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Mind Body and Soul: Reminiscence Therapy:

Can Dwelling on the Past Improve Dementia?

Shortly before her 50th birthday, Australian medical sales professional Kate Swaffer was handed a devastating diagnosis: she had a rare form of early-onset dementia. Although she has gone on to become a vocal advocate for those affected by dementia, co-founding the organization Dementia Alliance International, Swaffer does not hold back when describing the catastrophic feelings of sadness and hopelessness that the diagnosis brought with it, or the formidable challenges she now faces as part of her day-to-day life. “I think it boils down to a few constantly recurring feelings: confusion, frustration, humiliation, embarrassment, loneliness, isolation, anger, irritation, a deep sadness and, last but not least, worry, because I am constantly faced with an ever-changing playing field, never knowing what function is going to become impaired or lost tomorrow.”   

A Growing Public Health Problem

With the number of people suffering from dementia in the U.S. now nearing 6 million, the condition is rapidly emerging as one of the country’s most pressing public health problems. Alzheimer’s disease is the leading cause of dementia, accounting for approximately 60-70% of all cases. Although a number of important research breakthroughs have been made in recent years, including the discovery of potential links between the disease and factors such as brain-cell inflammation, cardiovascular health, and insulin resistance, the prognosis remains bleak. Alzheimer’s disease is currently ranked as the sixth-leading cause of death in the U.S., and it is the only disease among the top 10 leading causes of death that currently cannot be cured, prevented or slowed.

There are a number of treatments used for Alzheimer’s, with the majority being drugs. However, these treatments have a mixed success record and often bring with them an array of unpleasant side effects. One decidedly old-fashioned treatment for dementia has risen to the forefront and is earning plaudits for its effectiveness: talk therapy. Specifically, reminiscence therapy, which revolves around engaging all five senses in guided discussions about the past with people who have dementia. And although there are clinical specialists who are experts in advanced techniques, reminiscence therapy is simple enough that anyone–a caregiver, friend or family member–can draw out long-ago memories and lift the spirits of a person with dementia.

How does reminiscence therapy work?

According to psychological research, events that occur from roughly the age of 10 to 30 tend to be seared most indelibly into our memories. This period is known as “the reminiscence bump.” When a person develops dementia, the short-term memory is typically the first function to be impacted. But, remarkably, even people who have fairly advanced forms of dementia can often recall life events that occurred during the bump, particularly momentous occasions such as weddings, births, home purchases and others.

One specific type of reminiscence therapy is known as life story work, which involves putting together a photo album or scrapbook of memorable events in the patient’s life and then looking at the book together, allowing the patient to take the reins and tell stories triggered by photos and mementos. This type of activity has been shown to be emotionally beneficial for both the dementia patient and the facilitator, as the use of props, including scrapbooks, tends to help improve communication.

In addition to props that engage the senses, another key element of reminiscence therapy is using open-ended questions to gently encourage the dementia patient to access long-buried memories, pleasant feelings and associations. Geriatric nurse Sandy Klever says, “Other helpful tools include active listening, responding positively, asking follow-up questions, and allowing time for silence and emotion. If appropriate, share your own experiences as an offer of support.”

Although reminiscence therapy is a relatively new concept, it has been in use long enough to recently have been subjected to some evaluation research. The primary positive findings indicate that reminiscence therapy has been linked to improved cognitive health and mood, lessened depression, an improved sense of empowerment and self-esteem, and reduced strain experienced by caregivers and loved ones.

Reminiscence Therapy: A Journey of the Senses

The only real limitation when it comes to finding effective props to use in reminiscence therapy is your own imagination. It also takes some trial and error to determine which types of props and activities your loved one responds to most positively. In addition, if age-related vision or hearing problems are a concern, it is probably best to focus on the other senses.

Vision: The most widely used and effective prop in reminiscence therapy is the memory book. Although the family memory book is particularly popular, some caregivers have used other themes, such as career highlights, pictures evoking a hobby or recreational activity the patient once enjoyed, or even film stars or other celebrities from the era of the patient’s reminiscence bump. There are also hundreds of commercially produced games and props that can be helpful, such as the company Meternally’s themed memory mats.

Hearing: Few things provoke nostalgic memories as powerfully as audio cues, such as music. With today’s music streaming services and other technology tools, it’s a snap to put together a custom playlist of hit songs from your loved one’s younger years. Alternately, if you can’t communicate well enough to determine their favorites, Spotify, Pandora and other services have premade music playlists representing decades or historical periods. Add an audio punch to your memory book by purchasing a “talking” photo album, which allows you to record short audio segments related to each photo or album page.

Smell: Although one of the more recent areas to be studied in relation to reminiscence therapy, olfactory cues are starting to make a splash in the field, so much so that a number of companies are now producing “smell kits” or “smell cards” to help evoke memories of past environments, such as the forest, a garden, or a woodworking shop. Aromatherapy with essential oils is another increasingly popular activity. Allow the senior to smell each oil and ask open-ended questions about any memories or associations with the fragrance. An added bonus is that some oils can help soothe anxious or agitated patients.

Touch: Another reminiscent therapy technique that is gaining popularity is helping patients create virtual memory boards using touchscreen tablets and online platforms such as Pinterest. It can sometimes be easier to let a caretaker take the lead in creating an online memory board, then teach the dementia patient how to navigate it with the touchscreen device. Engage in simple craft activities, such as painting, may also evoke pleasant memories.

Taste: If food sensitivities or digestive issues aren’t an issue for your loved one, taste is a great way to access memories. Ideas include offering the dementia patient their favorite dessert, a beloved childhood comfort food, a dish that was served at their wedding or another special occasion, or a meal that is common in the culture or country they lived in as a child or young adult. Just a few bites can be the starting point for many happy memories.

Although a diagnosis of dementia can be difficult to process, it doesn’t mean your loved one is doomed to a lonely existence with poor quality of life. Reminiscence therapy is just one of many low-cost, simple methods you can call on to make sure your loved one is mentally engaged–and maybe even strengthen your bond and learn a few things about your family history in the process. 

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