Are you trying to understand reminiscence therapy?
Do you have a loved one that is showing early signs of memory loss?
Would you like to understand what you can do to help a person with dementia?
It is estimated that the number of people suffering from dementia worldwide is close to 50 million. As our aging population grows, that number is expected to double every twenty years. It’s a big problem and especially in lower to middle income countries. In the United States alone there is at least 5 million people, mostly seniors, who are living with dementia.
Dementia is one of the leading causes of dependency in our elderly population. If you or someone you love suffers from dementia or has recently been diagnosed, you are obviously not alone. It can be a scary diagnosis, as we commonly hear that diseases of the mind can be among the cruelest due to the memories of a lifetime fading away. It can also be very difficult for loved ones, caregivers, or those charged with dementia care for the patient.
There is help for dementia patients and even things that we can do as loved ones and caregivers to provide therapy for dementia including Reminiscence Therapy. But first, let’s take a closer look at dementia and alzheimer’s (go straight to Reminiscence Therapy).
What is Dementia (and Alzheimer’s Disease)?
To begin, it’s important to understand what dementia is, and what is not. Dementia it is a term that is used to describe a group of symptoms that are associated with the loss of cognitive function and behavioral abilities. When the impairment is severe enough to degrades one’s quality of life because they can’t perform everyday activities, a patient is described as having dementia. Dementia is not a specific disease, nor should it be confused with senility, which implies that mental decline and memory loss are a normal part of aging.
There are many conditions that cause symptoms of dementia in people but two account for the majority of cases. The first leading cause of dementia is Alzheimer’s disease. Alzheimer’s patients may account for as much as 80 percent of the cases of dementia. According to the Alzheimer’s Association, 5.8 Million Americans are living with the disease and by 2050 the number is expected to rise to 14 million. Alzheimer’s is the 6th leading cause of death in the United States and is characterized as an irreversible, progressive brain disorder that slowly destroys mental health. The second leading cause is vascular dementia, which occurs following a stroke. When blood vessels and brain tissue are injured, the outcome is cerebrovascular disease. The loss of blood flow can kill cells in the brain and result in sudden changes in thinking skills; however, damage to smaller blood vessels can also manifest in milder or more gradual thinking problems.
What are the Symptoms of Dementia?
There are many symptoms of dementia and these symptoms can vary widely. However, to be classified as dementia at least two of the core mental functions below must be significantly impaired:
- Communication and language
- Ability to focus and pay attention
- Reasoning and judgement
- Visual perception
Often the symptoms are gradual or progressive. They start slowly and worsen over time. Short-term memory loss is one of the most noticeable symptoms. Daily activities may become more challenging when people with dementia forget where they placed a personal belonging, such as keys or wallets. Or, they may get lost because they can’t remember directions to places visited in the past, including their own home.
What Causes Dementia?
In short, dementia is caused by brain cell death. Damage to the brain cells interfere with the ability of the cells to communicate with one another. This lack of communication can lead to problems with feelings and emotions, thinking and cognition, and behavioral problems as well. While most causes of dementia are irreversible, some can be treated by reversing the effects of the underlying causes. These include:
- Medication interactions
- Vitamin deficiencies
- Thyroid abnormalities
- Alcohol abuse
It can be challenging to diagnose dementia because there is not one single test that is used. Instead, doctors have to rely on medical history, laboratory tests, physical examinations and observations of day-to-day changes.
Since the 1970s, the medical community has been using cognitive dementia tests to help reliably make a diagnosis. In these tests, simple questions are presented to the patient which are used to determine cognitive impairment. Even if a diagnosis can be made, it might be difficult to determine the type of dementia, in which case a specialist, such as a neurologist, might be necessary. Different types of dementia may require different treatment plans.
What are the Treatments for Dementia?
Because brain cell death is irreversible, there are no treatments for most forms of dementia or alzheimer’s. Nothing is available to help slow or stop the progression. Instead, current approaches focus on helping people maintain mental function, manage behavioral symptoms, and slow down certain problems — mainly memory loss. There are several types of drugs called cholinesterase inhibitors that are approved in the U.S. These drugs prevent the beak down of acetylcholine in the body, which helps with cell to cell communication. If dementia is due to a non-degenerative, reversible cause, there are other treatments available to help prevent further damage.
As the case with many diseases, there are ongoing, controlled trials that are studying potential treatments. Even one clinical trial can yield positive effects leading to a break through treatments. Because of the complexity however, it is unlikely that one drug will treat dementia. Researchers are instead hoping to find ways to target genetic, molecular, and cellular mechanisms to prevent the underlying cause altogether.
Other Treatments for Dementia
Dementia may cause other problems with patients, such as mood and sleeping disorders; therefore, doctors might prescribe medications to help with sleep and depression. People with dementia may also be restless and anxious so other medications may target anxiety. Finally, some patients may benefit from antipsychotics to help relieve agitation, delusions or hallucinations.
Other therapies are focused at helping one to cope with dementia by bringing joy to their day. These therapies focus on “jogging” the memory to bring pleasure and improvements in quality of life. These other therapies include Cognitive Stimulation Therapy, Reality Orientation Therapy and Reminiscence Therapy.
Reminiscence Therapy — What is it?
Merriam Webster defines the word reminiscence as the process or practice of thinking or telling about past experiences. So, as the name implies, Reminiscence Therapy (RT) is a form of therapy where patients communicate and interact with another person in order to bring memories from their past into the present moment.
It is a non-pharmacological intervention that is intended to help people with dementia remember events, places and special people from their past. RT has been shown to help increase self-esteem and bring comfort to those experiencing memory loss.
How does it Work?
Dementia and depression typically go hand in hand. As people begin losing their memory it’s natural for them to feel confused, isolated and lonely. Older patients may start feeling like they are being left behind or disconnected due to the deterioration of their mental health.
The goal of RT is to help one to recall memories of the past that can help them feel more content and connected to the present. It may be administered in a group setting, or in an individual session.
All of the different senses can be employed during RT. A photograph from the past can be shown to a patient in order to help them recall a special time in their life. A song might be played (music therapy) that takes them back to a certain era of their life. Scents and tastes can even be incorporated. Anything that can help to relive a moment from the past can be helpful to the RT process.
Group reminiscence therapy can also improve communication and quality of life by encouraging participants to share stories about past events to a group of people. These reminiscence groups will have group meetings periodically to engage the participants on a regular basis.
Individual sessions can vary from a structured meeting with a therapist or counselor to a casual conversation with a family member or caregiver. These sessions can be considered formal or informal. In these one-on-one meetings, a life review can be used to walk a person chronologically through their life.
Some studies have suggested that a life story (a product from the life review) can help dementia patients engage with the reminiscence work. The life story is merely a collection of photos, stories and other memorabilia that help to spark the memory of the dementia patient. These life stories have shown that the even after the reminiscence therapy, a patient has improved quality of life scores and stability in depression scores as the life story book helps to trigger positive emotions tied to their long-term memory.
Benefits of RT
For patients with deteriorating mental health, it may seem like there is no hope going forward and no way to return back to normal. While it is true that things may never go back to the way they were, reminiscence therapy has shown promising results for improving one’s self-worth and sense of identity. RT has also shown exciting results for the family members and the caregivers of the dementia patient as they are not only able to bond with the patient, but also to share in memories and stories that may have been tucked away deeply in the mind. More studies are needed to fully understand the value of RT, but even with limited studies available, benefits have been reported that include:
- Opportunities to increase communication through social interaction and storytelling.
- Reduction of stress and agitation thru recalling positive memories and feelings from the past.
- Temporary relief from boredom and depression while focusing on memories and stories from the past.
- Increase of confidence and self-worth.
- Better emotional connection to loved ones.
- Preservation of stories, memories and important family history for future generations through the expression of stories from the dementia patient’s past.
Sandy Klever, RN BA very appropriately summarized the benefits of RT: “I don't know anybody who doesn't have a need to be acknowledged. Because most of us are healthy and mobile, we can usually seek out friends and family for listening support. Often though, older patients are isolated and have trouble finding someone to validate their worth. They often feel incapacitated in the modern world if they can't figure out how to use cell phones, replay phone messages, or operate a DVD player. The wisdom they've acquired through years of experience can seem inferior in our fast-paced world. Reminiscence therapy can reaffirm the importance of their hard-earned wisdom.”
Can Lastly.com Help with Reminiscence Therapy?
Lastly.com is a modern website that is intended to help families preserve their history by enabling users to capture their LifeStory™. Instead of letting history fade away, Lastly.com is allowing older Americans to preserve the special events and memories from their storied life so that their legacies are captured for the future.
Lastly.com has created an innovative approach to preserving one’s story by offering a simple, but structured LifeReview™, where a life is organized into over 20 chapters dedicated to either a time period of life (ie grade school) or special function (ie hobbies). Simple questions are asked that allow the user to answer, while providing the opportunity to upload photos and share more detailed stories. The LifeReview gives a walk down memory lane—the answers become part of the user’s LifeStory. All of it is preserved in the cloud so that future generations can appreciate those that came before them.
The LifeReview becomes an ideal tool for use with reminiscence therapy. Not only does it provide the questions relating to the past, but it allows the space to record the stories and associated photos that provide so much color to the happy memories and events throughout one’s life.
The dementia patient will likely need the help of a loved one. Lastly.com is a web-based tool and depending on the computer literacy of the user, he or she may need help using the web application. Let’s also not forget−it appears that one of the leading benefits of RT is the ability to reconnect with others and the opportunity to share proud stories and monumental life achievements. A life is meant to be shared; perhaps reminiscence therapy is all about providing that special window of time to share those special moments. Lastly.com should be shared as well. If someone you love is suffering from dementia, Lastly.com might be the perfect vehicle for you to not only reconnect and to provide joy, but to capture the invaluable stories of the past.