invisiblemikey wrote: I worked in a specialized dementia care facility for nine months as both a caregiver and medication aide (nurse delegate). We had 25-32 residents with not only Alzheimer's but also vascular, Lewy bodies, you name it. Ages 50s to 100+. I am near retirement age, so I could not continue, as it was too physically risky for me. The young ones bounced back from injury with two weeks of PT. The ones over 55 ended up with joint replacement surgery. I loved the job, but I'm needed to help care for my wife, whose own career was ended by injury. In addition to six ambulatory patients, each caregiver had responsibility for four adults who were semi-or completely immobile, though they still communicated even if just by eye contact. By comparison to the physical risks of caregivers being injured (back strain, knee injuries, shoulder problems), the creative management of resident behavior was a breeze. We did band together fluidly in pairs or even trios for lifts, feeding and toileting, but most residents still had at least one incident of combative behavior, and we couldn't always see it coming. I did enjoy Elizabeth's story, and we had some easy, pleasurable residents like her too, but most of ours had diabetes or other restricted diets because of non-dementia conditions unrelated to their mental state. We couldn't have used food-induced reinforcement. In case you might enjoy my own stories, here are some of the posts I wrote about it: http://invisiblemikey.wordpress.com/2010/04/30/make-me-a-saint-already/ http://invisiblemikey.wordpress.com/2010/05/02/endless-rewards/ http://invisiblemikey.wordpress.com/2010/05/24/destination-unknown/ http://invisiblemikey.wordpress.com/2010/05/27/from-here-to-there/ http://invisiblemikey.wordpress.com/2010/06/13/sweet-little-lies/ http://invisiblemikey.wordpress.com/2010/10/01/the-grid/ http://invisiblemikey.wordpress.com/2011/02/08/deep-river/ This is as close as I got to providing a place for people to respond with their own stories of Alzheimer's and caregiving. Perhaps seeing the responses I got will help you. Good luck!