A pot of fresh coffee, a circle of chairs, and the gentle hum of conversation: that’s the scene Denise Fettig-Loftesnes remembers from the Memory Cafe she launched in Bismarck after both of her parents were diagnosed with Alzheimer’s within weeks of each other. “It was like I got hit by a bus. I couldn’t breathe. There’s no cure,” Fettig-Loftesnes told KFYR-TV, describing the moment that set her on a path to build a community she couldn’t find in the medical system.
The caregiver gap is widening in North Dakota
North Dakota’s need for dementia support is rising faster than the workforce that can provide it. About 15,000 North Dakotans age 65 and older are living with Alzheimer’s, according to the Alzheimer’s Association’s 2024 Facts & Figures report, and thousands more face other forms of dementia Alzheimer’s Association. Families shoulder most of the daily care—often without training—contributing tens of millions of hours of unpaid support each year, a contribution the AARP values at hundreds of millions of dollars annually in North Dakota AARP.
That need collides with a strained care workforce. Long-term care providers across the state report persistent shortages of certified nursing assistants, aides, and memory-care staff, which has forced some facilities to limit admissions or reduce services, according to the North Dakota Long Term Care Association NDLTCA. The North Dakota Department of Health and Human Services has acknowledged workforce gaps across aging services and has directed families to programs meant to help older adults remain safely at home ND HHS Aging Services. The result for many Bismarck-area families: long waits, fragmented support, and a growing reliance on community-led groups.
Inside Bismarck’s Memory Cafe
The Memory Cafe model—low-pressure, drop-in gatherings for people living with dementia and their care partners—has become a lifeline for local families navigating a complex system. In Bismarck, Fettig-Loftesnes built the group as a welcoming space for coffee, conversation, and simple activities that spark connection, from music to reminiscence. For many, it’s one of the few places they can ask practical questions and be understood, no referral required.
Fettig-Loftesnes says the group grew out of necessity as much as love. After her parents’ diagnoses, she found that scheduling, transportation, and competing medical demands often eclipsed time to simply be together. “There’s no cure,” she said in that KFYR-TV interview—but there can be companionship, and a few hours of steady ground for both caregivers and loved ones.
Attendees describe a relief that’s hard to quantify: tips on managing difficult nights, a suggestion for a local respite program, or just laughter that makes the week feel possible again. While clinics and hospital visits remain essential—through Sanford Health and CHI St. Alexius in Bismarck, among others—the cafe fills gaps those appointments can’t, especially when the question is “What do we do tomorrow morning?”
Pro tip for families: the Alzheimer’s Association Minnesota–North Dakota chapter runs a 24/7 Helpline at 800-272-3900 for care consultations and local resources, and North Dakota’s Aging & Disability Resource-LINK (855-462-5465) can help locate respite and in-home supports Alzheimer’s MN-ND ND HHS Aging Services.
What it means for families here
In practical terms, the Memory Cafe is easing emotional strain and helping Bismarck-area caregivers stay afloat. Families say they leave with concrete strategies—how to structure a calmer afternoon, which local adult day options to call first, or how to explain a diagnosis to grandkids—along with a sense that someone else finally “gets it.” That peer connection is a form of care in its own right, according to dementia-care best practices cited by the Alzheimer’s Association, which highlight social engagement as crucial to well-being Alzheimer’s Association.
Community groups like the cafe can also shape the public conversation. As more neighbors see dementia in their own circles—at church, at the grocery store—the model normalizes asking for help and sparks questions for decision-makers about transportation, respite, and training. It’s a small room with outsized ripple effects: when caregivers feel supported, hospital readmissions and crisis calls can drop, an outcome aligned with state goals to help people age in place ND HHS Aging Services.
Other communities can replicate the approach with modest resources: an accessible venue, a few volunteers trained in dementia-friendly communication, and partnerships with local libraries, faith groups, or senior centers. Bismarck’s example shows how to start small and stay consistent.
How the community—and policy—are responding
Local providers and state agencies have been signaling support for community-based solutions while pushing on the workforce front. The North Dakota Department of Health and Human Services funds the Dementia Care Services Program—delivered statewide through the Alzheimer’s Association—to provide care consultations, education, and navigation for families, including in the Bismarck-Mandan region ND Dementia Care Services Alzheimer’s MN-ND.
Even with those programs, staffing remains the pressure point. Industry groups representing long-term care and home health continue to call for recruitment and retention strategies—training pipelines, tuition support, and competitive wages—so facilities can keep beds open and expand memory-care capacity NDLTCA. Locally, health systems have added caregiver classes and support groups through their geriatrics and neurology teams, while community partners like Bismarck-Burleigh Public Health promote dementia-friendly education events on city calendars Bismarck-Burleigh Public Health.
Policy discussions are expected to continue ahead of the state’s next biennial legislative session, where funding levels for home- and community-based services, respite, and workforce incentives typically take shape. For now, grassroots groups are filling the in-between.
Keeping the doors open
Sustaining a volunteer-heavy model takes steady hands. Organizers say reliable space, a small budget for supplies, and rotating volunteers make the difference between an occasional gathering and a standing fixture. In Bismarck, that could mean formal partnerships with local institutions—Bismarck State College or the University of Mary—to connect health sciences students with hands-on, dementia-friendly service hours.
The Memory Cafe’s next steps include keeping sessions accessible and expanding times to reach working caregivers, a common request. Donations of meeting space, music, or transportation vouchers can stretch the effort further. To learn about upcoming gatherings, families can check local community calendars, search for “Bismarck Memory Cafe” on social media, call the Alzheimer’s Association Helpline (800-272-3900), or contact North Dakota’s Aging & Disability Resource-LINK (855-462-5465) for referrals and schedules Alzheimer’s MN-ND ND HHS Aging Services.
What to Watch
State agencies and advocates are expected to outline workforce and respite funding priorities ahead of the 2025 legislative session.
Locally, look for new dementia-friendly training opportunities and potential partnerships that could extend Memory Cafe hours and locations in Bismarck-Mandan.
