The Dementia Queen Exploring the evidence, the anecdotes, & the hunches- a rehabilitation perspective
Hi Sue,
Can I have your thoughts of the value of psychosocial approaches , when supporting and working with a person living with Dementia, relating to their retention of emotional memory.
I think more can be understood and put into useful and effective psychosocial approaches with the person as a unique individual, if we can have a positive approach and understanding of emotional memory.
Thank you for reading and if you can respond that would be most welcomed.
Great topic for discussion. Care to chime in? Please leave comments below… I did!
This is a great question, but one I might not be qualified to answer. My “thoughts on the value of psychosocial approaches, when supporting and working with a person living with Dementia, relating to their retention of emotional memory” would be that I see tremendous value in them.
Speaking specifically to the retention of emotional memory, I would note that implicit memory circuitry (emotional responses to subconscious thoughts) is very complex. Positive intentions don’t always lead to positive results in terms of eliciting emotional memory- there are things like fear conditioning, post-traumatic stress, and confusing social contexts that might not result in a good experience for a person with impaired circuitry… kind of like poking the bear.
The amygdala and hippocampus, key players in the emotional memory circuit, are neighbors in the brain and are very susceptible to damage from Alzheimer’s disease. This is partly what is so upsetting to family members caring for a loved one with dementia who seems to morph into a completely different person, “He was never like this. He always enjoyed the outdoors. Now he won’t even open a window.” And the more the family tries to convince him he really loves the outdoors, the more stress and anxiety this can produce, because he doesn’t remember that quality about himself and it simply isn’t true anymore. Emotion and memory circuitry just isn’t always reliable.
Sorry, I’m off topic…
There are many psychosocial approaches that have been useful in helping people living with dementia cope with the stress of memory impairment and loss of introspective skills- reality orientation, cognitive-behavioral therapy, reminiscence therapy- I think these approaches honor “personhood” and facilitate the person having contact with their own identity. This subject gets very deep and complex (Erikson, Jung, Freud- these guys are way smarter than me and this is really outside my area of expertise) but I agree that at least a rudimentary understanding of psychosocial approaches is a very valuable tool for caregivers.
The bottom line is this…
I think people, the demented and the non-demented, like to be recognized…to be really seen, and appreciated, understood, and valued. Eliciting those feelings of recognition and value are not dependent on memory- those feel-good neurons are accessible well into the disease process. And I don’t think being able to provide quality psychosocial interventions requires a PhD in psychology. Reality orientation or reminiscence has its place in decreasing stress from confusion, and cognitive-behavioral therapy is useful for managing behaviors and fear. But at the end of the day, I think we really just need to slow down, make eye contact, find a way in, compensate for the deficits, and give safe touches and firm affirmations… and honor their sense of personhood.
Amen 🙂
Sue
As an engineer, this topic is definitely hard for me to fully understand. I know a lady that cries because she thinks someone is dying but they actually passed years ago. At times, she will suddenly snap out of this emotion when a particular dog walks by and reminds her of her dog when she was a child. Also, I stopped telling her my real name because her son’s name is also Mike, and this makes her cry. Is this kinda what you are talking about with emotional memory?