Joe lost his ability to tell time but could still play his violin. Mom could no longer speak but could sing Sarah Vaughn’s “Nearness of You” and identify the artist by name. What memory is lost for those with dementia? And how are other types of memory retained?
There are basically two types of memory: Semantic, which is our cognitive memory, and Empathetic memory, which is our emotional memory. Our cognitive memory serves as our database, containing all the knowledge and skills we've acquired throughout our lives, including language skills, mathematical abilities, navigation, and most importantly, our learned behaviors. On the other hand, our emotional memory encompasses our feelings and emotional responses to various stimuli such as happiness, sadness, joy, fear, and apprehension. Both types of memory are impacted by dementia diseases. However, while cognitive memory is severely impaired, emotional memory tends to remain relatively intact.
Throughout our lives, we rely on both types of memory to navigate and make sense of the world around us. Cognitive memory informs us about factual details, like weather forecasts, while emotional memory guides our responses based on how we feel about those details. For individuals with dementia, while they may struggle to process factual information or recall learned behaviors, they often retain their emotional responses. For instance, they may not understand the concept of a snow day or how to dress appropriately for cold weather, but they will still feel discomfort in the cold.
Understanding how dementia affects memory provides us with a significant advantage when interacting with and caring for those affected by the condition. By recognizing that cognitive challenges are likely to cause distress, while emotional connections can provide comfort, caregivers can adapt their approach to provide more effective care. This approach not only helps keep loved one’s calm and content but also reduces stress for caregivers. Mastering this insight can be a game-changer, offering a valuable strategy for navigating the complexities of dementia care.
For those who live and interact with individuals with dementia, the following points and interventions can make a significant difference:
1. Avoid correcting errors: For example, if they mistake the day of the week, instead of correcting them, validate their perspective. Agree with them, smile, and offer reassurance. For instance, saying "Yes, it feels like a Sunday today, doesn't it? Let's enjoy the day together."
2. Refrain from arguing: If they resist certain activities, such as joining a meal, acknowledge their feelings and try to redirect them with a comforting alternative. For instance, if they express a desire to go to bed instead, you might say, "It sounds like you're feeling tired. How about we have a little snack together before you go to sleep?"
3. Address disruptive behaviors: When faced with behaviors like sundowning or wandering, provide positive distractions and gently guide them towards soothing experiences. For example, take them to a window or outside porch and point out the beauty of nature, such as birds chirping or flowers blooming.
4. Use music to calm agitation: Provide a sense of familiarity and comfort through their favorite tunes. If they are feeling anxious or agitated, try using a headset with their preferred music and offer a warm blanket for added comfort.
5. Create a soothing environment: When encountering resistance to personal care activities, such as bathing, use pleasant scents, warm towels, and engaging stories to encourage cooperation. For instance, you could use lavender-scented soap, wrap them in a warm towel, and share amusing anecdotes and don’t rush them to make the experience more enjoyable.
6. Respond with understanding: If accidents occur, respond with empathy and suggest alternative activities to redirect their focus. For example, if they spill their coffee, you might say, "It looks like the coffee didn't taste quite right without sugar. How about we go to the other room and have your favorite treat instead?"
7. Utilize reminiscence therapy: During moments of confusion or longing, engage them with family photos or cherished memories to provide comfort and stimulation. For instance, if they are restless and looking for a loved one who has passed away, you could take out the family photo album and reminisce about happy times together.
These interventions focus on engaging emotional memory while avoiding triggers that may exacerbate cognitive challenges. While caregivers may sometimes feel conflicted about using strategies that deviate from reality or seem to reward disruptive behavior, it's essential to remember that individuals with dementia are navigating a reality shaped by their condition, where emotional comfort often takes precedence over factual accuracy
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Approach each interaction with tenderness, appeal to their senses, embrace the beauty of nature, and reminisce about cherished memories. For further guidance, consider exploring resources like my book, "Taming the Chaos of Dementia," particularly Chapter 3 on Trigger Factors, for additional insights and strategies to find peace on your caregiving journey.
Barbara Huelat, a dynamic force in healthcare design, author, and speaker, generously imparts her expertise in her latest publication, ‘Taming the Chaos of Dementia.’ Drawing from her profound understanding and passion for the subject, she delivers practical wisdom on navigating dementia care with empathy and skill, transforming this complex challenge into a empowering journey. Dive into Barbara’s world at https://barbarahuelat.com. 703-795-1743 for an enriching experience.
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