The ‘good old days’ are often lovingly joked about as people get older. Wartime stories, tales of food shortages, working conditions, ‘make do and mend’, homes without technology and roads free of congestion can all seem very old-fashioned to my generation and those who are younger. If history is not something that captures your imagination, you may view talking about it with boredom, possibly even contempt, but remembering where we come from becomes increasingly important as we get older, and if someone develops dementia it takes on a vitally therapeutic role.
A commonly recognised characteristic in dementia is an inability to remember current or recent events, whilst having an often perfect recollection of the past. Indeed it can be when a loved one consistently exhibits this behaviour that their family become concerned about the possibility that they are developing dementia. Often the further back in time someone with dementia goes, the stronger their memories become, until they seem to be exclusively living in a time that those around them can struggle to appreciate.
In a society that craves immediacy and recognition, people with dementia are often considered to have ‘lost’ everything by being unable to live in the same moments that we do, but in many respects I view the way someone with dementia lives in the past as a safety mechanism that the disease places around the person. After all, for most people their youth and childhood is a magical time of carefree adventure, excitement, happiness and discovery. Retreating back to the years when you felt cocooned, loved and nurtured is something most of us would like to do when we hit low points in our adult lives, and whether you have dementia or not, or will go on to develop it at some point in your life, the memories of your youth will remain with you forever – in that respect, as in many others, people with dementia are not so very different from those without it.
A common mistake many people make when caring for someone with dementia is trying to persistently drag them into an understanding of the present, rather than learning to embrace the past. Questioning someone with dementia about their day or seeking opinions on current events is often very bewildering for them and frustrating for you. What you should ask yourself is why are you asking them to join your world when it is far easier for you to participate in theirs?
Unless you grew up with the person who has dementia you will never really know the true picture of the world they are living in, but that does not mean you cannot embrace it wholeheartedly. Reminiscence has a major role to play in dementia care in all areas, whether someone is living in their own home, in a care home, in hospital or involved in community based activities. It can stimulate interaction, provide support for someone with dementia through being non-challenging to them, promote comfort by nurturing happy memories, bring families together in a shared activity of talking about the past, help professionals gain a valuable insight into the person that they are caring for, and may even result in someone with dementia surprising those around them with stories that can be insightful, inspiring and very moving.
As a key part of personalisation, reminiscence can take on many forms. For some people it may be about favourite music, films, poetry, novels or art, whilst for others it could be best approached by reliving key sporting moments, fashions, architecture, signage, engineering or customs. Pictures, both personal and public, that evoke memories and illustrate what someone with dementia is thinking about often play a vital role in reminiscence therapy; everything from old seaside photos to domestic scenes can stimulate conversation (see the cards made by ‘Many Happy Returns‘), alongside newspaper headlines of major events, old magazine covers or photographs of famous faces.
It is generally far easier to promote reminiscence when someone is in their own home, surrounded by many of the things that can help to support their memories. Once that person moves into a care home or is taken into hospital this often changes, leaving them very disorientated, disengaged, and alienated by their surroundings. It does not have to be like that, however. Memories can be supported in EVERY environment, bringing huge benefits to the person with dementia, their families and the professionals caring for them.
Reminiscence therapy is not an expensive option for health and social care providers; it simply requires an adjustment in thinking that is about supporting people with dementia in their world, rather than expecting them to adapt to ours. Reminiscence should not just be confined to specific ‘activity’ sessions either. It should be everywhere in every moment, and become a partnership between professionals and relatives, especially as family knowledge can often make reminiscence particularly meaningful.
Dementia may rob a person of their present day, but while the past remains alive you have a window into your loved one’s world that can only bring you closer to them. Remember together, explore together and work with what dementia has given, rather than what it has taken away.
Until next time…
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