Dementia Gateway: Keeping active and occupied

Reminiscence

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.

Faith Gibson (1998)

Explore the links below now to read more about this topic:

• 1. Why reminiscence (usually) works for people with dementia Open

  'Reminiscence' means sharing life experiences, memories and stories from the past. Typically, a person with dementia is more able to recall things from many years ago than recent memories, so reminiscence draws on this strength. So many of our conversations and interactions rely on short-term memory. Reminiscence can give people with dementia a sense of competence and confidence through using a skill they still have.

  Many people with dementia find themselves routinely having things done 'for' them or 'to' them. When a person shares something about their past and another person shows interest or enjoyment, it is a wonderful opportunity for that person to feel that they are the one who is giving something to another human being, rather than always being the one who is receiving or listening.

  Talking about the past can also bring up happy memories and good feelings, and this can be wonderful in itself, but particularly if a person is finding life difficult.

  It is also the case that reminiscence can sometimes provoke painful memories. Emotional reactions are not necessarily a bad thing, but we need to respond sensitively.

• 2. A person with dementia repeats the same story, over and over: why? Open

  It is not unusual for a person with dementia to have a favourite story which they return to again and again. Quite often the story will relate to a time when the person felt particularly happy or proud. Perhaps the person talks in detail about their job or their experience of raising young children. The message behind this repeated story may be that the person is now missing that sense of identity and purpose. By listening to the same story with interest, a good listener can help the person with dementia feel better about themselves.

  Sometimes the repeated stories relate to more painful memories or traumas. In these situations, the person may have some unresolved issues about this event and so is to some extent 'stuck' with that memory. In this situation, it is still important to listen. Sometimes it may be wise to distract the person with another memory or activity so that they do not stay in a distressed state for too long.

  For more on this, see the feature 'Repetition' in the 'Difficult situations' section.

• 3. Why asking lots of questions may not work Open

  'Do you remember when…?' is the question many people might associate with reminiscing. However, it might not be the best starting point for a person with memory problems. Plain, factual questions can be particularly challenging and stressful for people with dementia, who may fear they will get the answer wrong or be embarrassed about not being able to remember. 'How many children did you have?', 'Where were you born?', 'How old were you when...?': these are all examples of questions which a person with dementia may find hard to answer.

  So what is the alternative to asking questions like this? A good starting point might be to share a memory yourself as a way of leading into asking a question more gently. This helps gives clues for the sorts of things you will talk about, and may help the person to relax and recall their memories more easily, without fear of mixing things up or forgetting. It could go like this: 'I remember my first primary school teacher. She was called Mrs Jones, she was very tall with long hair and she was very kind.' You can then ask, 'I wonder if anyone here can remember their favourite teachers?'

• 4. Use a range of things to stimulate memories Open

  For people with cognitive difficulties, it is important to tap into all the senses to trigger memories. A picture to look at, an object to touch, a song or a poem to listen to or something to smell or taste can all take someone back in time, often to a very specific memory.

  If you know the person well enough, you will know the kinds of things that might relate to their past. If you know someone has been in the army, a picture of a person in an army uniform from a similar period to when they were in the forces might spark their interest. If you are working with a person from the Caribbean, offering some sorrel and ginger tea or playing some Caribbean or steel band music might be a good starting point.

  Reading an extract from an old book or a newspaper can also stimulate memories.

• 5. Doing rather than talking Open

  Sometimes it can work well to invite a person to show you a particular skill that relates to their past. For example, ask someone who has been a nurse to show you how they used to take blood pressure, or ask a mother how she burped her baby using a doll as the baby.

  When a person with dementia is struggling to use words, they may find it is easier to use actions to share something from their past. This is certainly what happened for Beryl, an older woman with dementia. One day I was spending time with her and, although I knew a bit about her past, I was struggling to get a conversation going. I knew she used to be a secretary, and for some reason it occurred to me to give her a small notebook, rather like a shorthand notebook, and pen – and to start dictating a letter to her, as if I was her boss. I started saying something like, 'Dear sir, thank you for your letter of… ' and so on. I was amazed to watch as Beryl immediately started writing extremely fast in shorthand. Within those few moments, her body language changed from a slumped disinterested position to an upright and attentive posture of a woman who knew her job.

• 6. Involving everyone in reminiscence Open

  Reminiscing can be a good way to make connections between people from different backgrounds or cultures or between staff and service users. When choosing topics or themes for reminiscence in groups, think about ways in which you can include people who may be in a minority, for example, someone who is a different religion or culture or someone who is lesbian or gay.

  Remember that some people may find it hard to talk about or may feel left out if certain topics are discussed. Sharing memories of raising children can spark lively discussion and can bring up some interesting comparisons about how different nationalities approach issues of discipline of children, for example. But people who have been unable to have children or have lost a child may find this a painful reminder of their loss. Knowing individual life stories will be important to ensure that you are aware of potentially difficult topics.

• 7. Some suggestions for reminiscence topics Open

  There is no topic that is entirely straightforward for everyone to discuss, although 'food' and 'holidays' might be safer themes to start with than 'wartime' or 'childhood' if you are running a series of groups. There are a wide range of other topics to choose from, for example:

  • working life: first jobs, best jobs, wages and working conditions, bosses, colleagues, uniforms
  • home life: housework, children, hobbies and interests
  • keeping warm: sharing memories of winter times without central heating!
  • transport: first cars, buses, trams, significant journeys
  • the local neighbourhood: favourite shops or shopkeepers, markets, street traders (a 'rag and bone man'), significant places in the community such as the town square, the library or the post office.

  Go to the 'Extra reading' section below for resources on running themed reminiscence groups (see Schweitzer and Bruce 2008 and Arigho undated).

• 8. Involving families in reminiscence Open

  'Remembering Yesterday, Caring Today' (RYCT) is the name of a particular reminiscence programme that has been used in many parts of the world (see Schweitzer and Bruce 2008). It brings together people with dementia and their families and staff to reminisce together over a series of weeks. The important principle behind the RYCT approach is that everyone reminisces together and learns more about each other as people, rather than the dementia being the main focus.

  Reminiscence is never something that is just done 'to' or 'for' older people only – it is something we can all enjoy. Typically, RYCT sessions give spouses or partners, sons and daughters or siblings the opportunity to see the person with dementia in a different light as they remember a song or a dance or tell a story that they hadn't heard before.

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