We talk a lot in dementia care about the importance of familiarity, whether it’s achieved through using words or phrases that are familiar to the person, or whether it’s through familiar environments (OWL FM) or familiar items or objects.
Familiarity in the latter sense is often associated with things like photographs or keepsakes, but I want to tell you a story about an ordinary, everyday object and its meaning to me.
An old box (that was important to me)
In 2019 I wrote about my experience of miscarriage, and in 2020 about my successful pregnancy with my son. As anyone who’s had a miscarriage followed by another pregnancy would understand, pregnancy after miscarriage is fraught with worries and fears. For the first 12 weeks of my 2020 pregnancy I was frightened, especially every nighttime (my 10-week miscarriage happened overnight), and I developed a routine of being on my own and having certain familiar things around me. Maybe it was superstition, but it was my way of coping.
During those lonely and scary nights, I kept a tissue box with (apart from tissues!) a few items for comfort at night (lip balm etc). It was an ordinary tissue box with absolutely nothing special about it, but I had it next to my pillow and memorised the pattern over those weeks.
Time passed, my pregnancy was successful and my son was born, but I kept that tissue box. In fact, I only finally put it in the recycling bin earlier this month, having patched it up with sellotape a few times until it was beyond repair. But even that wasn’t a quick decision. I thought about replacing it with another box for a few weeks until I finally did.
Why? Because it represented something. That old, battered box was a reminder of a dark, lonely and frightening time that I’d come through on my own with that box and its contents as my companion. It was a time that I didn’t want to forget (and will never forget) even though my life has changed so much since then.
Seeing the value in that which has no value
So, what’s the point of me telling you this? Well, think about a person in their own home, or a care home, living with dementia and having that ordinary and very battered tissue box alongside them and not wanting to part with it. You can’t see the point – you can get them a lovely new tissue box. Their one is falling apart after all.
But the person doesn’t want something different, they want that old battered one. Maybe you replace it anyway, thinking that your actions are kind. Or maybe you conclude that their dementia is progressing more rapidly than you thought if they are now ‘paranoid’ and ‘obsessed’ over an old box.
The thing is, we don’t always find comfort in the obvious things like a childhood teddy bear or a photo of a family member. Sometimes in the dark, difficult moments of our lives (of which a person with dementia would experience many that they cannot necessarily articulate) it’s the ordinary things around us that bring us comfort and familiarity.
Sometimes too, things that are with us through those times and represent our struggle are kept to remember that struggle. Yes, a person may not be able to explain what they’ve gone through, but they will know the feelings associated with an item or object. We don’t always want to move on or airbrush difficulties from our lives. Sometimes we keep them close to us as a mark of what we’ve overcome.
Familiarity comes in many guises
The lesson for us all is to remember that anything can be an item of familiarity to a person. For a person with dementia, however, who can’t explain their story like I just have, we need to be particularly sensitive and careful.
In my care home work, I once knew of a lady who always drunk from the same mug and would never allow the staff to put it in the dishwasher. She had her tea in it, her coffee in it, and her water in it at nighttime. She was adamant she didn’t want it to disappear behind the door of ‘that thing’ (the dishwasher) and staff couldn’t understand why.
I went to see this lady and observed the mug. It had a faded picture of a house on it and it had got chipped from when a staff member had tried to wrestle this mug away from this lady. We got chatting and I admired the mug. The lady smiled proudly, like the mug was a trophy she’d won.
I asked about the picture and she smiled again and held it closer to her face, drinking in not the contents but the image, carefully rotating the mug. I said I liked the roof of the house. She replied, “But it leaks a bit.” I laughed and said, “With tea?”, to which she looked quite annoyed and said, “With water of course.”
I asked where the leak was, and she said, “In the corner of my bedroom, can’t you hear the drip, drip, drip?” And then I realised. The mug, or more specifically the faded picture on it, reminded this lady of her childhood home.
From that day on, staff supported the lady to wash the mug up herself and make her own drinks in it just so that she didn’t ever need to be parted from it. It even went to the bathroom with her and sat on the shelf.
It was old, battered, faded, chipped and probably the least smartest mug in the entire care home. It had been at the back of a cupboard she’d been unpacking one day, early on in her stay in the care home, and she’d instantly taken to it. It represented a memory for her, a house that reminded her of home, and the comfort that home represents.