When people receive a diagnosis of dementia, they can often become frightened of what the future may bring. A large part of this revolves around personal identity and sense of self. It involves who they are as a person and whether this will slip away as cognitive abilities decline. It is, therefore, not surprising that fear is a natural reaction when faced with what can be an unpredictable time.
Identity is essential for everyone, the core of who we are. It defines us. It goes hand in hand with feelings of self-image and self-esteem. This is important for our health and feelings of well-being. This is no different for people with dementia.
As a consequence of the symptoms of dementia, the loss of short-term memories and inability to carry out activities once capable of mean that feelings of connection, identity, and self-worth can fade. As dementia progresses, potential vulnerability increases and the need to promote and preserve identity and self-worth becomes even more critical.
“Self-worth is a feeling that you are a good person who deserves to be treated with respect.”
(Merriam-Webster)
Reminiscence Therapy
In response to this, reminiscence therapy has become one of several popular methods aimed at helping people with dementia. It does this by helping to nurture feelings of who they are as a person by connecting to their past. By activating memories, we can help promote identity, self-perception, and self-worth, reinforcing feelings of meaning and wholeness.
“By showing a genuine interest in the lives people have lived, by reminiscing with them, it is possible to rekindle or reinforce a sense of uniqueness, personal identity, and self-worth” (Gibson, 2011).
In this article, we look at reminiscence therapy.
We consider what it is, how we can engage at home, and why it’s important.
However, before we do this, let’s consider some of the thoughts behind this area of therapeutic support.
Identity and Self-worth – a Fundamental Right of Every Human Being
The rights of people with dementia are now very much at the forefront of dementia care. Historically, much regarding dementia has focused on what the person can’t do. This emphasis has had the negative effect of accelerating dependency, reducing feelings of self, and increasing social isolation. In contrast, a new approach that nurtures and builds on retained ability is key in supporting people with dementia. It does this by maintaining feelings of well-being and self-worth.
In line with this, maintaining personal identity is a critical aspect of dementia care. As such, it is now reflected in many governmental policies and practices. Programs such as Promoting Independence in Dementia (PRIDE) are now central to understanding some factors associated with cognitive decline. They consider how it relates to identity. In addition, initiatives call for several core factors to be in place to promote the personal identity of people with dementia. These are known as the FREDA principles, namely Fairness, Respect, Equality, Dignity, and Autonomy.
In short, it is important to look beyond the diagnostic label and symptoms of dementia to the person. One way we can do this is to engage in strategies that promote a sense of self in people with dementia. Doing this, we help build on retained abilities such as long-term memory. Reminiscence therapy can help us do this.
What is reminiscence therapy?
People with dementia are better able to recall things from a long time ago as opposed to more recent memories. Reminiscence therapy is a practice that helps people with dementia remember events, people, and places from their past. Doing so gives people with dementia feelings of competence and confidence by using and strengthening a skill they already have.
By using appropriate stimuli connected to the person’s background and life experience, reminiscence therapy can help trigger personal memories and connections, surfacing positive feelings.
Reminiscence work doesn’t take a one-size-fits-all approach. Different people have different experiences and interests. They will engage in ways that align with what is meaningful to them. This can range from simple activities, such as a conversation, to more advanced therapies, such as this purpose-built facility of a 1950s town. Each method aims at helping bring memories from the distant past into present awareness.
Author of Reminiscence and Life Story Work, Professor Faith Gibson, has this to say on the topic:
“We all possess memories. We all have our own unique life history. Recalling the past is a means of owning it and hence preserving ourselves. It is a here and now process which holds the teller and the told in relationship with each other.”
How does reminiscence therapy work?
Reminiscence therapy uses prompts to encourage a person to recall memories and can work in one-on-one or group settings. Strong emotional bonds to the past allow people with dementia to recall familiar places, people, and events. These deep-seated memories remain. And, with some prompting, we can help our loved ones recall and connect with their personal histories. In so doing, it replenishes feelings of belonging, connectedness, and self-worth. Remember who they are and thus connect with their identity and sense of self.
Reminiscence therapy uses the ability to recall events that happened long ago, even when short-term memory is failing. It can also help to boost mood and stimulate wider conversation.
Reminiscing is not the same as simply remembering. Asking someone with Alzheimer’s disease or another form of dementia to remember something specific can make them feel pressured. It can make them feel stressed or put on the spot. They may not clearly understand or recollect what they are asked to remember. Reminiscing allows people to share as they choose and as memories come to them. It’s not about focusing on every detail to ensure accuracy. It’s about allowing the person to open up and share what is meaningful to them. The idea is to enable the person to reminisce in a calm, relaxing way.
Asking someone with dementia questions such as “where were you born?” or “where did you work?” may be difficult for them to answer. However, by engaging in reminiscence work with prompts and cues, such as photographs or objects, we can help trigger memories. By listening to the person, we support self-expression, connect with them, and facilitate communication.
What can we do at home?
As life-long family members, we are ideally placed at home to engage in reminiscence work as we know how best to tap into past life events, likes, and dislikes that have meaning for our loved ones.
This doesn’t have to take a formal approach. Just some simple prompting with different memory joggers can be all it takes. These can help plant the seeds necessary for the person to start recalling. You can develop your ideas. Or, you can use products on the market, including Reminiscence Conversation Prompts or Themed Memory Card Games. This opens up conversation channels. It lets your loved ones remember objects or events in life that were meaningful for them.
Some Examples to Try at Home
- Photographs: Photos are one of the best conversation starters; they help us remember. Old photos can stimulate the brain and open the floodgates of memory. All of a sudden, there is a conversation happening. It allows everyone to remember better times together – a lifetime spent together. It doesn’t just have to be photos of family, friends, or significant life events. It can be photos of favourite hobbies such as gardening, sports, crafts, or cooking.
- Music: Music is an excellent reminiscence tool – an easy and effective way to evoke emotions and memories. It is recommended for people with dementia, even those in an advanced stage. Founded by Scottish TV presenter Sally Magnusson, the charity Playlist for Life offers personalised music playlists of favourite and meaningful songs from the past. Read more in our article “Dementia and Music: Unlocking Memories, Nurturing Wellbeing
- Connecting with the Senses: Smell is a powerful way to access memories. Many people connect smells with comforting or emotional memories. There are many ways at home to help connect with aromas from childhood or as an adult, such as a favourite perfume. Taste is another wonderful way to evoke fond memories. Perhaps a favourite dish, coffee or tea, or a snack can help.
- Memory boxes: Families may find it helpful to create a memory box of photos, objects, or trinkets related to a loved one’s past. Sitting down together and gathering these items can help reminisce about the person’s life. You can hunt out old photos, dance shoes, handbags, newspapers, adverts, cinema cuttings, treasured objects, or letters. Anything that might remind the person and others of a time remembered with fondness. Watch this helpful video on creating a memory box for someone with dementia.
- Life Story: Life Story work is an activity in which someone with dementia is supported to gather information on their past life events and build a personal biography. You can find some helpful tips from Dementia UK or This is Me, created by Alzheimer’s Society. Another way to do this is through something like Book of You. This offers a great way to create a life story by capturing the precious moments that make up the foundation of our lives and who we are. It can include words, pictures, music, and film.
- Themed reminiscence boxes: Themed boxes contain items relevant to a particular theme or interest area. The contents of the boxes may be used to prompt memories or remind the person of different experiences. This can be done from scratch yourself or by purchasing ready-made boxes online. Examples include those found here or here. The Memory Box Project in England also offers several videos on reminiscence for people with dementia. These cover topics such as health, cookery, and gardening.
- Reminiscing with Screen Legends: For many people, old movies and film stars can arouse memories. Well-known clips from famous films can conjure up memories from the past. Five hundred all-time favourite actors can be found here to help evoke memories of Hollywood greats. There are lots of products online to help out with this. Watching an old movie can also do the trick. Here are the most popular by decade.
- Nature: Being outdoors in nature is a great way to help recall different times in our life. Or, it can even just allow us to immerse ourselves in general feelings of well-being. When outdoors, we trigger both emotional and aesthetic responses. We all benefit from a change in environment, indoors to outdoors. Nature and gardens provide a multisensory environment, great for pulling on different sensory stimuli that can tap into different memories. Thoughts, feelings, and meaningful activities all come to the surface. We feel a sense of freedom. Look at this video by Alzheimer Scotland in which people with dementia enjoy being outside in nature. This experience contributes to reminiscence, and how connecting with nature allows them to connect with themselves and others.
- Museums: Many museums around the UK offer loads of opportunities to indulge in reminiscence. The Living Memory Association, set up in Edinburgh in 1986, is one example. The project provides reminiscence museums in Edinburgh and Livingstone. Anyone can go in and browse around and enjoy the activities offered. They also share memories through newsletters. They have a range of reminiscence videos. These include topics such as washing days, school days, old games and toys, and more. You can find out about forthcoming events at the museums by visiting their blog.
What benefits does it offer?
We all like to recall happy memories from our past. It gives us a feel-good factor. It allows us to connect with ourselves, who we are, and our nearest and dearest.
Reminiscence work allows people with dementia to participate actively in their remembered lives. As a result, it enables them to overcome feelings of isolation and powerlessness. It enables them to feel valued as an ongoing family member or social group. It also helps them to relate positively to those around them and with themselves. They are part of something enjoyable and mutually acceptable. Each person is an equal participant.
It builds confidence and self-esteem. The opportunity to share something from the past opens the doors to feeling connected. It provides a sense of belonging, with a story to tell – theirs!! Sharing stories about past life experiences can help people with dementia feel less isolated and more connected to the present.
Reminiscence offers many benefits, not only for the person with dementia but also for ourselves as family carers. Sharing memories from the past can help “normalise” life when faced with disruption in life. The past is a place where family members and friends can relate. It offers a place where life was perhaps more equal and balanced in relationships. It creates a space where at one time, tasks, responsibilities, and pleasures were once shared more evenly. Recalling these times can significantly reinforce and support relationships in the present.
Thank you for reading.
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Please also check out our other articles on self-care for family carers and therapeutic interventions for people with dementia.