This is Puppy. (Puppy’s the one on the left.) Puppy is a stuffed animal. Puppy is not real. 
Several months ago, my sister and I realized it was time to move my mom from the assisted living floor of her Senior Living center to the more structured, protected area designed specifically for residents with dementia and memory-care needs. Moving to this area meant that my mom would not be able to keep her dog Bonnie with her anymore. My mom had reached the point where she wasn’t able to properly care for Bonnie and she was going outside and wandering around more frequently with Bonnie which caused fear that her “sundowning” (Alzheimer’s patients have a tendency to wander in the evening hours, often becoming lost and/or incapacitated) would lead to a scary, dangerous situation. The only downside to moving her would be the loss of Bonnie who had been her only source of constant, 24-hour comfort.
With the advice of the staff at her residence center, we decided to make the move, whereby Bonnie would live with me, and my mom would move into the secure wing. It was a difficult transition as we knew it would be, but within a week of her move, my mom had transitioned into her new room and living situation and adjusted better than I’d ever expected.
A few days after the move, my sister and I decided to get her a stuffed dog to ease with the loss of Bonnie. Alzheimer’s patients eventually regress to a childlike state, and many times, patients are comforted by things like baby dolls, so we decided a stuffed dog couldn’t hurt. Little did we realize what a life-saver this toy dog would become.
During the first week after her move, my mom would carry Puppy (because we couldn’t land on a name and Puppy seemed as good as anything) around and would say things like “I know she’s not real but she’s just as cute as can be and so soft.” The second week, Puppy’s story became “She used to be a real dog but she’s not anymore and she’s just as cute as can be and so soft.”
By the third week, Puppy was real. Not just “formerly real” but real. Live. And still “as cute as can be and so soft.”
Here’s what I know about Alzheimers and dementia: you just go with it. Reality doesn’t matter to them anymore, so don’t correct them. Embrace their reality. When people ask me how my mom’s doing, I tell them she’s doing really well. And she is. She isn’t in any pain. She isn’t angry. She isn’t suffering. She doesn’t know that she’s lost who she was. She lives day to day.
Alzheimer’s sucks. It is an awful disease that has taken away my mom. She thinks that my sister and I are her cousins, she doesn’t remember that my dad died, and she doesn’t remember her grandchildren’s names. But she’s not in any physical pain, she’s not in distress, and for that I’m so very grateful.
The plus side of this is that now we have Puppy. Puppy has become a very real part of our new normal lives. Puppy has become a source of hilarity for my sister and I. 
Puppy has brought an entirely new creativity to text conversations between my sister and I.
Puppy is a vital part of the family and plays the most important role in my mom’s life. Puppy is so important that, in addition to Original Puppy (the O.G. Puppy) who lives with my mom, Backup Puppy 1 and Backup Puppy 2 are riding around in the back of cars to be brought into the game in case OG Puppy goes missing.
Here’s the other thing about my mom’s Alzheimer’s. She doesn’t know that I’m her daughter, she doesn’t know that her husband of 55 years died a year and a half ago, but she still has foundational relationships. She may think I’m her cousin, but when she sees me or my sister, she knows that she trusts us and we will take care of her. She can’t follow a story line or plot in a book or movie anymore, but she still writes down Bible verses in a notebook. She carries her Bible with her almost as much as she carries Puppy with her. Those foundations in her life remain, despite so much else in her history that has fragmented away. So when people ask me how my mom is doing, I say she’s doing really well. She’s carries around a stuffed animal that she talks to and thinks is real … but when I walk in as she’s taking a nap and find Puppy at her side, I know she’s doing really well. I remain grateful.
P.S. You can follow more of Puppy’s hijinks on Instagram: @alzpuppy. 