Dementia can affect a person’s memory, thinking and language skills.
Many people living with dementia experience:
- progressive loss of memory
- the merging of recent and past memories
- decreased ability to organise and express thoughts
- progressive loss of verbal skills.
These changes can be upsetting and lead to uncertainty, loss of confidence and frustration.
The following therapy and communication approaches may help to build self-esteem and provide both a sense of security and support for the person’s wellbeing. You may already be using these approaches instinctively, without realising their formal names.
Validation therapy is useful when the person you care for experiences severe short-term memory loss and can no longer make use of intellectual thinking or make sense of their present.
When this occurs, the person is likely to go back to the past to:
- resolve unfinished conflicts
- relive past experiences
- retreat from the present.
Using validation therapy means you accept what is going on for the person. Empathise with their feelings and avoid challenging what is real for them.
For example, someone with dementia might believe that they are waiting for their (now adult) children to come home from school. Rather than challenging them, you could respond with: “They’re lovely kids, you must be very proud of them.” This may be an opportunity to reminisce about the person’s children when they were younger. You could then gently shift the focus to another topic.
Benefits of validation therapy can be to:
- develop empathy with the person
- create trust
- build a sense of security
- reduce conflict and stress
- maintain their dignity and self-esteem.
Music activities can be used when dementia affects communication. Often when communication skills have gone, the person can still enjoy familiar songs and tunes, unlocking memories and feelings from the past.
Music activities can be a way for family and carers to respond to changes in behaviour. For these activities to have a positive impact, it is important to know a person’s musical likes and dislikes.
Depending on the setting, you might like to:
- play recorded music
- listen to the radio
- sing, move or dance together
- play an instrument
- invite friends to take part
- attend music concerts.
A music therapist can also help to support someone experiencing very complex behaviours.
Reminiscence is a way of reflecting on events from someone’s past and is usually a positive and rewarding activity. Even if the person with dementia cannot participate verbally, they can still experience pleasure in their past. It can also be a way to shift focus if the person is upset.
While recalling events can provide a sense of peace and happiness, it may bring up painful and sad memories. It is important to be sensitive to the person’s reactions if this happens. If their distress seems overwhelming, then it is better to reduce their anxiety by engaging them in another activity.
Make a memory book
A memory book is a reminiscence activity that can be worked on together. It can record the accomplishments in your friend or family member’s life. Family, friends and carers may use the memory book to get to know the person.
This is a visual diary, similar to a family photo album, so could include memorabilia such as photographs, letters, postcards, certificates, mementoes, written stories and drawings.
Tips for making the book:
- Consider the format; a large photo album with protective plastic sheets will be hardwearing. A digital version may be created using an iPad or tablet. Caption photographs, to act as a memory prompt for the person with dementia.
- Keep the layout simple, with one topic and two to three images per page.
The following ideas may help in getting a book started:
- the person’s full name and preferred name
- their place and date of birth
- photographs and the names of their parents and siblings
- photographs and the names and birthdays of their children and grandchildren
- photographs of their partner and wedding day
- photographs of family friends, relatives and pets
- places the person lived in
- photographs from their schooldays
- their occupation
- hobbies and interests
- favourite music
- holiday snapshots and postcards
- letters and certificates
- a diagram of their family tree and short stories about specific events.
The memory book can provide a great deal of pleasure and pride for someone who may be feeling increasingly disoriented in the present.
Where to get help
National Dementia Helpline
The National Dementia Helpline is a free telephone service that provides information, advice, counselling and carer support. Ask about support groups and programs for family and carers.
Carer Gateway provides free practical information, resources, education and counselling to support carers.