Scent-based workshops are helping people with dementia tap into good feelings — and good memories.
As celebrity “scent guru” Ruth Sutcliffe watched her mom adapt to life in a dementia care facility, she wanted a way to help make life better for her mother and for other residents living with dementia in long-term care facilities. From this desire came a therapeutic kit of scents for people living with Alzheimer’s and other forms of dementia in residential care facilities.
The chocolate did it. Sallie (not her real name) regularly attended the smell awakening sessions Ruth Sutcliffe had been conducting since 2017 at her dementia care residence, The Greens at Greenwich. During her workshops, Sutcliffe invites participants to engage with carefully selected smells. She coats paper strips with scents like jasmine, lilac, pine, popcorn – and chocolate – and provides prompts and clues about each scent and then asks participants to smell, recall and share any associated stories.
Sallie would always smile, and sometimes, she joined the conversations, even though she usually could not detect the smells. But, Sutcliffe told Being Patient that in February 2020, in what would be the last session before lockdown, the group had an “ah ha” moment: “Sallie held the paper strip coated with the chocolate scent up to her nose and said, ‘It smells sweet.’”
The link between smell loss and dementia
Smell loss has long been associated with dementia. In fact, a diminished sense of smell impacts about nine out of 10 people living with Alzheimer’s. Because of this prevalence, researchers from McGill University suggest that loss of smell could be useful in the early diagnosis of Alzheimer’s. While it is common, this Alzheimer’s-linked smell loss, like Sallie’s, is usually not total. That could be good news for people living with dementia, because recent research on memory processing shows that, at least for some people, sense of smell may have the power to elicit or reinvigorate memory.
Another interesting link researchers have found between Alzheimer’s and an ability to smell is that smell can be an effective means to evoke autobiographical memories for people living with Alzheimer’s. For example, one 2019 study looked at odor exposure on the retrieval of recent and remote memories in Alzheimer’s and found that study participants with Alzheimer’s who were exposed to certain odors were better able to retrieve memories than participants with Alzheimer’s who weren’t exposed to any odors.
So, researchers say, it’s possible to tap into what’s left of a person’s sense of smell to connect with memories and emotions of past experiences. In other words, scent can be used to enhance the quality of life for people living with Alzheimer’s.
This was the impetus for Sutcliffe’s smell awakening sessions. Sutcliffe, who calls herself the scent guru, had a long career as a fragrance designer for major brands, developing scents for everything from blue Windex to a fragrance for Beyonce. But when her mother developed dementia, she wanted to help. Her mother had lost interest in food and was losing weight. Sutcliffe knew the power of scent to heighten enjoyment, and realized if she could stimulate the sense of smell for her mother, it could stimulate her desire to eat.
Bringing smell therapy for Alzheimer’s and dementia to care facilities
By 2016, Sutcliffe had seen the range of activities offered in dementia care facilities and noted there were no activities that focused on engaging residents’ sense of smell. So, she thought, “What if I develop an activity and go into assisted living communities from memory care, to give smelling sessions and see what happens?”
Since then, Sutcliffe has conducted more than 70 smell awakening sessions in the Northeastern U.S. and in Florida and has created kits that can be used in residential facilities or by family caregivers.
The scent memories that surface in Sutcliffe’s sessions are often from people’s childhood. That’s because, as Alzheimer’s progresses, it first impacts the areas of the brain involved with short-term memory, leaving the parts of the brain that store long-term memories untouched for longer.
Because of the unique nature of our sense of smell, the scent-driven journeys back in time tend to be emotionally charged as well. Smell memories are intertwined with emotion because smell is processed differently than our other senses. Smell messages bypass the thalamus and instead are processed in the amygdala and the hippocampus, the areas of the brain that govern mood and cognition.
At another session at a memory care residence in 2019, Sutcliffe recalls talking about her own memory of the smell of baguettes on the streets in France. That spurred one of the attendees to share his own memory of being a little boy in Paris when the Americans liberated the city from the Nazis. She captured the next moments on video, as the whole group started singing France’s national anthem, “La Marseilles.”
Sutcliffe often begins her sessions with an introduction about the sense of smell, how it impacts our well-being — and how it is one way we sense danger. She talks about sniffing food to see if it is spoiled, or detecting the smell of gas from a stove. At a group at an adult day program for Alzheimer’s, that introduction prompted a man to share that his sense of smell had saved his life.
He told the story of being in the jungle in Vietnam and smelling fish and garlic. American soldiers ate pork and beans, and other dehydrated foods shipped to them by airplane, he said, so when he smelled fish and garlic, he knew the Vietcong were nearby. Because he detected this scent, he was able to get himself and his comrades out of danger.
Reflecting on some of her visits to memory care units and nursing homes, Sutcliffe said she sometimes leaves these sessions, “feeling like I had been to therapy, my own therapy session,” she said, “because I realized how happy they were, and that they were sharing stories.”