Remembering Home: Rediscovering the Self in Dementia

Caring for individuals with dementia is a formidable task.  Preserving their health and basic functions is enormously demanding physically and emotionally for both families and professional care givers.

 Most long-term care facilities use the medical model of care and promote the social roles of “old” and “sick”.  Consequently, this deprives the residents of their familiar and meaningful context and offers few links with their personal or cultural past.

 Experienced events are not stored in memory directly from perceptions, and their storage in memory is different.  Instead, memories are stored through an interpretive process and are stored in selective methods so that emotionally driven memories can be retrieved more easily than others.

 During dementia, self-identity is threatened by losses of physical and cognitive abilities and often relocation from a place to which one was attached.  They try to hold on to the identity they have known for years.  However, this task becomes increasingly more difficult, and help needs to come from the environment.  The question is, “What is the best way for people around the memory impaired person to help?” 

 Reconstructing emotionally charged experiences can be an effective way of helping a person with dementia to recapture meaningful aspects of their life.   Emotional experiences result in the most vivid autobiographical memories, likely to be recalled more often and with greater clarity and detail.  Most emotional experiences occur in early life.  For persons with dementia, reality reverts to the distant past.  They experience themselves as being in early childhood or early adulthood and talk about family or friends from those times.  Sense of self is influenced not only by these memories, but also by a relationship with the physical settings that define everyday life.  Since home is so central to our lives, memories of home are the powerful means for sustaining sense of self.

 Staff in residential care facilities should consider the importance of environment as well as providing activities with reminisce groups etc.  They should seek to stimulate as many senses as possible through the environment and change the traditional “medical model” of care to a social model of care.  The environment should reflect an emphasis on colors, textures, sights, sounds and smells to help the resident with dementia feel safe, secure, familiar – and at home.

Resource :  John Hopkins University Press

10-09