Share Your Experience

Use the form below to tell your story and connect with others who are coping with dementia or have lost family members or friends to these terrible diseases.

Questions to Consider when Telling Your Story

• How has caring for someone with dementia affected your life? Your relationships? Your job or retirement plans?
• What problems have you encountered in getting help? Have you been able to get information, healthcare and other services when you needed them?
• Tell us about other aspects of your life. For example: What you do for a living or are you a student or retired? Are you married? Do you have children? Where do you live? What is your highest level of education? What are your hobbies or interests?
• What has been most helpful to you as you have worked to cope with the difficulties of caring for someone with dementia?
• How has the UCSF Memory and Aging Center team been helpful?
• Is there anything else that you would like to say?

Instructions

1. Stories should be written from your perspective.
2. Video segments are limited to 10 minutes and 100 MB. We accept video files from most digital cameras, digital camcorders and cell phones in the .AVI, .MOV, .WMV and .MPG file formats. Please note that large videos will take a long time to load.
3. Pictures should be no larger than 5 MB (5000 KB).

Your Name or Nickname:
Your Hometown:
Your Email Address:		(required)
Your Story:
Your Photo or Video:

		I agree to these Terms and Conditions and acknowledge that I have granted the UCSF Memory and Aging Center the right, but not the obligation, to display my story on its website and use it for legislative, educational and media purposes to help other family caregivers.
		I am willing to speak to reporters about my story.

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