Rivers are life sustaining. They connect people, serve as the information highway between villages, support the livelihood of families and communities, provide connections to mother earth, play an integral role in cultural traditions, stories, and values, and help families and friends stay connected. Rivers are dispersed, consisting of tributaries and smaller creeks that flow out to the ocean. The look, feel, and temper of the river is influenced by the changing seasons. The river is a metaphor for identity, wellbeing, and connection to ourselves, family, community, and environment. As we age, our journey down the river is filled with stops: to visit family, to start our own family, to engage in subsistence or other work activities, and to settle down and enjoy the fruits of our labor as we age. Each bend in the river brings with it new memories, and over time the river changes direction, slows down, and adapts to its environment. The changes in rivers are similar to the changes in our brains due to Alzheimer’s Disease and Related Disorders, or dementia. Dementia changes our brains, our relationships, our sense of self, and our ability to feel safe. It requires us to adapt. While the river of memory may change due to environment, changing seasons, or other forces, the memories still remain, especially the longterm memories created as a child. Just as the river changes with the seasons, we each go through different seasons in our lives. If we become disconnected from the river (our memories) we still have our identity and sense of self and place. Rivers carry many things; similarly, memory loss is not the only facet to dementia. The dementia diagnosis carries many things as well – various health conditions, personality changes, and increasing need for assistance. ​ Just as breakup and log jammed ice or other tangled debris in the river can cause the water to rise, plaques and tangles in our brains cause jams. River flooding may lead to a natural disaster, something uncontrollable or unstoppable and even seen as a threat to the survival of our families and communities. Nature can be unpredictable or shrouded in fog, making it difficult to predict or plan for, just like dementia is difficult to predict or plan for and can disrupt family and community life. While the river looks calm on the surface, just below unpredictable events have changed our lives, our memories, and our neural connections. Unforeseen disruptions result in changing water patterns or flooding which are not always noticeable until years later, just like the hidden, unpredictable, and permanent changes to our brain as a result of dementia. Just as each neural pathway will always contain short and long-term memories even if we can’t access them, the rivers also contain our memories that will continue to flow and join the larger collection of memories in the ocean. No matter what happens, the memories we carry are grounded in the river. Sitting on the riverbank, smelling the tundra, hearing the gurgling water, brings us back to other times, just like sitting with family and friends reminds us we are all connected. - Written by Dr. Jordan Lewis