available to people through every system that we can.

As I’m hearing you talk, it feels broader to me than, simply, dementia care — that somehow, we shouldn’t be afraid of people changing even if it’s painful.

You know, once I, kind of, successfully — and I feel like I’ve got it down now — this simplicity of this communication technique and infusing creativity into relationships. I now see that I happened to start on that locked Alzheimer’s unit, but it’s infused into every relationship I have in my life, every encounter I have.

Every system can have this poured into it. And it just — in some ways, it happens to have started with people with Alzheimer’s and dementia, but it can really be applied to absolutely any human being.

Anne, thank you so much.

You’re welcome. Thanks for asking the questions.

That’s Anne Basting. Her organization is called, Time Slips. And her most recent book is “Creative Care: A Revolutionary Approach to Dementia and Elder Care.” “First Person” is a production of New York Times Opinion. Tell us what you thought of this episode.

Our email is firstperson@nytimes.com. And please subscribe to our show wherever you’re listening. This episode was produced by Sophia Alvarez Boyd and Rhiannon Corby. It was edited by Anabel Bacon and Kaari Pitkin; mixing by Carole Sabouraud; original music by Isaac Jones, Sonia Herrero, Pat McCusker and Carole Sabouraud; fact-checking by Mary Marge Locker.

The rest of the “First Person” team includes Stephanie Joyce, Olivia Natt, Wyatt Orme, Derek Arthur and Jillian Weinberger. Special thanks to Kristina Samulewski, Shannon Busta, Allison Benedikt, Annie-Rose Strasser and Katie Kingsbury. I’m Lulu Garcia-Navarro.