“Memory Matters” for ALL Ages PROGRAM LINK
Creating memory strategies for those with advancing dementia is one of the keys to increasing safety, decreasing confusion, increasing activity participation and connections with others.
One of the frequently mentioned complaints of those close to a person with advancing memory loss is repetitive questions. There are many simple techniques that can be very helpful. Each person is unique and setting up the actual strategy requires working with the primary caregiver. It begins with helping them to understand what is actually going on and the specific wording that might be most helpful to cue someone if memory props are being used.
Things to think about:
1. How did a person keep track of information previously? Did they use a calendar, a day planner, an electronic device, file folders or did they just keep the information in their head? Is the person organized or somewhat disorganized? Did another person keep track of that information for them in the past? It is essential to understand previous patterns first and not jump in and create what works best for you, make it too complex or expect that the person will be able to use it as you have.
2. Many of those with early onset dementia may have become accustomed to electronic messages. Some of my older clients may have cell phones for phone calls only but may be able to use the alarms for medication reminders if someone sets them up. Then there are those who may be a bit more savvy so understanding the extent of their comfort zone is essential.
3. What are the obstacles? If there is advancing dementia, decreased mobility, vision and/or hearing concerns, it may be necessary for others to do all of the prompting. If a person asks you over and over about an appointment or upcoming event, a memory prop could be helpful if created to meet their specific capabilities and needs.
4. Continually reassess if the system you have created is still working. Remember the person with dementia may no longer have the higher level thinking skills to modify something. So they often do nothing but that is where a speech-language pathologist can be helpful in educating the caregivers and suggest some appropriate techniques at the level where the person with dementia is currently functioning.
Tips to consider:
Here are a few memory props which can be effective if they are personalized to the individual’s needs and capabilities. This is a general overview and if they are of interest, give them a try. Remember that a speech-language pathologist is an excellent resource for helping you create something tailored to a person’s specific needs and level of functioning.
1. Journal/ diary: There are many levels of this memory prop. Frequently the person with dementia will ask what is going on, forgot what they ate, how much water they drank, who visited, etc. Depending on the person’s capabilities, they may be able to write it down when prompted. In other situations it would be best to have the person with them write it down. Make sure it is basic and easily read. Printing the information is most helpful. Keeping this on a daily basis, perhaps in a spiral notebook, allows for easy reference. Many caregivers also find it helpful to record information at the end of the day some of the things that they need to recall later, like medication changes or some new situation of concern to bring up to the doctor or another healthcare professional. Caregiver stress has its own memory issues with all of the multitasking and repeated distractions so family members can also benefit from memory props.
When a person resides in an assisted living or other senior community, this daily journal is a great place for visitors to make a notation of when they were there and what they did or talked about. This allows caregivers or future visitors to have something to refer to when there are repeated questions saying someone did not visit as well as a resource for conversation starters. One size does not fit all so this will be most effective if created keeping the person’s current level of functioning in mind and simplified as necessary.
2. Memory board: This one of the most effective tools I have found for the repeated question asking what day is it. As a provider of speech-language therapy in the home, a dry erase board appropriately placed with large enough print to be easily read has been a frequently recommended strategy. Typically the caregiver puts the date at the top and then adds appointments. The details must be easily read and contain only a few words. It is not meant to be studied and memorized. The goal is that the person with memory loss learns over a period of time with proper cues to check the memory board instead of asking someone what day it is, who is coming, or what time. When it is set up in way that works for the individual, it is an invaluable tool. Further assessment by a speech-language pathologist can help families and caregivers to set up one that works best for that individual. Caregivers have often commented it is helpful to them as well and they find making it up the evening before works best since AM schedules can be hectic.
3. Memory books and wallets: A person may benefit by having something to refer to that lists their address, family member names, or past history highlights to name just a few typical areas. Memory books and wallets are excellent resources to consider. A friend’s grandmother would always get upset when she could not tell her doctor what she wanted during an office visit. With some help, she wrote down her medical updates, and her questions and then she read them instead of someone else speaking for her. When I saw her for home health care, she was a decent historian because now she could read the information that was pertinent. For those with a more significant deficit, albums with a picture on one side and a few words or a short sentence on the other side can allow a person to share their story when reading aloud is still possible. It will all depend on the memory-impaired person’s capabilities at the time and that is very important to keep in mind.
4. Repetitive questions in the car. If the person with memory loss keeps asking you where you are going, print a note in large and bold enough letters to be seen on a light colored sticky note (not blue or green or anything dark). Make it simple with just where you are going and the time of the appointment or visit if that question is also asked. Put it on the dashboard in front of the person. Each time they ask the question refer the person to the note in front of them. Remember that a person with Alzheimer’s disease can usually read and understand short pieces of information in the middle stages of the disease. They may ask the same question over and over but having that to refer to may reduce the driver’s frustration and possibly the person with memory challenges will start looking at it eventually without prompting.
The sooner some of these ideas are put into place when a person’s memory declines, the more effective they can possibly be for longer periods of times.
TO DO THIS WEEK: Many caregivers with a loved one at home may not have any idea that there are helpful strategies. Pass along the wide scope of information in the “Memory Matters” for ALL Ages blog series which accompanies a Cable TV show available on YouTube. These were created to hopefully help families seek out additional resources and engage in an ongoing dialogue with their doctors. Schedule an appointment with a speech-language pathologist specializing in working with older adults in your area. The journey with a loved one can be enhanced for all involved when appropriate strategies are explored.
“Your presence is the most precious gift you can give to another human being.” Marshall Rosenberg