While discussing the challenges of providing care to patients with dementia in a clinical conference, I mentioned that the patient's inability to communicate was the greatest obstacle to providing quality individualized care. A colleague presented an interesting response noting the person with dementia does communicate, though not in the expected or usual manner...

"the challenge for us is to enter the person's world and use our knowledge, senses, and abilities to understand their needs and provide appropriate care."

This change in perspective should be considered. Rather than viewing the person with dementia as unable to participate in meaningful communication and being impossible to understand, we can use research results and creative strategies to bridge the gulfs of confusion-both theirs and ours. This special issue of HHN will show you how.

Through centering and patience, expert assessment and symptom management, music and massage, knowledge of disease process and problematic behaviors, and owning the problem of honing our communication skills and approaches, we can be better practitioners and communicate hope and assistance to those devastated by dementia. Each of these vantage points is considered in the many interesting subjects in this issue.

It's been exciting to work with the talented authors who've shared their expertise with you. Like you, they are committed to improving the knowledge and skills needed to provide compassionate care to those coping with this illness.

In The Notebook (1999), author Nicholas Sparks captures the story of the love and devotion of a husband whose wife has end-stage dementia. Noah Calhoun persisted in his daily efforts to communicate with his wife even when her disease was far advanced and others had stopped trying. On certain days he was successful and the encounter was indeed meaningful. Other days he was not so lucky, but he never gave up! Noah continued to see his wife as the cherished individual he had known and loved for many years.

As professionals, we can learn from Sparks' example. We can honor the individuals and treat them with respect, maintaining their dignity regardless of the disease progression. We can continue to communicate and understand and celebrate successes while connecting with our patients, improving their quality of life and instilling hope in their caregivers.

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