Reminiscing and dementia

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What is reminiscing?

Reminiscing Manual version 1,

The benefits of reminiscing

Someone with dementia may only give you a small piece of themselves – all

there is, and enough, at that moment. That small piece is precious and may

become a strand or thread woven into your life as well. The fragments may,

like the creation of a mosaic, gradually be pieced together and something new

is created (Coaten, 2001, p 21).

Outcomes for the older person: one-on-one

When reminiscing celebrate the richness of life experience, allowing in the

process and the voice of the person to be communicated, however it is

expressed (Coaten, 2001, p19).

Involving an older person in reminiscing has many benefits for that person.

Some of these benefits are:

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Increase the ability to communicate and practice self expression.

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Increase social interaction through the sharing of experiences.

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Increase feelings of belonging and togetherness.

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person.

Emphasise the individual identity and unique experiences of each

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their experiences.

Allow the older people to take on a teaching role through the sharing of

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Help people to come to terms with growing older.

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times.

Encourage older people to regain interest in past hobbies and past

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Encourage creativity.

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Increase self worth and provide a sense of achievement.

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people.

Reduce apathy and confusion, especially in confused or disorientated

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(St George Museum, 2004, pp 4-5)

Alleviate depression.

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Increasing life satisfaction.

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Improving self-care.

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(Jones, 2003, p 27)

Helping older people deal with crisis, losses and life transitions.

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(Wareing, 2000, p 22)

Meeting psychological and emotional needs.

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interaction.

(Spencer and Joyce, 2000, p 20)

Involvement in a meaningful and pleasurable activity and positive

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Reminiscing Manual version 1,

Outcomes for the older person in a group

There are some unique outcomes for people who participate in reminiscing as

part of a group. Some of these outcomes are:

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individual member and of the personal effectiveness and significant

contribution of each participant

Increase awareness among group members of the uniqueness of each

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and concerns

Increase realisation that other group members may share similar problems

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and achievements

Gain knowledge and understanding about the older person’s life, history

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behaviour

Find links between the older person’s past experience and present

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understanding more about a person can facilitate more meaningful contact

Assist the relationship between older people and their carers, as• Provide.....more next time

Benefits for the carer, family and volunteer

Reminiscing not only benefits the older person but the carer, family member

and volunteer who may be engaging the older person in the activity. Some of

these benefits are:

Increase the sense of belonging and acceptance by the group

Sometimes we remember because our memories have been triggered

involuntarily by a favourite song or tune and sometimes we remember on

purpose. Reminiscing gives us a pleasure and a sense of relatedness and

connection with what has gone before (Coaten, 2001, p 19).

Reminiscence allows us to relive events from our past. It is a process which

focuses on the personal way we experience and remember events, rather

than on chronological or historical accuracy. When we reminisce we don’t

simply recall random events in a cold factual way. With reminiscing we are

able to relive the experiences that are personal to us in a way that is vivid and

engaging.

Reminiscing encourages older people to become actively involved in reliving

and sharing their past with others. Although reminiscence involves recalling

past events it encourages the elderly to communicate and interact with a

listener in the present. Reminiscence groups can operate on different levels.

Groups can be run with older people and with a range of competencies

including those who are confused.

As a recreational activity reminiscence can provide occupational and leisure

activities for older people. As a means of psychological support reminiscence

is aimed at generating self-esteem and the expression of individual identity.

Reminiscence can also be used as a therapeutic tool to aid the life review

process.

Reminiscing kits can contain items from the past that will be of significance to

the lives of elderly people. Interaction with objects from the past is an

important way of stimulating responses and can provide a focus for the

recollection of deeply embedded memories. As memories can be triggered by

a variety of different senses people will respond to the objects differently. The

use of objects as prompts for memories is especially useful when working with

people who have dementia.

(St George Museum, 2004, pp2-3)

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Reminiscing with a group of persons with dementia

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Group numbers should be small. Let the following be a guide:

o

have dementia.

No more than 8 or 10 when working with older people who do not

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moderate stages of dementia.

No more than 6 when involving older people who have early to

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advanced dementia.

No more than 3 when working with older people who have

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•

o

reminisce and communicate well.

An appropriate group size allows objects to be circulated rapidly to Session times may vary depending on the group. Let the following be a Up to 45 mins when working with a group of people who can

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dementia.

20 to 30 mins with a group who may be in moderate stage of

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Small pockets of time for people with advanced dementia.

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make people feel at ease.

Quiet, intimate and comfortable surroundings are important in order to

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Placing seats close together helps promote an intimate atmosphere.

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• It is important not to use too many objects per session, as this can Select up to 6 objects that you feel are most appropriate for the group.

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.

As facilitator it is important to do as much listening and as little talking as

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It is important to ask open ended questions that require more than yes or Its is important to keep track of who has not spoken in the session. As a Don’t be concerned if the discussion leads to subjects beyond the theme Reminiscing Manual version 1,

Suggestions for group work

Some extra tips for group reminiscing are:

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Use a room where the participants will feel comfortable and able to talk.

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participants to hear others.

Seating in semi circle allows for easy passing of objects and for

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considered as women’s work.

Men can be encouraged to discuss topics which have traditionally been

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people but be careful not to offend or disregard anyone’s personal

experience.

Use the opportunity to hear different versions of an event form different

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insights into each object or experience.

Use the differences within the group, such as age, to obtain greater

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Introduce the topic and then gradually pass the items around.

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remember while others will speak up quickly and often.

Allow plenty of time for discussion. Some people may need time to

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accommodate spontaneity.The groups need some structure however allow sufficient flexibility to

Reminiscing with Groups

When holding a group reminiscence keep the following in mind:

Reminiscing and dementia:The five senses

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Hearing Sight Smell Taste Touch

Some older people may no longer have the ability to explain or express their

thoughts through words. Reminiscing is much more then simply talking about

a memory. Reminiscing can involve all the senses.

For people with cognitive impairment and difficulties in communicating

verbally the opportunities offered by a different, non verbal, way of

communicating may be of great importance (Coaten, 2001, p 21).

Providing sensory stimulation through sound, movement, dance, rhythm, beat,

smell, changes in light and colour, objects, tactile surfaces, materials,

vibration, food and experiencing flavour can provide vivid and strong

reminiscence.

The persons ability to derive pleasure from the use of some or all of the five

senses is an important strength. Many activities can involve some sort of

sensory stimulation which helps to engage the person with advanced

dementia in a pleasurable activity (Spencer and Joyce,2000, p 18).

Activities mediated through visual and tactile modes can help the person with

dementia in orientation, in feeling safe and in both stimulation and enjoyment

(Armstrong and Wright, 2002, p 19).

The importance of hearing and ‘touch’

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thus hearing is a major sense.

Hearing is one of the last senses to go as an older person looses abilities,

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non verbal types of communication that can be fully perceived.

Deterioration of other senses can result in touch being the one of the only

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This can result in a loss of reality.

If elderly people are not touched they can lose touch with the environment.

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their hand and talks to them.

An agitated older person will often relax when someone sits and holds

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be faked. So… what is communicated if we do not touch?

(Boney, 1994, pp 26-27)

Touch conveys attitudes and feelings. Touch is something which cannot

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Reminiscing Manual version 1,

When reminiscing brings up difficult, sad or

distressing emotions

Not all memories are positive so it is important to ‘check in’ with the person

throughout the reminiscing experience. Keep the following in mind:

•

not necessarily a bad thing. Sometimes it is OK for the person explore

their feelings and for these feelings to be acknowledged.

If an older person starts remembering a sad or difficult time in their life it is

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These experiences are just as important as happy ones, so don’t feel that

you need to steer discussion on to a happier topic unless it is clear that the

person or group is becoming distressed. Sometimes reminiscence can

lead to feelings of depression and may require one to one follow up (St

George Museum, 2004, pp 6-7).

Often sad experiences will be recalled as part of reminiscence therapy.

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When painful emotions arise and the group has difficulty in dealing with it,

the leader should intervene or advice should be sought from staff and

family (Museum Victoria, 1995, p3).

Environments should be supportive and confrontations should be avoided.

Engaging a person in a reminiscing session

Reminiscing one-on-one

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reminiscing session:

It is important to gain the attention of the person you will be with during the

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Be physically at the same level with the older person.

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Make eye contact if possible.

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reminiscing objects in a place the person will be able to see as this

will help to make a connection.

If eye contact is not possible be sure to have your hand or the

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them through touch, movement, talking or possibly move them to an

area where there will be a difference in light.

If the person has a sight impairment let them know you are with

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are minimal distractions and where you will not be interrupted.

Always use a space where the person can feel comfortable, where there

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Use the following methods for an introduction:

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told you on a previous reminiscence or use an object they reacted

well to previously.

Introduce yourself and possibly mention something the person has

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theme.

Give the person a clear introduction to the reminiscing session and

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they are comfortable with.

Don’t rush the person. Allow time for them to communicate in a way that

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Reminiscing Manual version 1,

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channels but probably more powerful. Look for the following:

Look for non verbal cues as they are often more subtle than verbal

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Watch for facial expressions.

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Is the person looking?

o

Is the person adding a gesture?

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time.

If using objects from a reminiscing kit hand the person an object one at a

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objects for a long time whilst others for only a short time.

Keep to the pace of the older person. Some people will keep interest in

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and that the person knows the reminiscing is coming to an end (Armstrong

and Wright, 2002, p18).

When closing the reminiscence make sure the activity has a formal ending

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memory. If someone is thinking about a sad or distressing memory keep

the following in mind:

Check that the older person is not left thinking about a sad or distressing

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‘Walk’ the person out of that memory onto another.

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genuine.

Acknowledge how the person is feeling, that their emotions are

o

(Armstrong and Wright, 2002, p18)

Stay with the person a little longer if time permits.

Tips for successful conversation

Keep the following in mind for clear communication:

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they often work better e.g.

Don’t ask specific questions that are closed ask open ended questions as

o

‘How are you getting on?’

o

advanced dementia).

‘Please give me some advice on…” ( not suitable for people with

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may take a while to get to know the person.

Building up a sense of trust is important. Be realistic and recognise that it

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conversation flow under the older person’s control wherever possible.

Allow the person with dementia to set the agenda. Let the topic of

•

older person time to speak. What may seem like an uncomfortable, silent

wait for us can allow the older person time to gather their thoughts and

respondBe a good listener. Listening means learning to stop, wait and allow the

The five senses

Reminiscing and dementia (part 2)

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Provide an opportunity to learn about the pastA way of finding a connection with another person and sharing similar It is important to recognise that your view of someone else brings with itWe are all seen by others in different ways.

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There are many ways you can view an older person e.g. as a mother,The way you think about someone else can also be influenced by yourYou may find yourself relating easily to one person but not another for aIt is important to look at the approach you take when engaging with anReminiscing Manual version 1,

Tips on approaching reminiscing

When engaging in a reminiscing activity with an older person use the following

approach:

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A person centred approach used with sensitivity, flexibility, awareness andA focus on positive interaction with emphasis on brief, high qualityIt does not matter if the enjoyment is for a short time or fleeting as it is stillBe aware of attempts to communicate as what we see as ‘difficultBe person focused and let the person talk about what is important to them.

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Give everyone the opportunity to interact:

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their experiences and feelings were most likely to be given

opportunities for conversation.

In one study it was found older people who were able to talk about

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have withdrawn completely as they may have given up altogether

on communication.

This same study emphasised the need to focus on those who may

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Spending time listening to a person with dementia says to them they areThe use of humor as a means of communication can catch a person’sIt is important to recognise the many factors that influence one’s life.

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It’s all in the approach: Engaging older people

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Follow up:Tricial Pursuit Activity

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Trivial Pursuit: Junior Edition

Thank you Lorelei for your suggestion of Trivial Pursuit. If you find that the standard games are not appropriate for your audience,make your own game. Thatcan be an activity in itself.

If you need help doing this, leave a question in the comment ares

Some Fun and Stimulating Dementia Activities

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Nursing Home Activities Resource

Dementia activities should focus on enjoyment rather than achievement. A caregiver would want these dementia activities to reduce boredom but not to over stimulate either.

Laughter is always the best medicine. Though the patient may not always understand your humor, they can appreciate a good tease, a little nonsense and some clowning around.

Movement is very important for many dementia patients, as they can become prone to sit for long periods in one place doing seated activities like board games and crosswords. Walks outside or mild exercises, either seated or standing, can help to get the blood moving again and ward off boredom and a sense of isolation if they've been without much group activity.

With Alzheimer's and dementia activities care should be taken to eliminate expected outcomes and focus primarily on the activity itself. Cognitive dysfunction makes remembering game rules, sequences and strategies very difficult, if not impossible in later stages of the diseases. Slower paced activities involving simple repetition can prove most effective. Sometimes it is just a fidgeting type of activity that can best keep these seniors occupied.

More next time

Focus on: Cultural Competency

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