(gentle music) - [Amanda] Funding for Compass is provided in part by: The McKnight Foundation; the Otto Bremer Trust; and members of Pioneer PBS.

Thank you.

Next on Compass.

- [Diane] We have beautiful singers in our group.

We have care receivers and caregivers.

- [John] There's no point in trying to make a secret out of this thing called Alzheimer's Disease.

(upbeat music) (calm piano music) - We have beautiful singers in our group.

(group singing) We have care receivers and caregivers, and it just balances everything perfectly.

But you don't have to be an excellent singer to be in the group.

♪ When the stars begin to fall ♪ - I think the community sees this group- - Yeah.

- ...and is encouraged by it.

- Yeah.

- So, you know, you don't- - We all have gray hair.

Or white.

- [Amanda] Or white.

- If we have hair.

- [Amanda] If there's hair at all.

- Yeah.

(interviewer laughing) - [Jan] A good warmup song today, let's do tab four.

Amazing Grace.

(soft piano music) ♪ Amazing grace ♪ - My name is Jan Lerohl.

I am currently the senior advocate here in Granite Falls.

I also work with the Building Bridges Memory Choir.

The Building Bridges Choir is actually part of a program called Act On Alzheimer's that was started here in Granite Falls, I believe in 2016 by the Living at Home Block Nurse Program.

- [Amanda] Act On Alzheimer's is a statewide network that helps communities improve Alzheimer's related care, support caregivers, and decrease stigma around Alzheimer's.

The Building Bridges Memory Choir is for people living with various forms in various stages of dementia and their care partners.

The choir meets every Thursday morning at St. Paul's Church.

- Dementia is a, think of it as a large umbrella, and underneath that umbrella there are different memory issues.

Alzheimer's is the one that maybe is most familiar.

They're all kind of related with memory and communication.

- [Amanda] In 2016, Granite Falls was designated a dementia-friendly community through the Act On Alzheimer's Initiative.

The Living at Home Block Nurse Program identified three focus areas.

Dementia related community education, caregiver support groups, and using the arts to provide meaningful social interaction.

- [Jan] In a dementia-friendly community my view is that people in a community are aware of people who may be experiencing this and are more sympathetic but we want people to realize that have these conditions that are dealing with this is that they can do anything anyone else can do.

They just wanna be included.

They wanna be part of the communities.

- [Amanda] John Linden and his wife Diane Linden, sing in the choir.

John is a retired pharmacist and Diane is retired from teaching special education.

- Well, Diane and I are not singers, so, coming- - He didn't have to mention that, are you kidding?

- Coming to this, we had to spread our wings.

So a lot of the people that are coming to help, to be with maybe one of their friends or they're a caregiver maybe they haven't been in choirs either.

So it's been, I think it's a really a building thing.

- [Amanda] Do you consider yourself singers now?

- Yes, of course.

- [Amanda] Yeah.

- Sure.

- [Amanda] Oh, yeah.

- We can do it.

- Yes.

- We can do it.

(coffee grinding) - [Amanda] The Lindens also work behind the scenes to make rehearsals run smoothly.

- [John] We usually get here about 15 minutes to 8:00 and then I gotta get the coffee going right away.

That's one of the most important things.

- [Diane] And they come trickling in about 20 to 9:00.

And by the time nine 10 arrives we've got chitter chatter all over the room because they're just enjoying the fellowship of each other and being together.

And we've really become, I would say, a family.

(indistinct chatter) - They come earlier every time so that they can sit and visit, because they don't see some of them- - Yeah.

- ...for the rest of the week until the next week again, then they come early to visit.

- This socialization of being able to sit down with people and visit across the table is huge and they enjoy it so much.

So why don't we warm up?

You can stand or sit, it's up to you.

So let's, oh yeah, let me just...

I feel out of place today (laughs).

- [Speaker] You're over this way.

- Yeah.

I'm usually back a little farther.

I don't even know where I'm going.

(all laughing) I worked as an elementary music teacher for 33 years, and I loved that the age group K-6.

We just did a lot of echoing back and forth, whether it was learning the tune or melody to a song or rhythms, that was just part of my natural training.

When I was asked to do, be the director of the Building Bridges Choir, I thought: Well, okay I have that background but I also attended the Giving Voice Initiative.

- [Amanda] The Giving Voice Initiative is based in Bloomington, Minnesota.

It was started in 2014 as a way to create wellbeing for people living with dementia and their care partners.

And to reduce the stigma around what it means to live with dementia.

Eyleen Braaten is the executive director.

- For some reason, the areas of the brain where music memory was held was being impacted last when people are living with Alzheimer's.

- [Amanda] The Giving Voice Chorus participated in a health partners study, looking at people living with dementia and their care partners.

The study was conducted in two phases: The first looked at the effects of four and eight months of choir participation; and the second examined the effects of one rehearsal.

Phase one preliminary results showed an improvement in feelings of depression by 50% in care partners and 30% in people living with dementia who were tested.

And people in phase two self-reported improvement in overall mood states.

- So not only did you see a significant elevation in mood or just, you know, self-assessed, do you feel like you are capable of doing X, Y, and Z?

It was significant.

- [Amanda] But this was a very small study involving about 20 people in phase one, and 25 in phase two.

- So you know, we're doing everything we can to continue research because there just isn't enough out there.

Because we can tell you that their mood is improved or their cognition is improved.

But we want brain stats.

We had a really cool opportunity to perform at the Ordway in 2018.

And that's a big venue.

- [Amanda] Yeah.

- And that's a lot of, kind of pressure on any performer to be under the big lights in a big venue.

And we had a duet, which were actually just two good friends, that were singing with us.

And the man was living with Alzheimer's, and his friend, she was just singing with him as a volunteer to be his partner.

And before the concert, she didn't voice this to us but she was really apprehensive, because she kind of felt like, why are you putting him through this?

Like, I understand you want us to sing at rehearsal and it's great and it's full of joy and I'm so glad I get to go with him every week because we have so much fun.

But why do you need to put him through this performance because he's gonna be on stage and it's gonna be uncomfortable?

And we didn't know this at the time, she wrote us a letter afterwards.

And she said, when they got on stage and she saw his face light up when he saw his family in the audience, that it totally clicked why we do this.

Because that is a gift that he can give his family who probably takes care of him all the time that he never gets to give back.

And he was up on that stage singing his heart out to his family.

And people with Alzheimer's don't get asked to do that anymore.

They're always needing the care and needing the help.

And so she said: Oh my gosh.

For me, it totally clicked.

Of course, we have to do this.

Because it's so important when these people are singing you can't tell who has Alzheimer's and who doesn't.

As an organization, we wanted to create a replication process that would be a worldwide movement.

And so we worked really hard to produce this toolkit, sort of a step by step guide in how you could create your own chorus.

- I like to choose music that I think is familiar that's part of this concept.

If there is a tricky rhythm or a melody or something that's where this echo clapping that you saw us do comes in handy.

Because when you repeat it physically you have a better chance of remembering it.

Would you please clap on any word that starts with a B.

(gentle piano music) ♪ My (claps) Bonnie lies over the ocean ♪ ♪ My (claps) Bonnie lies over the sea ♪ ♪ My (claps) Bonnie lies over the ocean ♪ ♪ Oh (claps) bring back my Bonnie to me ♪ ♪ Yeah (claps) bring back, ah bring back ♪ ♪ Oh (claps) bring back my Bonnie to me to me, to me ♪ ♪ Yeah (claps) bring back, ah bring back ♪ ♪ Oh (claps) bring back my Bonnie to me to me, to me ♪ (group laughing) ♪ Good morning, good morning to you ♪ - [Jan] You're sounding good.

Good morning everyone.

- [Group] Good morning.

- [Jan] John's gonna come and talk to you.

Diane couldn't come today, so I thought, he'll give you a little update, okay?

And then we'll go from there.

- Thank you.

- Thank you for coming.

- Good morning.

- [Group] Good morning.

- Diane had all plans on coming today but last night she's been struggling with the fluid problem and with some blisters and different things on her feet.

And so she's not getting around very well.

And she just wanted you to know that she's thinking about all of you and how much she loved being here and knowing and being a part of this.

- It started out in December when I was diagnosed with cancer for the fourth time, by the way.

I hope that gives people encouragement.

But I think tomorrow I'm gonna go and visit the choir for the first time in all those months.

And I'm coming back differently than when I left.

When I left, I was this bubbly, kind of wild 80 year old and now I'm going back a little bit different.

- Hi.

- Hello.

- Hello.

(group clapping) - Good to see you.

Hi, John.

- Hello.

- Do you wanna say something to them?

- Yeah - Why don't you come a little closer.

- Oh my God.

- Oh, yes.

- For, for someone who does not like this part of things I can't imagine I'm here, but I'm so thankful that I am.

And it's been one thing after another, but I just wanted you to know that I don't think I would've made it without your prayers.

And I mean that, sincerely.

(group applauding) So thank you.

Thank you, thank you very much.

And gee, by the fall when we start again, we're gonna have lots of fun.

♪ I long to see you always ♪ We cannot express, we give and we share but what we get back is astronomical.

♪ A way ♪ ♪ I found a way ♪ ♪ Across the wide Missouri ♪ - [Jan] You guys are so good.

(group giggling) - In a small town like this, where we've been here for a long time and well, I guess pretty well known in town, I decided that there's no point in trying to make a secret out of this and just not let anybody know about this thing called Alzheimer's disease.

(soothing violin music) My name is Tom Birkey and for all intents purposes, I'm a retired physician, a general practitioner or now they call 'em family practitioners.

- Dr. Tom Birkey moved from a Milwaukee suburb, Wauwatosa, to Richfield, Minnesota when he was about seven years old.

- I got an old family album to show you my hero who's my great grandfather, Sherman Ballard.

He's my beard model.

Yeah, you might say that.

That's what got me into liking history and especially history where the farm was and why they came there in the first place.

I've pretty much done my Swedish and my German history but my English history, I still gotta work on.

And I'm hoping that I have the memories or some of the papers that are down there to do it.

- [Amanda] But having the photos helps trigger.

- Yeah, very much.

- [Amanda] Yeah.

- Yeah.

- [Amanda] Dr. Birkey graduated from Washburn High School in Minneapolis in 1954.

And from there, moved to pre-med then medical school at the University of Minnesota.

- This was our whole fraternity together.

And what will this be?

Oh, yeah.

This is my university Bachelor of School of Medicine, class of 1961.

And I'm somewhere here.

And then after that, I, I said I was in the Navy as a naval flight surgeon for two and a half years.

That picture is when I was in the Navy, yes - [Amanda] Had no beard.

- No beard then.

(both laughing) - But I've had one ever since 1970, so.

- [Amanda] But Dr. Birkey's true professional physician's passion was to work as a small town general practitioner, a small town doc.

This dream stemmed from time spent visiting his grandparents in Flag Center Township.

- Yeah, I need to go back to about when I was 11 years old.

(upbeat music) Flag Center is where I spent some of my summers.

Flag Center was about half the size of Watson, I would say.

I mean, it's a really small place, but I loved it.

- [Amanda] Dr. Birkey has two distinct memories.

Two encounters with a small town doc in Rochelle, Illinois during his visits to his grandparents that inspired him.

One when he got a fish bone stuck in his throat and the other involved a rotten apple fight where he caught a piece of foul fruit with his eye.

Typical kid stuff.

(upbeat music) - I was kind of glad that I did have a bone in my throat and apple in my eye.

And I had that experience and I'm not sure up to that point that I knew that I wanted to be a physician and I knew that I wanted to be living basically in a small town environment.

- [Amanda] Dr. Birkey was also one of the first to host medical students from the University of Minnesota's Rural Physicians Associate Program.

He's dedicated his career to educating and advocating for rural physicians, for the health of the people in the community, and for the health of the profession.

And now Dr. Birkey is embarking on the next phase in his healthcare journey.

He suspected that he was developing Alzheimer's disease in early 2022.

Dr. Birkey and Doris Thompson have been married since 1997.

Viewing this journey as a care partnership is important to them.

Making sure they're doing things like eating healthy and exercising for both of their benefits, for example.

- We've both been talking about it before the diagnosis was made, but I'm learning to be, I'm patient about this because I would want him to be patient with me.

So I try to keep that in mind that I listen and I can repeat it, you know, and I can repeat it and I don't get upset or well, don't you know, that kind of stuff.

- Yeah.

- I don't do that at all because I don't wanna be in that position myself so I can feel what he's feeling.

- Main thing is memory, and that's, I worry about that because at least in my life, I'm sure I've had a couple things that were not fun to go back and dwell on or anything like that, but mostly I have happy memories.

And the idea that someday as I'm not gonna be able to pull those up into my mind and for sure, almost, I won't be able to talk to somebody else about it.

(soft music) There was a time when I could start, most of the, I could say: Well, that's a Beethoven, I'm quite sure.

And then I could probably say I think that's Beethoven's fifth or sixth or something like that.

And I was pretty good with identifying birds too, and I could say that this is- - [Doris] And trees.

- And trees and trees.

Yeah, trees particularly.

Yeah, I could name a tree by looking at its leaf and looking at its bark.

(soft music) This is a- - Catalpa tree.

- A what?

- You call it Catalpa.

- Catalpa.

- I call it catalpa.

- Yeah.

- See it's getting all those beans?

- [Amanda] Yeah.

- Yeah.

And this is an ash tree over here.

- This tree here is still doing okay, even though it lost that great big part of it.

- What is that?

Is that another ash tree?

- That's an ash.

- No, that's a.... With a rough trunk.

Oh yeah, now I'm losing it.

This has a real rough trunk on it and it lost part of the- - Box elder?

- Box elder, yeah.

(soft music) - Being a care partner is so being solicitous of them.

- [Amanda] Dory said that she's the most proud of Tom for being open about his diagnosis and approaching it as he approaches learning about tree types, gobbling up as much information as he can about Alzheimer's disease and how to live well.

But Dory has been the same, going one day at a time, learning as much as she can, being honest about what she's still working on, and making sure to take time to take care of herself.

- [Dory] Oh, Gretchen has a care or support group and I think we pick up really good things to know.

(upbeat music) - I'm Gretchen Reeves, I'm a speech language pathologist, and I work at CCM Health.

but I specialize working with people who have dementia because it affects their ability to recall things and to communicate In dementia people have not only difficulty with memory, but they also have difficulty with language.

So they might have difficulty finding words, stringing words together to make a complete thought, staying on track in a conversation.

So those language deficits also negatively impact a communicative interaction with people.

So one of my big jobs is to educate the people around the person with dementia and help them understand how they have to change, how they interact with the person with dementia.

- One of the main things that we have had to change is to be more direct in our conversation and our needs.

I'm learning to be more direct and I'm not putting in three or four or five different things that need to be accomplished.

- One of the services that CCM Health offers it's called the Dementia Care Partner Support and Education Group.

It's a group designed specifically for the care partners of people living with dementia.

So they come to a support group once a month at the CCM Wellness Center.

And I feel like you're a better care partner the more you know about the disease.

Then we have MAMLN, the Montevideo Area Memory Loss Network.

- [Amanda] MAMLN is a group of healthcare providers who work with people living with dementia and their care partners.

Reeves participates in MAMLN as a member of the CCM Health Memory Care Clinic.

The clinic offers speech pathology and occupational therapy assessments, plus the medical appointment as an alternative to the traditional neuropsychologist or neurologist dementia diagnosis which can be hard to find in rural areas.

- But what we like about our process is if there is a diagnosis made they're just not pushed out the door.

We stay in touch with those families over time because as the disease progresses the care partners needs also change.

- The hardest part is when I need to say something and that I think needs to be done.

And it might just be me thinking it, you know maybe Tom doesn't feel that way at all but I'm feeling like, I don't think that's you need to wear this holey sock today (both laughing) but it's just Tom's choice and I can let it go.

And I think that's a skill you learn with people who have Alzheimer's and you're the caregiver.

Is that, does it really matter?

- I think it's important to talk about dementia as a whole in our community because we are aging.

And right now, if you look at the statistics in Chippewa County, Lac qui Parle, and Yellow Medicine there's approximately 650 people living with dementia.

10% of people over 65 have some degree of dementia and almost 50% of people over 85 have dementia.

So the more we understand the disease the more the public is aware of, of early signs, you know and getting a diagnosis earlier so that medications can be attempted so that families can be educated on how to best support that person, the better.

- [Tom] I'm not sure that all my memories will be wiped out but I'm reasonably sure that I'm gonna have a hard time necessarily talking to somebody else about it in any detail about I was doing this in college or taking that kind of course or then I met Dory and that sort of thing.

I'm not sure that that's gonna hold up my memory.

- It's just a journey, it is a journey.

And every day is, we think about it and we don't look too much into the future.

It's just, let's live our days.

And mostly for through our marriage, we've sat at breakfast and we have said our grace and counted our blessings.

So we do what we can.

And that's another thing we say, help us to do the best we can with what we are able to do.

And so that keeps us in a more positive mode for the day.

So, I just think we're doing well with it.

- [Amanda] Funding for Compass is provided in part by: The McKnight Foundation; the Otto Bremer Trust; and members of Pioneer PBS.

Thank you.

(gentle piano music) (upbeat music)