This blog is written by Walt Reid, a supporter of Total communication Services CIC. Walt’s interest in all forms of communication and history are combined in his role as a guide. Walt’s blog considers the powerful impact reminiscence can have on all of us and in particular people with dementia and how in terms of a therapeutic approach we are looking at engagement and positive experience.
Dementia is a persistent disorder of mental processes caused by brain disease or injury and marked by memory loss, confusion, personality changes and impaired reasoning. The commonest form of dementia is Alzheimer’s disease. Working as I do in the cottage in Styal village I often have occasion to welcome visitors who experience the challenges
of dementia. There was one day, as I was beginning a tour, a family who were visiting with an elderly relative pointed out that she suffers with dementia. “but was no trouble”. As we moved from room to room I was struck by the rapt expression on her face. She never spoke a word during the whole time of the tour but as she left she shook my hand warmly and offered me a contented smile. I remember thinking how happy she seemed and that for those few moments wherever she had been transported to, was a happy place or time which she couldn’t express in words as she was non- verbal.
For a few moments I envied her and wondered how memories can be therapeutic for those experiencing dementia.
It took me back to the first time I myself visited the cottage in preparation for leading tours as an interpretation assistant. Standing at the top of the stairs and looking down I was suddenly transported back to my own childhood. I was a boy again, aged three years and standing at the top of a chasm, holding tight to the handrail and emerging into the back kitchen where my mother was hard at work preparing breakfast. The room was warm and welcoming, lit only from the flames dancing merrily in the hearth. For a fleeting moment I was back in the terrace house where I was born in the old mill town of Ashton.
All sorts of stimuli can evoke memories. One of the most powerful is our sense of smell. Nervous pathways of memory are closely linked to our sense of smell. Familiar smells can transport us back to our formative years. Sound and our sense of touch and taste are also powerful evokers of memory.
For this reason nostalgia relayed through different senses has
a part to play in therapy for people with dementia. Media for nostalgia can be through music, visual artefacts such as photographs and object . People who have dementia are usually able to recall long term memories but couldn’t remember what they had for breakfast or the names of their children. The same person might find no difficulty in singing a favourite song or naming long lost relatives in a photograph album.
Oral histories are a major way people can experience the “nostalgia effect.” You don't have to experience dementia to feel the soothing effect of listening to voices from a bye gone age.
In this regard people with dementia or simple memory loss can serve a useful function by relaying their reminiscences to others.
In a world where they are so reliant on others for most day to day functions. When they are asked about their past experience they can come into their own. Drawing upon a powerful faculty they may still possess. ie. Long term memory.
The heritage industry offers nostalgia experiences at many of its properties but also through it’s oral histories. The talking newspaper a popular broadcast started by the RNIB has employed this strategy. Intended for those with sight loss, it is now recognised as an aide to those with dementia - a great benefit for people who may be confined to their own home.
According to researchers in Bristol and Bangor pathways in the brain can be exercised through nostalgia. A reflection of
a bye gone age can be therapeutic to those who struggle with their memory loss, as it can be calming and help them deal with frustrations leading to aggression. Furthermore nostalgia can maintain brain function, help with thinking about the future as well as the past as these are shared pathways. Studies report that reminiscence and life review, (recalling former times or so called life story recall), can have beneficial effects for those with various kinds of dementia. These include improvement of mood, communication, cognitive function and quality of life.
I became a dementia friend in 2019. It’s something I would recommend and you can sign up by learning some simple facts about the illness. Next time I escort a party around the cottage in Styal, I shall do so with renewed vigour secure in the knowledge that I might be helping someone with dementia.
Ismail (2018) University of West England
Woods (2018) University of Bangor
Admittedly, before starting to study Speech and Language Therapy in September 2020 I think I had been quite ignorant to how inaccessible the world can be for people with learning disabilities and communication impairments. That’s not to say that I thought that accessibility was unimportant, but I had never been immersed in a world that needed extra support to access the world around them. I did not consider often enough how society functions mostly for those who do not need the help. Since my placement with Total Communication Services CIC/ Elysium Healthcare I have started to notice all the work that needs to be done. I have started to notice the poor quality of subtitles on most video platforms, the lack of willing support and patience in fast paced services such as coffee shops, banks, and post offices. I have also noticed that what some people might consider to be the ‘small details’ are in fact huge details or even impossible for someone who does not have the capability for them. I’ve never felt myself become so eager to be involved in change.
During my time with Alison at Total Communication Services, I spent some time creating accessible leaflets on various topics, like an introduction to Autism and DBT therapy. I spent a lot of time thinking about how a lot the people who might require these accessible leaflets will struggle with these so called ‘invisible illnesses’ and might not think to ask for information in a more simplistic way.
In 2016, the introduction of the ‘Accessible Information Standard’ made it mandatory that all organisations that provide NHS care make ‘reasonable adjustments’ to their services so anyone and everyone can access their services in the same way. Some of the adjustments being made you could argue are still not good enough, and some services are seemingly only providing the bare minimum. Despite this, the Standard is a massive leap forward. My next question would be: Why can this standard not be projected into the rest of society?
The Royal College of Speech and Language Therapists (RCSLT) are definitely trying! In November 2020, the RCSLT announced a new symbol that can be displayed outside of shops and businesses to highlight that the business has people at hand to help those with communication difficulties. Our various lockdowns have not allowed me to experience this symbol in the big wide world yet, but I am hopeful *with everything crossed* that it will be used and embraced!
Being exposed to all of this information has made me really consider who and how I want to be as a future Allied Health Professional and Speech and Language Therapist. If one of my client’s needs accessible information, such as simplified resources to help them do their therapy outside of our sessions, I know that I, myself, will need to be more accessible than perhaps I would normally be. This might be in how much time we spend on goals, my voice and language, my initial approaches with them…there is so much I am yet to learn, and I am so keen to involve myself with people that can teach me.
Whilst with Alison at Total Communication Services, I was invited to a self-advocacy group that spend a lot of time looking at ways they can raise awareness for the need of further accessibility in society for people with Learning disabilities, like themselves. It was such a privilege to have them provide me with feedback on the accessible leaflets I had been making because who am I, someone without a learning disability, to make a document aimed at people with a learning disability and claim it is accessible? They let me know what language was too difficult to understand, what images were too abstract, whether the font was too small or unintelligible. I cannot thank them enough for helping me, teaching me, and making me aware of the details I would not have even considered. Co-production should be an essential part of creating documents for anyone with an impairment.
Student Speech & Language Therapist
My name is Gareth and I’m a self- advocate. I volunteer with Total Communication Services CIC and some time ago
I created the leaflet about autism - You can see it here https://753e2037-f764-4c1c-b2bf-ad4632bf81f7.filesusr.com/ugd/f5d6b4_2081dc1a1016497d9e221c65cf434821.pdf
Recently I have made a short film which shows 20 core vocabulary signs .
I think all care staff need to know some basic signing, just some basic idea of how to communicate would be a good start. Some people with learning disabilities are non -verbal and rely on signs to communicate. Imagine if people couldn’t speak
your language how isolated you would feel. It’s problematic.
We need to be inclusive to all needs, this means adapting our communication. It means meeting people on their terms on their level and using their ways of communicating.
Signalong generously gave us permission to share the signs with other self-advocates and we are grateful for their support. See link to watch the film: https://www.totalcommunication.org/training