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Here is my first twiddle muff and I used this pattern by Shirley McDonald. These muffs are very therapeutic for dementia patients as the decorations (buttons, beads and ribbons) give them something to do with their hands and can help calm restless impulses. I added one large button with a buttonhole for buttoning. People also add zippers but I didn't try that yet. Inside has more of the same items. I plan to donate this to a lady at our local nursing home that I think will like it.