The gentleman was in the late stage of Alzheimer's, but we still found ways to create a smile on his face.  He could no longer walk, and his speech was mostly garbled. 

Sometimes he waved his arms and looked at empty space, obviously seeing hallucinations.  His hospital bed was in the living room, facing a huge window and a door we could open to let the breezes cool the summer heat in the room.

He and his wife were in their early nineties. His wife explained to me that they had started their dairy farm in the 1920's.  

Recognizable words that he said included "horses, springs, calves, feeding, watering, leaves, and clean."  When I said, "The horses and cows are O.K.," he smiled.  I could see he wanted to be sure everything was alright.

Eventually we progressed to my saying, "Your sons have cleaned the leaves out of the spring."  And then to, "Your sons have fed the horses and cows.  The calves are O.K."

These were the things he had spent a lifetime doing, and the familiar words were still there.  I would smile big, and frequently say, "The farm is O.K., the animals are O.K."  He would have a big smile back for me then.

He was at peace.

When I walked out of the room for a moment, he would be smiling and waving at me from his hospital bed when I came back into the room.  I would wave happily and nod and it became a game.  When someone cannot verbalize, the person may be understanding more than we think. 

I believe he could not speak but was responding to familiar words and to a happy or reassuring facial expression.  It was instinctively important to him to know the farm was O.K. in order to be at peace.

He had been active as a singer in a men's Christian choir, and when I played tapes of his choir's music he laid back with a soft smile. 

He was on a soft diet, and I spoon fed him small bites, with the head of his bed elevated.  Playing the men's choir music, looking at the beautiful view outside, and bringing his dog to the door created pleasure for him.

Making him feel everything was safe and secure gave him peace.  This was important because it calmed the agitation.  His facial expression and body language would show he was mentally and emotionally comfortable. 

Of course, other aspects of comfort included arranging pillows and bed position, putting the covers back on when he threw them off, and other steps to make him physically comfortable.

Despite the fact he was in late stage Alzheimers, he was at peace.