Reminiscence and Alzheimer’s Disease
Talking About One’s Past Has Many Benefits
It is a funny thing about Alzheimer’s that memories are lost in reverse order; memories formed recently are more fleeting than those from many years ago. Alzheimer’s disease starts in the hippocampus, the region of the brain responsible for putting experiences into memory. When the hippocampus is damaged, recent experiences never have a chance to become memories. Not until much later in the disease’s progression does it affect the regions in the brain in which older memories are stored, and so those memories are available even into later stages of the disease. Because of this, reminiscence and Alzheimer’s disease go hand-in-hand.
The phenomenon described above is responsible for much of the behavior and the symptoms commonly associated with Alzheimer’s, and we need to consider its effects when communicating with and selecting activities for people affected by the disease. As an example, the photograph at the top of this page shows seven American League players from 1937’s All-Star game. including Lou Gehrig and Joe DiMaggio. An avid baseball fan with Alzheimer’s disease may remember this game and these players better than this morning’s breakfast. If your loved one loves baseball, this image would be a better thing around which to base a conversation than the mornings routine.
Memory, Reminiscence and Alzheimer’s Disease
Many people with progressive memory disorders are much more comfortable talking about earlier memories. Because the area of the brain that stores memories long term is affected later in the disease’s progression, the affected person will know more about her life when she was 40 years younger than she knows about what has happened this week. This is part of the reason that reminiscence and Alzheimer’s can be such powerful therapy. A person with Alzheimer’s disease, for example, might have a detailed and lucid conversation about something that happened after the war (World War II or the Korean War) than what he or she had for breakfast, or experienced at the theater the night before.
Reminiscing and reminiscence therapy involve reaching the memories that reside in these still viable regions of the brain. There are many ways to encourage these memories, and you should. They can be comforting, even therapeutic. A study published in the June 2007 issue of Geriatrics and Gerontology International concluded that a reminiscence group program was an effective way to enhance the cognitive capacity of people with Alzheimer’s disease and vascular dementia as well as their ability to participate in normal activities of daily living. A summary of existing data, including studies published in professional journals, and interviews with specialists concluded that the general mood and cognition improved in subjects with dementia who participated in some form of reminiscence therapy.[pullquote]…there is some evidence that RT can improve quality of life, cognition, communication and possibly mood in people with dementia in some circumstances[/pullquote]
In a strict sense, reminiscence therapy involves discussing and sharing memories, reviewing and evaluating those memories, and re-capturing the emotions and feelings that are an integral part of those memories. This process can be done one-to-one or in groups. However, when reminiscing with someone with dementia it is often better to take a less formal approach, and one-to-one can be preferable to group reminiscence, especially for people in more advanced stages. You may want to eliminate the evaluation and review part and focus on the emotions inherent in the memories. The activity should be enjoyable and nonthreatening, and talking and sharing is not even a strict requirement. Never try to force the conversation, but you may have to lead it by making suggestions, like, “Do you remember what you were doing when Neil Armstrong landed on the moon?” Props or aids are also a good way to initiate and sustain the process.
Reminiscence and Alzheimer’s
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