A flat-screen TV glowed like a hearth fire in the darkened family room where Ron and Joy Pott huddled cozily on a sofa watching a Kentucky-Alabama college basketball game. Occasionally, their peace was interrupted by the announcer's shrieking.
"Dick Vitale can just drive you crazy," Joy Pott said, reaching for the remote.
Later on that raw Saturday, the Malvern couple switched to Premier League soccer – a sport Ron played in college – then to the Valspar golf championship, in which Tiger Woods was making a run. Finally, that night, they tuned in to the event they were most avidly anticipating, Villanova vs. Providence men's college basketball in the Big East Tournament championship game.
Watching sports is more than an idle pastime for the Potts. The pleasant memories that sports provoke and the calming familiarity they offer Ron, a former athlete and lifetime fan who has been afflicted with Alzheimer's since 2011, have led his 80-year-old caretaker wife to utilize them as therapy.
"If you can make a person feel happy then it's less likely that they are going to be mean and difficult," Joy wrote in a journal that not only chronicles her 81-year-old husband's long battle with the disease but provides her with some respite from it. "He has no problem following the present, the game, giving his opinions, calling fouls, and calling referees stupid."
By utilizing sports as therapy, Joy Pott inadvertently hit on a strategy that is gaining traction in the treatment of Alzheimer's, especially among men. Although there are no large such groups in the United States, a United Kingdom organization called the Sporting Memories Network runs programs for the elderly at more than 100 locations.
"People come alive," said the group's co-founder and director, Tony Jameson-Allen, a former European golf tour caddie. "The images, the conversations, the memories, it all just helps trigger cognition. We use different stimulus. We have 90,000 images of sports. We have videos. We produce our own sports paper. We sometimes meet at soccer stadiums or at Lords Cricket Ground. And the biggest thing about these sessions is how much laughter emerges."
Reminiscing, or triggering pleasant memories, has been a widely used tool in treating Alzheimer's. But much of that therapy, Jameson-Allen said, has been aimed at older women.
"What's bizarre is that even though sports is a kind of universal language, it's never really been used in the field in any special way before," Jameson-Allen said.
Sports were always Ron Pott's passion. The 6-foot-4 former corporate lawyer and father of three grew up the youngest of five sports-crazed brothers in Summit, N.J. He was a basketball star in high school, a Division III soccer all-American at Wheaton College, a lifetime golfer, skier, and tennis player.
"The things he did for a living weren't all that wonderful," Joy Pott said, "There wasn't that wonderful immersion he got with sports. Now, when he watches sports, he goes back there, and that part of his mind is really engaged."
Like three of his brothers, Ron Pott eventually developed Alzheimer's. It was in 2011, while at their ocean-front summer home in Castine, Maine, that the condition surfaced. There were uncharacteristic emotional eruptions over tennis or the condition of his lawn. On one occasion, while weeding his garden, Pott apparently couldn't decide where to stop and tore up the flowers as well.
"We played mixed doubles together three times a week until recently," Joy Pott said. "We had to stop golf, too. He'd hit a ball into the woods, and I'd help him find it. But by the time I'd get back to my ball, he'd have forgotten where his was. I could see the handwriting on the wall."
The daughter of French parents, Joy Pott was raised in a small Scottish village. Though she came to America at 17, she occasionally still rolls an R. A teacher who later worked with the intellectually disabled, she absorbed everything she could about her husband's condition. Some advice helped. Some didn't.
It was while watching baseball – the Phillies while in Malvern, the Red Sox in Maine – that she recognized the game's calming effects.
"Baseball really gave me the clue," she said. "Whether we were here or in Maine, I could count on us watching a game together every evening. And I really began to see a difference in him."
Those sessions not only seemed to pierce the Alzheimer's fog, they eased his anxiety and provided routine, particularly in the evenings, the restless "sundowning" hours that can be difficult for sufferers and caregivers.
So his wife began to watch, learn, and appreciate "that visually beautiful game" of baseball as well as other sports that had been foreign to her, such as basketball and football. She became her husband's "TV color girl," explaining what was happening, giving it context, sweetly goading him into unlocking pleasant recollections that helped keep the demons at bay.
Eventually, she developed a routine. They read the sports section together in the mornings. Then, on weekday evenings, they typically watched baseball or basketball. On weekends, when a lack of routine can aggravate the condition, she filled their days with tennis, golf, and football. She saw the year ahead clearly – the Super Bowl, college basketball's March Madness, the Masters for golf, the French Open and Wimbledon for tennis.
Versions of the program she instinctively developed had already been used in professional settings, with music being the most common stimulus. A Drexel University professor created a system called TAP – Tailored Activity Program – during which caregivers identify a patient's interest and use it in treatment.
"The challenge for caregivers is to find a way to help the patient relate to their environment in a meaningful way," said Laura Gitlin, dean of Drexel's College of Nursing and Health Professions. "It's about tapping into preserved areas of the brain that have meaning.
"I think this woman has hit upon something very important. But sports might not work for others. What is going to work is the principle. She found what he liked, and she introduced him to it at a time of day that is very stressful for him."
Despite a recent stroke, Ron is lean and fit. He walks their dog, Sugar, twice a day around a cul-de-sac, and can raise his Lincoln-esque frame easily out of a seat. He loves baseball and can recite the 1946 St. Louis Cardinals lineup. At his wife's gentle urging, he can speak rationally about body surfing at the Jersey Shore, playing basketball in high school, or working in Wheaton's sports information office.
"Every case is different," Joy Pott said. "My husband has an incredibly complicated profile. Sometimes you think nothing is the matter with him. He thinks he's fine. He really doesn't comprehend. He still has reasoning. But his short-term memory is gone."
That was apparent on that Saturday, when every 10 minutes or so, he would smilingly tell a visitor about the genesis of his sports passion.
"I was the youngest of five brothers in a family that loved sports," he said over and over, each repetition of this disease-fueled mantra delivered as if for the first time.
Despite that, as he sat through his sports-filled TV schedule with his wife nearby, he seemed calm and content, particularly when summoning a distant memory.
"No one is going to help caregivers but themselves," Joy Pott said. "They are not going to change. You have to do the changing. I have to find a way to live in what I call his biography world, with all his memories. But this weekend, with the Villanova win, the return of Tiger [Woods], he was all in. We talked about everything, and it was all so natural. Then he spotted [news in the Inquirer about the Phillies' signing of pitcher Jake Arrieta], and that prompted more discussion."
The therapy isn't foolproof. There are difficult times when Ron's frustrations spark emotional outbursts. Little things can ignite him, and he sometimes responds by demeaning others.
"Unfortunately I hear the word stupid a lot, more than I want to," Joy Pott wrote. "I suppose increase in criticism is a natural cover-up and rationalization for what he feels."
When they're watching sports, Joy, who likes to carve out time for swims at the nearby Upper Main Line YMCA, usually has a book on her lap. But the attention she must increasingly pay to her afflicted spouse — "He wants to see me sitting there" — doesn't leave much time for reading.
"I need to be close, with eye contact, clear happy tones, all tempered with patience," she wrote. "Background noise, speaking from a distance or another room is very frustrating and uncomfortable for Ron. … The familiar can feel new every day for Ron. … When Ron is happy, Joy is happy."
Joy Pott has been inspired, she said, by reading former Inquirer columnist Bill Lyon's thoughts on his own battle with Alzheimer's.
"This disease is so prevalent," she said, "Bill has done an amazing job bringing this out."
According to Lyon's physician, Penn's Jason Karlawish, Joy Pott's caregiving ought to be a lesson for others.
"What you're witnessing is an upending of the notion that there's nothing you can do," Karlawish said. "There's no one-size-fits-all set of activities for people with dementia. But this shows us that if you really want to take care of patients with dignity and quality of life, you need to pay attention to the individual as an individual."
In the meantime, Joy Pott will keep refining and adding to the treatment – and to the jounral she hopes might someday help a member of the Alzheimer's-afflicted community.