Living in the past is often viewed with negative connotations and discouragement. However, when it comes to patients with Alzheimer's or dementia, reminiscing can be a healthy and beneficial way to feel connected, valued and heard.
Reminiscence therapy or a “life review” was first proposed by Dr. Robert Butler, a psychiatrist specializing in geriatric medicine, in the 1960s as a new way to look at aging and the natural process of memory. This was counter to what the other leading psychologists and psychiatrists promoted as they felt that one should focus on the present and the future rather than try to relive broken or disconnected memories.
For caregivers working with patients who have cognitive difficulties, reminiscence therapy can be an effective tool for engaging in conversation, making the patient feel valued and heard, and dealing with difficult emotions. There are several easy and effective ways for even non-trained professionals to participate in this form of therapy.
What is reminiscence therapy?
The practice of reminiscence therapy involves exchanging memories from one’s past as a way to remember more things. Its main goal is to stimulate the brain and improve overall well-being. Professional clinicians and family members can use this approach in both a clinical setting as well as an informal setting.
There are three main types of reminiscence therapy:
- Simple: reflecting on the past in a natural and enjoyable way
- Evaluative or Life Review: examining life and sometimes addressing hard memories
- Life Story: a narrative approach of past, present and future
The strategy one uses will depend on the patient and the intended result. It’s also important to note that one method may not work every time, and the caregiver may need to use one or more methods over time. Some methods may not work at all while others may work quickly. If one type doesn’t work, don’t simply give up. Consider trying another day or maybe at a different time of day.
Reminiscing vs Remembering
When asking patients to remember something on command, many can become frustrated or embarrassed as they may not be able to remember certain information right away. Patients may also try to read the expressions or tone of the caregiver to see which response is appropriate and may say that they do remember when in fact they don’t. There are a few key differences between simply remembering something instead of reminiscing.
Remembering is the recall of specific things such as where you were born or where you parked your car. Reminiscing is walking through past events or memories but doesn’t always entail analyzing them.
The goal of reminiscence therapy is not to get someone to remember something from the past, but instead to create an atmosphere that allows memories to arise organically. The difference between these two can be tricky to understand at first, but when done correctly, this approach can help foster a deeper understanding and emotional connection between caregiver and patient.
Benefits of reminiscence therapy
The benefits of this therapy will vary from person to person and some benefits may not present themselves for each session. However, top benefits of using reminiscence therapy include:
- Creates happiness or a happy environment
- Encourages participation from both parties
- Reduction of negative behaviors or outbursts
- Improvement in feelings of self-worth
- Higher rate of daily confidence
Reminiscence therapy can be especially useful for patients who also deal with depression and anxiety as it helps to be reminded of past accomplishments, joys and struggles endured through the years, and how their past has defined who they are today.
Studies have also suggested that it can help improve a patient and caregiver’s relationship. Many caregivers are often focused on a needs level instead of an interpersonal level and reminiscing on both positive and hard memories.
It’s important to note that even though there is no research to show any negative effects of reminiscence therapy, recalling old memories can be difficult or challenging for some. Therefore, the caregiver will need to ensure an open and non-judgment mind as this can be a challenging scenario to work through.
Reminiscence therapy ideas for caregivers
You don’t have to be a trained clinician or professional caregiver to participate in reminiscence therapy. Here are a few easy ways for caregivers and family members to begin:
- Use a variety of mediums: Photographs, smells, music, food or objects can be a great first step to begin the conversation.
- Ask open-ended questions: As with any conversation, questions that result in a simple “yes” or “no” can be challenging to expand upon, so be sure to continue with follow-up questions if you ask a yes-or-no question.
- Use your observational skills: Are there objects or photographs they keep in a special place or tend to look at regularly? Look for conversation starters in the environment or home that can help trigger a conversation.
- Be open to emotional responses: Some memories can be hard or painful but that doesn’t mean they’re bad. Encourage these emotions as it can provide a therapeutic response.
- Begin early in the day: Many patients with Alzheimer's or dementia report the best time for recall is early in the morning. Working with them at a time that works best for them can lead to better results.
- Revisit special settings from one’s past: If possible, taking someone to an environment that is significant to them from their past can trigger these responses. Places like old homes, schools, religious places of worship, and workplaces are easy to visit if close by.
Reminiscence therapy is just one approach to help patients who suffer from cognitive related diseases. One must consider the patient's personal and medical history before starting this form of therapy, and it may not be suitable for all individuals.
Find more resources for dementia family caregivers in Texas in our Caregiver Toolkit—from communication tips for positive interactions to simple and effective activities to stay engaged.