Michelle Bourgeois, professor, speech and hearing science, is part of a group of scientists whose work marks a sea change in how caregivers deal with people who have dementia, focusing on what they can do rather than on what they've lost. With support from the National Institutes of Aging (NIA) and the Alzheimer's Association, Bourgeois is leading the effort to systematically investigate the use of memory aids with persons with dementia residing at home and in institutional settings.

Alzheimer's disease, which affects up to 5.3 million Americans, first strikes the hippocampus, the part of the brain that is critical for learning and memory processes. Typically, long-term memory and certain kinds of skills like reading (which is overlearned so it is automatic) are less afflicted.

"Even when dementia is so advanced that people cannot speak, they can read if the words are large enough," Bourgeois explains. "We know because they smile, make pleasant sounds, and stroke photos of loved ones with captions."

In contrast, she says, "Spoken words literally go through one ear and out the other. Patients understand, but they can't store the memory. That's why they ask the same question again and again."

Bourgeois has taught thousands of caregivers her methods, and they've taught thousands more. When she discovered over 20 years ago that memory could be reclaimed with simple tools, she set herself a high goal -- one she still holds: "I want families to remember these as happy times in their lives."

Bourgeois' work grew out of her PhD research in the 1980s, when she developed some of the first memory books, which use pictures and sentences to help people with memory problems -- including Alzheimer's patients -- recall past events. Bourgeois is the author of the book, Memory Books, and Other Graphic Cuing Systems: Practical Communication and Memory Aids for Adults with Dementia and co-author of the recent book, Dementia: From Diagnosis to Management.

With a grant from the Alzheimer's Association, Bourgeois hopes to next dispel the belief that Alzheimer's makes people miserable. Using pictures with captions, she is asking patients about their quality of life. "We find that if caregivers aren't stressed and in a hurry, if the patient is well cared for, and if they feel safe and in a good environment, they think their lives are good," she says.