Photos, videos, and music help reignite once-lost memories for people with dementia. Experts discuss how caregivers can use this media.
As Alzheimer’s and other forms of dementia progress, brain cells and their connections degenerate and die, including those crucial for recalling old memories. That doesn’t mean all these memories no longer exist — but they might become damaged or harder to access.
If memories are files meticulously organized in rows of cabinets, dementia throws the organization into disarray. Reminiscence therapy is a way to guide people with dementia to help them make sense of the chaos and help them pull out memories with the guidance of past photos, music, or familiar items. There’s also been an explosion of technologies and applications to augment reminiscing.
“I believe in our everyday life as we have conversations with older persons, including persons with mild to moderate dementia, engaging in reminiscing is pleasurable and worthwhile,” Dr. Erik B. Larson, a former investigator at Kaiser Permanente Washington Health Research Institute, wrote. “And in turn, it’s meaningful for families to learn as much as possible from their parents and aging relatives about their family’s past, especially in a time when we are so mobile throughout the life course.
How well does reminiscence therapy work?
Amanda Lazar, an assistant professor at the University of Maryland, studies how technologies can be designed to support health and well-being as people age.
“The benefits [of reminiscence therapy] are fairly well documented,” Lazar told Being Patient. “This intervention is useful for people with dementia because it relies on their continuing abilities — which include the ability to engage in social interaction, to remember from their past, and engage with their senses.”
Lazar added that the music, photos, or other media used to facilitate reminiscence therapy also build bridges between caregivers and people with dementia, allowing them to connect through the shared experience. “In terms of how soon people can notice it is working, this depends on how it is implemented but also, what kinds of benefits we are looking for,” she said. “If the outcome is a pleasant time together, then the benefit can be immediate!”
What are some examples of reminiscence therapy?
Many non-pharmaceutical interventions for dementia fall under the broad umbrella of reminiscence therapy. Some of these include:
- Music and dance therapy. Listening, singing along, or even dancing to familiar music can help spark memories and reduce agitation.
- Browsing through old photos or videos with a loved one. Lazar explained that interacting with loved ones through the context of these materials can bring back memories and fuel conversation.
- Putting together a personalized biography. Caregivers can also walk their loved ones through a curated biography of their life. Lazar cautions that some biographical memories may be uncomfortable or traumatic.
Is new technology a bane or boon for reminiscence therapy?
Many apps like bAIgrapher and LifeBio Memory integrate artificial intelligence alongside cues and prompts to facilitate the therapy. But although Lazar has found some new technologies useful, she cautioned that many of them aren’t explicitly designed for people with dementia.
“We often simplify them [the technology] according to our assumptions of what is easier or harder for someone with dementia to use,” Lazar said. “I have found these technologies usually need someone without dementia involved anyways – which can be okay, since much of the benefit is around the interaction.”
She still thinks a better approach is spending money on skilled individuals like activity directors or art therapists who know how to use digital media and new technologies to maximize the benefits of the therapy. If this is unaffordable, she also recommends going to the library, googling shared interests, exploring memories through Google Maps, and borrowing old movies or music from the library.
Best practices for reminiscence therapy
While everyone is different, some common practices can help improve the experience for caregivers and their loved ones.
Inviting loved ones directly into an activity
Rather than asking a loved one a yes or no question, like “Would you like to look at some photos with me?”, ask open-ended invitational questions like “I would love to look at these pictures with you.” Avoid asking loved ones whether they remember something in a photo, as it can put people on the spot and make them uncomfortable.
Be mindful of the reminiscence materials that are selected
Lazar explained that picking materials that won’t overstimulate or understimulate a loved one is important. “More media is not always better,” she said. Limiting a reminiscence session to photos or art from the time period when a loved one was younger could be sufficient stimulation for one session. A caregiver could introduce videos, physical objects, or other media types in another session.
The social interaction doesn’t have to be verbal
Some people with dementia have trouble with verbal conversation, but that doesn’t mean they can’t interact and bond over familiar media with their caregiver.
“You can lean on continuing abilities instead,” Lazar said, explaining that these are skills, motor memories, emotional awareness, and a sense of humor retained long into dementia.
If a loved one has trouble with speech or conversation, there are other ways to reminisce — ways that stimulate skills or procedural memories, like cooking familiar recipes together or listening to old favorite albums or songs.
Whatever the medium, experts say reminiscence therapy can be a gentle, helpful way to engage in meaningful experiences with people who are living with dementia.