As he handed out shiny, star-shaped balloons one by one to squealing children gathered on a rug — sunlight streaming in from a nearby window — 78-year-old Win Mann seemed taken aback by all the ruckus he’d caused.

“Teacher’s gonna be busy!” he laughed.

Last week’s visit to Happy Learners Preschool in Bend marked Mann’s first public appearance in at least 50 years in full clown gear — big shoes, painted face, rainbow-colored wig and all.

The kids giggled, leaned their heads back to gaze up at the balloons and held them in front of their faces, amused to see their reflections. They sang songs and took turns trying on Mann’s red foam nose. He grinned the whole time.

“I enjoy it as much as they do,” Mann said. “I have a lot of fun with it.”

Mann worked as a clown after graduating from college, visiting children’s hospitals and schools. He then traded the costume for a professional career at Anheuser-Busch in Bend.

About five years ago, a doctor diagnosed Mann, whose full name is Winthrop, with Alzheimer’s disease, an incurable form of dementia that destroys memory and other mental functions over time. It’s estimated that roughly 5 million Americans are living with Alzheimer’s disease, according to projections in a 2013 study in the journal Neurology.

Mann moved to Mt. Bachelor Memory Care in Bend about a year ago. Back then, he slept until noon or 1 p.m. Even when he was awake, he’d often just lie in bed, said Mallory DaCosta, the facility’s executive director. Mann’s wife passed away about a year before he moved to the facility.

It’s estimated that up to 40 percent of people with Alzheimer’s disease suffer from depression, a condition marked by indifference, a loss of interest in activities and isolation, according to the Alzheimer’s Association.

DaCosta thinks it wasn’t so much sadness, but dispassion that Mann was feeling. That’s common among her residents.

“It’s not so much the aggression or anxiety, it’s the apathy,” she said. “‘What is there to do? I don’t really have any reason to get up.’”

Assigning purpose

One of the ways DaCosta and her staff lift residents from their funks is to assign them unofficial jobs within the community. DaCosta believes having roles and responsibilities reduces the symptoms of dementia by providing people a sense of purpose.

The staff’s job, then, is to learn about residents’ former careers or hobbies. Can those skills be used today?

“If you give them that consistency and you tell them, ‘I’m relying on you. I really need your help’ — which is how the staff are trained to approach it — then they feel like equals,” DaCosta said. “They feel like, ‘OK, I have a responsibility to do,’ and they get excited about that.”

Research seems to back up the practice. Several studies have found that engaging dementia patients in activities in accordance with their capabilities, such as events, crafts and exercise, can be an effective nonpharmacological approach to easing dementia symptoms, such as agitation.

Researchers at the University of British Columbia explored the subject further in a 2007 study in which they conducted in-depth interviews with dementia patients about their daily activities. The study determined subjects found daily activities like household chores and work-related endeavors meaningful because they provided a sense of connection and belonging and helped subjects retain a sense of autonomy and personal identity.

A 2008 study assigned 60 dementia patients to activities based on their capabilities. After four months, the patients’ caregivers reported observing less frequent problem behaviors, greater activity engagement and less agitation and argumentation, according to the study, published in the American Journal of Geriatric Psychiatry.

At Mt. Bachelor Memory Care, one resident, who relies on a wheelchair to get around, insists on setting the tables before meals and cleaning up after them, DaCosta said.

“We don’t even ask her to do it, she just does it.”

She’s meticulous, too: She pulls out every chair to sweep beneath it and then replaces it. She even has a nametag that says “kitchen aid.”

“She absolutely lives for it,” DaCosta said. “Every time she’s sick, if she has to miss a meal or miss setting the table, she is so apologetic. I think it actually helps her get better.”

Another resident, an Italian woman in her 90s, makes pasta. Even though she relies on hospice care, she still knows exactly what to do, DaCosta said.

“You’ve got to go for things that are long-term, hard-wired skills,” she said.

Staff members learned of Mann’s past while assembling photos for a facility-wide slideshow. Mann’s family submitted photos of him dressed as a clown, and a staff member asked them whether he’d like to relive those days.

Rusty Mann, Win’s 51-year-old son, said he never imagined his dad performing as a clown again. But when Win said he’d like to try, the family brought him makeup and a costume similar to the one he used to wear.

Last week’s performance didn’t involve any special tricks or jokes — mostly just smiling and waving. Mann readily accepted a chair when someone brought it for him, and he tapped his feet to the kids’ songs. His agenda that day included two visits to the day care and another to a senior living facility.

At the daycare, DaCosta stood in the background in case things went awry. When it comes to dementia, a person can be clear one minute and confused the next, she said. But sometimes, the memory lapses happen simply because they don’t have anything in their daily lives to look forward to, she said. They get up, take their medications and eat.

“If we can give them things to look forward to, they do remember better,” she said. “It’s just got to be worth remembering.”

— Reporter: 541-383-0304,

tbannow@bendbulletin.com

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