The expression, "It isn't whether you win or lose, but how you play the game" is the gold standard principle in using recreational games with those with Alzheimer's disease. Playing games with people who have Alzheimer's disease can help in some important ways. First, games are a great way to connect and feel normal, especially if playing games had been a part of the person's recreational life prior to the onset of the disease. Second, playing games can help exercise the parts of the brain that are still functioning well, although some adaptations may be necessary. Third, games can provide an avenue for reminiscing, often bringing up memories of times long since past. And lastly, games are above all a social activity and can provide a wonderful way to break the ice in a new relationship, such as that of caregiver or companion.

Before shuffling the cards or setting up the board there are some important principles to remember.

First, keep it light. Don't set up playing a game as any kind of test of how the person is doing. Although I use games frequently in my work as an occupational therapist, I hope that the person quickly forgets that we are there for therapy, so that they will relax and enjoy themselves. So much of the day of an Alzheimer's patient is filled with difficulty, confusion, loss, and unfamiliarity. One reason I use games therapeutically is to create an oasis of normalcy. Memory lapses, confusion about the sequence of events, fumbled strategies, unexpected trips to the bathroom and other interruptions, are to be taken in stride. Do not even mention them.

Second, set the person up for success. If the person can't physically handle the pieces, find bigger ones, or move the pieces for them. You may have to write for the person or use large print cards. You may have to tell them when it is their turn, and even point out the move they should make. I've found that none of that matters. What matters is that you're taking the time to be with them.

Third, set yourself up for success by adjusting your expectations. It's impossible to predict what will work until you try. You may at first pick the wrong game, or attempt to play at the wrong time of day. Your friend with Alzheimer's may suddenly become too sleepy, agitated, or want to do something else. You may not finish the game. You may reach an impasse. The beautiful and forgiving thing about being with someone with Alzheimer's disease is that even if nothing goes "right,"

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