Ten Suggestions to Perk up Your
Visits with the Housebound

"While your world continues to expand and you're actively pursuing your interests and amassing experiences, the world of the invalid, infirm, or incapacitated is bound to contract, and they are likely to bring less and less to the table. Unless they have enormous inner resources, your relationship with them, which formerly was one of equals, eventually tips out of balance. Though still fond of them, you may find yourself visiting less frequently, and when you do, it may be harder and harder to make conversation.

"The secret to more satisfying visits with a long-term housebound friend lies in advance planning and creative activities. Here are ten ways to make your time together more relaxed and rewarding.

"1) Rehearse the visit in your mind. Don't count on spontaneity or serendipity to start the conversational ball rolling. Decide in advance on three or four subjects that might stimulate discussion. Bring along an item of interest — a newspaper clipping, a CD, a new app.

"2) Watch a movie or TV show together and talk about it with them in detail. Don't just ask, 'How'd you like it?' Ask what they thought of the direction, script, casting, scenery, background music. Challenge them to think of other actors who might have played each role more convincingly. Discuss the pivot points of the plot. Housebound patients may have lost their mobility, but they haven't necessarily lost their ability to form an opinion. Before you leave, ask your friend what movie they would like you to bring on your next visit.

"3) Convene a book group composed of the two of you or add a few others to the mix. The idea is for everyone to read the same book and meet in the patient's home once a month to discuss it. (These days discussion guides are often included at the back of the book.) Be sensitive to the limits of the patient's concentration. Don't choose War and Peace or the two-volume biography of Emma Goldman if Freakonomics or a breezy novel is about as much as your sick friend can handle.

"4) Bring a jigsaw puzzle. Offer to do it with them, and if the two of you don't finish it by the end of your visit, encourage your friend to continue without you. Tell her you look forward to seeing the finished product on your next visit. (Before buying, check the puzzle box for the number of pieces it contains: three hundred-piece puzzles allow for more immediate gratification and less chance that the patient will quit in frustration. Thousand-piece puzzles can be daunting.)

"5) Play checkers or chess, and keep score. If your friend is enthusiastic about either game, buy them a unique-looking set that will always remind them of how much you care about them.

"6) Use poker chips when you play cards. They feel good and add gravitas.

"7) Play one of the 'With Friends' games. Try 'Words with Friends' for starters. Available on Facebook, Android, or http://www.zyngawith friends.com/wp/category/blog/.

"8) Create a Trifecta of game classics. Scrabble, Monopoly, and Battleship could together comprise a tournament that lasts for months. Trivial Pursuit, Bananagrams, and Uno could be another. Whoever wins the first three games gets to choose the next three.

"9) Ask other friends of the patient to send artifacts — photos of themselves, mementos of shared events, personal anecdotes, written messages — and collect everything in a scrapbook or dedicated box. Go through the stuff with the patient, and as you do so, encourage them to share whatever thoughts each item evokes.

"10) Combine forces with other friends to create different cadres of visitors. Stagger your visits. Coordinate who comes when and which group brings what. With each constellation of visitors, the chemistry of each visit will change, providing a variety of stimuli to the patient."