Fred Libby, who at 88 has moderate dementia, volunteers once a week at the Utah Food Bank with his wife, Joan. On a recent morning, Fred happily sorted boxes of mac-and-cheese and jars of peanut butter that will eventually end up in the cupboards of hungry Utahns. No matter that, later in the day, the former Eastman Kodak supervisor won't remember having been there. In the moment he knows he's contributing to his community.

Advanced dementia is more problematic, and "usefulness" more of a stretch. When one local woman was desperate to keep her mother engaged as Alzheimer's narrowed her world, she brought dried pasta for her to sort by shape, bringing the exact same noodles back week after week. Bernice Earl's husband, Lavar, thought he was a staff member at the adult day care he attended every day, and both Bernice and the staff never contradicted him.

Yes, says Morrison, "it's sort of like a white lie. But it's validating the person's emotional experience."

Meaning also comes from relationships, but a person with dementia may not recognize her own children, says Nick Zullo of the Utah Alzheimer's Association. The organization teaches family members to create a "joy box," which can act as a bridge between people who've lost each other. It may be as simple as a cardboard shoebox with a few treasured trinkets and photos. Chances are, he says, that even if someone doesn't remember, she'll enjoy and feel connected to once-loved things.

Expression, too, can provide meaning, which is why at the Neighborhood House Riverside adult day care program, director Kathie Williams says she tries to provide art projects and group poems that "reach into" the clients. "There's always something left in a person, no matter how much dementia, if you take the time, if you can find the right question to ask or the right activity."

Eden's DeVries challenges nursing homes to find the simple pleasures for each person who lives there — a cup of coffee each morning in a favorite mug or sitting in a favorite chair to read the newspaper while the sun streams in. "There's a sameness, a ritual, to these pleasures."

After a long life as "somebody" — when you've lost your vision and your hearing, when most of your friends have died and you no longer have a career, when it's hard just to get up out of your chair — it's easy to make a long list of what you can't and won't do.

"I don't dance, I don't play cards, I don't have a husband, I don't want to do any crafts," says an 89-year-old woman who lives with her daughter. While everyone is at work, she's alone all day, and when they come home she makes it a point not to talk to her daughter's new husband, whom she doesn't like. Macular degeneration makes it hard to see, so she can no longer drive. If you suggest she might enjoy going to a senior center — the center would pick her up in a van — she dismisses the idea. Ask her if she might want to help an immigrant learn English, and she says, "They don't want to learn English." Suggest that she might enjoy going to church, and she frowns. The last time she went, she says, she spilled the sacrament water.

Dwelling on her limitations, the woman has made her life a little island. She sits in the center of it, unwilling to find much that makes her happy. "I have no future," she says, "only the past."

Meaning, as we age, is sometimes brought to us by a thoughtful caregiver or a family member with a joy box. But sometimes we have to be willing to look for it ourselves.

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E-mail: jarvik@desnews.com, lois@desnews.com