Navigating the symptoms of FTD can be difficult for loved ones, especially when someone living with the disease experiences memory-related challenges. However, as Catherine Savini shares, meeting symptoms with “yes, and” instead of “no, because” can turn encounters with frustration and isolation into meaningful moments of playfulness and connection.

Recently, a close friend was telling me a story about her mom, who was throwing a family party. She asked my friend to be sure to invite her brother and sister. The problem was, the two siblings had a falling out several years ago and no longer spoke. My friend dutifully reminded her, “Mom, you won’t see them both this Sunday. They had a falling out, remember?”

After hearing this story, I couldn’t restrain myself. “Stop telling your mom about their estrangement!” I said. “She doesn’t need reminding. Let her live in a world where her kids still get along!” My friend was taken aback. My advice seemed counterintuitive: why shouldn’t she correct her mom, especially about something so important?

Meanwhile, I had surprised myself with the intensity of my reaction. But there’s an obvious explanation: My own mom was diagnosed with behavioral variant FTD at 60. At times during her 10-year decline, I, like my friend, found myself setting her straight.

Here’s an example. One summer following her diagnosis, as I was struggling to help my mom get dressed, she kept looking at her closet. “I need to figure out what I’m going to wear to the wedding,” she said. I knew what wedding she was referring to. It had happened months ago; she and my dad traveled to New York City to attend. “Mom, you already went to that wedding,” I reminded her. “Now lift your leg so we can get your pants on.”

There’s an episode of This American Life where an actor named Karen shares a story about caring for her mother, Virginia, who was living with Alzheimer’s. Karen and her husband, Mondy, stumbled upon an approach that they found worked surprisingly well in dementia care: “Yes, and…”

"Yes, and…” is the first rule of improv. Improv performers are trained to always greet their scene partners’ utterances by first affirming them (the “yes…” part), then adding something new (“…and”) that layers onto the scenario they are collectively creating. “No” is banned in the improv world.

What I was doing with my mother could be called “no, because.” No, we don’t have to figure out what to wear to that wedding, because you already went. Instead of joining my mother in her world, I was jerking her back into reality. Unfortunately, it wasn’t until after she died that I realized the flaw in this approach.

For Virginia, “yes, and…” worked so well that Mondy, also an actor, started to enjoy it. When Virginia thought she saw monkeys, Mondy responded, “It’s pretty early in the season for monkeys…[But] if you see one again, we should try and capture it, because that would be a blast to have in the house.” Virginia had fun with it too. Of course she did; instead of being corrected for getting things wrong, she was met with affirmations and playfulness. Who wouldn’t prefer that? Not only did “yes, and…” make Virginia happy, it made her more likely to go along with Karen and Mondy’s caregiving suggestions.

“Yes, and…” sounds easy – it’s just two words. But FTD caregivers know that nothing about this disease is quite that simple. As motivated as we may be to take an approach that promotes good feelings, the effort needed to maintain this is monumental. Karen explained that practicing “yes, and…” with her mom frequently required her to disavow actual memories that she and Virginia once cherished. It can feel like you are not only losing your loved one, but also your shared past, and even yourself.

So what do we do?

First, simply try “yes, and…,” particularly in moments when it feels doable. My mom’s perpetual preparation for a wedding that she’d already attended would have been a perfect opportunity. Instead of focusing on putting her clothes on, I could have had some fun with her. We could’ve gone through her jewelry together, pulled outfits out of her closet, and skimmed magazines for hot looks. (To be clear, I’m not suggesting that we let our loved one engage in dangerous behavior; “yes, and…” does not apply when our loved one asks for the car keys or a bottle of wine.)

Second, recruit others to help “yes, and…” your loved one. Watching the person you love be devoured by this disease creates a pall over everything. Accessing the playful part of your brain in these moments can feel like trying to open a jar when your hands are covered with olive oil. Knowing this, we can recruit others to help us with a “yes, and…” approach so that when it’s too hard for us, others can tap in. There’s a reason improv is performed by troupes. And, given that “yes, and…” can be easier for those who don’t have a history with your loved one, hire people early and often to help out (if finances permit). I know that it doesn’t always feel comfortable to invite strangers into our homes to care for our loved ones, but it can lead to beautiful new relationships: one caregiver we hired formed such a bond with my family that when she got married (on my mother’s birthday), she delivered a toast to my mother. My mother died in 2017; today, we still see Trina and her husband at least once a year.

Before FTD vacuumed out her personality, my mother was a sharp woman who loved playing Scrabble, teaching students in her middle school library, entertaining guests at our beach home, and caring for her own mother and children. When my mom was diagnosed, we had never heard of FTD, and we did not receive any guidance on how to care for her, yet despite some regrets, I’m proud of how we did. My dad kept her at home as long as he could. When his own health issues forced him to move her into a memory care facility, he visited her every day, sometimes twice a day. He took dance classes with her and often fell asleep next to her on the common-room couch, while she and the other residents watched Hello, Dolly and My Big Fat Greek Wedding for the umpteenth time. I took a leave of absence from work and moved nearby so she could get to know her first grandkid. My father and siblings were great at injecting humor throughout the caregiving journey (as my sister demonstrates in her essay “What’s So Funny? Caregiving with a Smile”). We all tried to care for her as she cared for us, with good humor and compassion.

The heaviness of the daily tasks and the emotional burden of caring for someone with FTD can make levity feel impossible. But the simple framework of “yes, and…” can steer caregivers out of the frustration and isolation and toward playfulness and connection. I wish that instead of forcing her back into reality, I had joined my mother in a world where a wedding was forever on the horizon.