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Sarah's Web
by Richard Owen Geer, Ph.D. (richardowengeer@gmail.com) Community Performance International Arvada, Colorado Eighty-eight year-old Sarah looks around apprehensively before her friend, Helen, 92, takes her elbow. As they walk back to their rooms, after dinner they chatter about great grandchildren. Two minutes later they bid a happy goodnight and enter their adjacent rooms, neither aware of the significant role each is playing in the avant garde of group living. A senior living community is made up of diverse parts teaming with information, intelligence, experience, and the power to do work, like the internet. Both also contain elements which are partially impaired. In SLCs, many residents live with cognitive and physical impairments; on the internet, too, servers, sites, and individual computers routinely crash or function sub-optimally. Why, then, is the experience of internet users usually excellent? Because, in brain terms, the internet boasts robust cognitive reserves. Cognitive reserve, is an abundance of alternate neural pathways available, when needed, for cognition. Cognitive reserves enable a person to feel normal even when the brain is damaged, as in Sarah's case, by Alzheimer's Disease. No effective Alzheimer's medicines have come forth in the last ten years, and recently the Stage Three trials of two drugs were discontinued when no evidence of efficacy was found. Viewed as a disease of the brain, Alzheimer's gives us little cause for hope. But, the brain of an Alzheimer's patient is able to continue functioning normally, if it is furnished with the alternate circuits of cognitive reserve. These circuits are stimulated to grow by brain/body activities, like the performing arts. Peter Davies, Scientific Director, Litwin-Zucker Alzheimer's Center, says that participation in dance can reduce the rate of Alzheimer's by 75%. No pill can come anywhere close to this astounding number. So, when considered as a disease of the brain and body, the situation brightens. What might be possible if Alzheimer's were viewed as disease of the community, if one human could provide "alternate circuitry" for another, and thereby support her normal functioning? The other day Sarah was sitting, talking to a friend. Ruth lost the word she was reaching for, and Sarah supplied it. We all do such things, likely many times a day, without

2 thinking. By supplying words, by taking a child's hand, by carrying a heavy bag, by offering an arm, giving directions, remembering how she likes her coffee, or bringing him his medicine, we provide alternate circuitry for one another. Sarah, Helen, and Ruth are filling in for each other's cognitive and physical deficits and making important improvements in their shared quality of life. Yet these tiny gestures-holding a coat--barely merit mention. But together they transform a collection of individuals into something supple and connected like a woven garment, or the silicon web of the internet. We don't come within hand's reach by simply holding her jacket. We get this close through relationship. And we get to relationship through our stories, which we share most deeply with those we love. Once close, we begin this remarkable group activity--the building of community cognitive reserve--of which we're barely aware. Only when irked or abused do we count the times we help each other. Families, teams, platoons, and dance ensembles bond tight with this social velcro. As a theater director, I help connect the loops and hooks. First, the risk and trust we extend each other as we begin to shape characters. Stories follow, over drinks, on breaks, or as part of the process. Hooks extended, loops offered. The field of mistakes and do-overs that is rehearsal supplies hooks and loops in slews. Actors catch, cue, compel, and cover, and thereby cohere. By the time the best ensembles reach performance they are masterworks of resilience. Nothing can trip them. My first theater was in a depot; when the train came-always at a different time--it would stop the performance for the time it took 100 coal cars to clatter past. By the third or fourth car, something broke out on stage, an actor initiated something. No one could hear, it was all by mime. The ad lib would spark and roar to life, often including the audience in the performance of, say, raving asylum inmates, driven mad by the noise, or riders on a giant roller coaster, rising and falling in waves. As the racket receded the actors dropped back into the show, a seamless splicing in and out of realities. Years later, the internet came along to help me understand what I'd witnessed. Switch on an IPad and open an app; the app is on a server in China; your data is on a computer in New York; the processing happens in Portugal. Situation normal on your IPad in Colorado. And then the New York computer crashes; instantly your circuitry is routed to Chicago and your experience flows unchanged. You're completely unaware, as you play Angry Birds, that the internet is using its "cognitive reserve," to bypass sub-optimal elements, and allow things to work perfectly, like magic. Distributed systems, like the internet, resemble bee hives or ant nests, where members benefit in return for participation. Hives and colonies work even as parts fail, owing to death, disease, or a boy with a magnifying glass. A high-functioning community--human or

3 ant--operating as an efficient distributed system, can lessen the experience of dysfunction for all its members. Given the right conditions, a clutch of individuals can amalgamate into a communal, hyperintelligent, fast, spontaneous, caring, transcendent "self." Some propositions about this "we" that is "one." 1. At the most basic level, it happens between individuals who pay attention to each other. 2. Relationship bonds must be present before it appears, and are greatly strengthened as a result of it. 3. It happens among groups who rehearse (re-behave behaviors) together--triage teams, soldiers, string quartets, actors, dancers, and first responders, to name a few. 4. It manifests in the transcendence of fear, grief, or anger, which are necessary to its formation. 5. It is not conscious of itself, it is never its intended result; the group has another task entirely (winning the battle, entertaining the audience, caring for the injured) 6. It consists of saving or being saved, and in its most robust incarnations, everyone does both, without shame or pride in individual actions. 7. It is performance, but not confined to an 8PM curtain. It can be cued by ordinary life--a gunshot, a flood, or a moment with comic potential. 8. In its simplest guise, it is invisible and feels normal. At higher amplitudes it is incredibly fun, deep play, peak performance, flow. Time ceases to exist. Everyone loves everything and everybody. We're more used to the hive idea when thinking of highly trained teams, but what about communities in daily life? The insignificant function of supplying a forgotten word, is this the first step? How do we grow it in the commons? And once it roots and begins to flourish, what is the upper limit of co-living? Is there a role for the community in preventing, or minimizing Sarah's experience of Alzheimer's? As the internet provides cloud computing power to individual machines, senior living communities (residents, staff, families, neighbors) might provide cognitive reserve for one another. When Alzheimer's becomes a disease of the community, can the community "cloud" transform the experience of it? Sarah lives with mild cognitive impairment. After dinner, Sarah's brain fails to tell her where her room is. But Helen, who lives next door, is there with the needed cognitive reserve. Helen's brain can no longer processes sight, so Sarah, with a guiding elbow, provides Helen's cognitive reserve. The cloud, through Helen, knows the location of Sarah's room and that she often needs assistance finding it; and through Sarah, it knows that a blind person appreciates a guiding arm. Each night Sarah and Helen navigate to their rooms by

4 being "online" for each other. Tomorrow, when Helen stays after dinner to practice her part in the radio show, Sarah will find her way home by accessing the cloud through Seana, on the cooking staff, who happens to pass by. Along the way Seana asks Sarah how she liked the mashed potatoes. Sarah congratulates Seana on the hint of allspice. Seana thanks her for the tasty tip and says goodnight at Sarah's door. Sarah goes in to find her iPad beeping and sits down to a game of Scrabble with her grandson Trevor in Minneapolis, his friend, Hakim, and Bill, a new friend Sarah met in her cooking class. Trevor's spelling has improved since his dad, Sarah's son, gave Sarah the iPad for Christmas. Through it she has discovered the internet, shares recipes with her family and Seana, volunteers to bake each Tuesday morning for the Rotary which sponsors a free immunization program that Sarah initiated twenty years before as a public health nurse. Sarah, who keeps her license current online, still gives the kids their shots, and is celebrated for her painless injections. Like the internet cloud, the community cloud is transparent to the purposes of those using it. We aren't aware of the digits rushing and crunching in cyberspace, and Sarah was less aware of being guided by Helen than she was of sharing enjoyment with her friend. Similarly, Helen enjoyed time with Sarah, Seana enjoyed complimenting Sarah's refined palette, and Trevor was revved up about beating his grandma at Scrabble; he wasn't thinking about spelling. No one was focused on how they were supporting or being supported, by the cloud, they were, instead, enjoying their lives. People receiving one minute were giving the next. Experience has shown that virtually everyone, from newborns to people in hospice care, both give and receive in a high-functioning community. Once the cloud reaches a critical mass, the ability for all to contribute and receive is axiomatic. Though we don't do enough to support it, the human cloud called community has forty thousand years of vitality behind it. Community blooms when shared needs connect individuals in relationships. The payoff for making relationships is huge. When 10 people connect, their community has 10 x 9/2 = 45 relationships. When 10 times more people connect, the possible relationship increase not by a factor of 10, but by over 100 (100 x 99/2 = 4950). If Sarah were in relationship with only 10 people, she would likely have a different experience of her community. After dinner she'd wander around in increasing agitation, aware she was lost, aware that her brain wasn't functioning correctly, scared and alone. A staff member, returning from taking another resident to her room, might see Sarah and fetch her home where she would sit alone in front of the TV set unable to remember how to turn it on, till another staff member came to get her ready for bed. And so on and so forth, day after month after year. But that's not our Sarah. Sarah has many more than a hundred relationships. The fact that, at any given moment, she may forget some doesn't really matter. In her senior living community, relationships are supported as the treasured community asset. Google for living. The distributed system, the cloud, the cognitive reserve of the SLC is very intentional about

5 co-resourcing. It is the highest expression of the community's highest good--to give and take in support of the community. Sarah knows this most of the time, and anyway, gaps are the norm, they don't impede smooth functioning. Community members participate, they give and receive. Sarah receives love and value through the purposeful actions of her neighbors; and she contributes the very same, her goodness, her word for Ruth, guiding arm for Helen, and encouragement for Trevor. Add these up, and despite cognitive impairment, Sarah feels like Sarah most of the time. The cloud of community enfolds all its members and even reaches out into the broader community where it begins to transform. Children experience the power to give and receive. Sarah's great granddaughter Maggie is just learning to write cursively, Margaret met her at dinner where they compared names and handwriting. Margaret, a retired elementary teacher, passed along tips about the difference in the tail of a "g" and a "q," and staying inside the lines. Maggie helped Margaret find her room, 231, and picked up a cookie for her trouble, before making it back to Sarah's room in time to help her great grandmother decorating Frankie's photo book with scrapbooking materials. The photo book with pictures and stories from Frankie's life, will be one of the main ways that the community gets to know Frankie, who is just moving in. The book provides pictures and stories that spark memories, conversations and build relationships. It is one of the ways the senior living community adds cognitive reserve. The many benefits should drive people to form community clouds spontaneously, but they won't. The professionalization and specialization of society has shriveled peer-to-peer participation. But humanity has deep social memory. In the wake of natural disasters communities spontaneously pull together to form clouds of care greater even than the clouds of a hurricane's destruction. At such times everyone, or nearly everyone, comes "online" to participate in the marvelous hyper intelligent distributed system of giving and receiving. Short of catastrophes, though, how do people, especially strangers, become the caring cloud that so enriches the experience of participants? For the better part of half a century I've convened large groups of strangers and helped them form high-functioning communities, first in the professional theater and then, for a quarter century, with ordinary people and their neighbors. The move from alienation to caring community begins in an ancient way as people share stories that define them and their purposes on earth. These are everyday stories, the sort you might thoughtfully share around a cozy table. A prompt to story sharing might be "What event stands out from your childhood, and how did it shape you?" After one person tells how his kid brother was kicked by a stallion, Sarah responds with a story about the wind one March that tore up the old corral and whisked away the final evidence--and the smell--of Buddy, her last horse. Out of stories, communities form.

6 When we witness each other's stories, teller and listener co-create the performance. The listener's non-verbal cues encourage the speaker to dive deeper into his submerged memory, through mutual toil they arrive as friends at the end of the story. Connections multiply when the group shares its stories with the surrounding community. Performance intensifies the process in beneficial ways. Brains add new neural pathways as dance, theater, music, and visual art are added to the stories. The community benefits as people risk and trust in the business of preparing performance, even a simple performance, like sharing a few stories in the dining room. In a story circle of six, fifteen new relationships begin. In a story-sharing for 60--10 story circles--almost 1800 relationships are born or strengthened. Community members build the cloud and benefit from it. Shared formally and informally, stories build love and relationship between folks who come to love their place, and christen it as a place of caring and fun. Stories uncover new purposes and projects for community members to support through promotion, donation, and participation. Stories, poems, songs, and jokes remembered by the community become material for the Yarn Exchange Radio, produced and performed each month by residents with the participation of families, staff, and neighbors, who love these simple to create shows showcasing talents in their ever-growing community. In the course of a year, performances feature most all the residents and many of their family members, especially children. Stories of local service organizations also provide themes for the Yarn Exchange. Sarah's story of Buddy, mixed with tales and facts from the local animal shelter, build care and relationship both ways. Residents become shelter volunteers, and pets find new homes with families and at the SLC, for instance. Stories combined with live music create narrative dance experiences for every age and ability. Stories create energy among the tellers who emerge as advocates around ageism and misconceptions of dementia. Stories made up spontaneously, prompted by 'what might be going on' in a photo or painting, provide stress free fun for community members with healthy imaginations and impaired short term memories. The making of photo books (photos and stories of each resident made by other residents working with the new move-in) can involve everyone who loves stories, conversation, writing, scrapbooking, photography, and art. Stories shared in weekly story circles, support folks in the important late-life activity of re-storying their lives to discover insights, passions, and new meanings. Stories begin conversation groups which research community-building practices from around the country and pick new purpose-driven activities to initiate in their area.

These, and similar activities, enrich community cognitive reserve at every level. Activities armor individual brains by laying down alternate neural pathways. Activities enhance bodies by strengthening muscles and improving coordination. Activities build community by creating new relationships and growing the distributed system in which shared reserves counter individual deficits. The participation of many encourages the participation of more. The community consciously engages with its own paradigm through conversations that support giving and receiving as the highest good for all. Gossip and bullying can give way to the joyful experience of being knowledgeable and actively "online" for one's community. All of these activities are done, first and foremost, because they are fun and we experience them as good. We have our ancestors to thank for evolving community in ways that give back even as they give joy. Seana brings her tea just the way Sarah likes it, Helen steers her straight, Bill celebrates her cookies and help with the measuring, Sarah slips in a lost word to Ruth, a needed arm to Helen, spelling help for Trevor, and so on and on. All of which make Sarah feel just like Sarah, most of the time.