Every two weeks, Mike Van Rysin, 75, and his sister Kathy Morrison, 71, take their 82-year-old sister, who has Alzheimer's disease, to a "memory café" at the Atlas Coffee Mill in Appleton, WI. The gathering, one of eight Wisconsin memory cafés run by the nonprofit Fox Valley Memory Project, is designed to allow people with dementia and their families and caregivers to socialize without being embarrassed by memory lapses, repeated questions, or even silence. At memory cafés, the challenges of dealing with dementia are understood and embraced.

Judgment-Free Zone

"People know they can relax and have an enjoyable time without any shame," says Susan H. McFadden, PhD, professor emerita of psychology at the University of Wisconsin-Oshkosh and the research and development consultant for the Fox Valley Memory Project.

At one gathering, for example, a woman with dementia brings a doll, and rather than look away or snicker, many people comment on her lovely baby, and the woman smiles sweetly, says Dr. McFadden. "In other settings, I think her husband would probably not feel comfortable having his wife hold a doll, but in our memory café, he knows she's accepted and both are supported."

Morrison says that although her sister participates in a limited way, she really responds to the kind and loving environment. "It's wonderful to see her enjoying herself and interacting a bit."

Appropriate Activities

Some groups use the meetings as informal opportunities to chat. Others schedule speakers or entertainment. The first gathering Van Rysin and Morrison attended with their sister had a train theme. Participants were invited to recount stories or sing songs about trains. Most groups offer food, which promotes the social aspect of the gathering, but the meeting doesn't have to take place in a café or restaurant. The memory café at the Penn Memory Center in Philadelphia, for example, is held at a local church, and a local restaurant provides the food. Groups can reach out to hospitals or local organizations for funding, space, and food.

A Different Kind of Support

Memory cafés are not considered formal support groups, but rather places where people can compare notes and get a break from daily routines, says Debora Tingley, PhD, a gerontologist at San Francisco State University, a memory café developer, and coordinator of Memory Café Catalyst, an online community of about 100 cafés. "Friendships that develop at the café are often therapeutic and provide respite," she says. "The common element seems to be creating a space where people can connect socially and experience a 'normal' get-together with friends." For that reason, café organizers tend to avoid senior centers or institutional settings—anything that reminds people and caregivers of the disease or their age.

The Atlas Coffee Mill memory café works so well, Van Rysin says, because it allows his sister to feel good about herself. "And when our sister feels good about herself, she's almost like her old self," he says. It also gives caregivers a break, says Morrison. "I'm not working so hard to entertain her. I feel less pressure."

The Alzheimer's Association maintains a registry of memory cafés, as does the Memory Café Directory. At least one café can be found now in almost every state, and nearly 200 cafés exist around the country.

Create Your Own café

For those interested in starting their own gathering, memory café organizers offer these recommendations:

Focus on social interaction. At the memory cafés Dr. McFadden has helped establish, the organizer and the volunteers make everyone feel welcome. They introduce new people and help facilitate conversation. "We sing 'Happy Birthday' to those who've had birthdays in the past month. We also sing a welcome song that names everyone, and the old Girl Scout song 'Make New Friends' before we leave. Other cafés have different welcoming and parting rituals."

Find the right venue. Look for a warm and inviting but quiet atmosphere with comfortable furniture and easy access, plenty of parking—including handicapped parking—and wheelchair accessibility.

Avoid institutional places. The locale shouldn't feel like a doctor's office or a daycare center. Some younger people with dementia might be put off by attending a café held in a senior center because they are not yet seniors, says Dr. Tingley. Several organizations have created separate gatherings for younger people with dementia who may not want to attend memory cafés where the average age is over 75, says Dr. McFadden.

Choose a host with experience. Collaborate with someone who has training in dementia, such as a social worker or a nurse, who can assess and handle situations. But remind participants that the leader will not provide formal care or assessments.

Set expectations. Memory cafés are designed to enhance the life of a person with dementia and the people who care for them, says Ronald C. Petersen, MD, PhD, director of the Mayo Clinic Alzheimer's Disease Research Center in Rochester, MN, and the Mayo Clinic Study of Aging. "But they are not going to change the diagnosis or the progression of the disease."

Van Rysin and Morrison appreciate the sense of community. "You look around and see husbands, wives, and children of people with dementia, and you realize it's a big group out there," Van Rysin says. "It's good to be part of that."