A speech therapist (Bonnie Bereskin, one of CNI's "Ask a Professional" contributors), gave me an outline for a memory book, a place to put pictures, documents and narrative about my father's life. Not only would it help him remember his life and the meaning it has, but the book would also make it easier for those who visit when conversation is limited.
I collected everything I could find; it took quite a long time to organize and describe the stages of dad's life -- his early years, military service, courtship of my mother, their wedding, the kids, the trips, the friends, their life in California, his life now. I called my uncle to fill in some of the gaps because dad can't remember anything. The reaction has been great -- everyone loves the book and it is a permanent reminder for my dad.
When we review the book (only a little at a time) sometimes I get tears, other times I feel his pride or his confusion. When he states that some of his pictures are missing, that someone stole them, I explain that they are all in his book. It seems to reassure him.
I have read quite a lot about this approach to communication with those who suffer from dementia and have placed here some comments from some professionals on the subject they call "life review."
Obviously every person will react differently but I definitely think it is a path worth exploring.
How to Make a Memory Book
- Select a photo album with large-sized pages to accommodate pictures/documents of all sizes.
- Decide if your loved one can help with choosing the visuals and writing
the narrative; my dad couldn't so I proceeded on my own.
- Decide how you want to name the life stages. The following are suggestions:
- original family (parents' and grandparents' birth, life, death information)
- early years (birth to young adult)
- work history (childhood jobs, work history and on to retirement)
- courting and marriage
- spouse's history
- children, children's weddings
- family and friends
- recreation, hobbies and interests
- travel and vacations; summer/winter homes
- religious celebrations
- If the senior has vision problems, try and choose pictures that are
large enough for them to see clearly. I had tons of wonderful pictures of
us a kids, with aging relatives but the snaps were so small I had trouble
with them! Try and locate interesting documents; I found my dad's airforce
documents and wedding day books.
- Create a narrative for each life stage so anyone reviewing the book has
enough background to understand the family and can ask appropriate questions.
Place this narrative at the beginning of the appropriate section.
- Enjoy your "historical" document; I learned some interesting things about my family. I can trace my ancestry to two U.S. presidents including Lincoln; as a young man my grandfather on dad's side helped to survey the 49th parallel between the U.S. and Canada.
Comments/thoughts on Lifestorying, Narrative
Counselling
By Whit Garberson LICSW (with permission)
Newton, MA
jwgg@WORLD.STD.COM
- When I started doing psychotherapy with seniors in nursing homes, there
was still a sort of mentor figure in our clinical group and her specialty
was life review therapy. She is long gone now, but I adapted a couple of
things she suggested and am very happy I did.
In one case, I worked with a depressed 85-year-old male, former engine mechanic, referred for self-isolation, anorexia, global decline in functioning. I learned he had been separated from his Canadian parents in his early teens because their farm was failing and they believed he could do better living with a relative in Massachusetts. We spent a lot of time reconstructing those early years but he really could not approach the huge unresolved feelings of pain and loss involved in that separation. I discovered many of his fondest memories revolved around logging in the woods with his dad, using only hand tools and teams of oxen pulling sleds...
... now logging is work I know a little bit about, having done some myself... and as it happened I had a wonderful collection of photographs by a photographer named Kinsey who, along with his wife, had spent years documenting logging in the U.S. Northwest back in the early days of this century. These are spectacular black and white photos of massive trees and 12-foot crosscut saws and logging camps and proud, tough men in the woods.
I took the photos to show them to my client and we spent a couple of weeks examining them together. At first he was so depressed and cognitively impaired that he had a great deal of difficulty making visual sense of the photos, so this took some perseverance. But these photos eventually unlocked some very powerful memories and with them some strong affect triggered by the light and smells and sounds of the woods, the trees, the sweat, the animals -- and a lot of very positive sessions followed. Clearly the visual thread was connected to the more primitive auditory and olfactory memories. I have since tried similar improvisations with clients with good results.
- Some therapists I know use a somewhat more overt approach -- they carry
with them one of those books of newspaper front pages, and explore key periods
with their clients. "Where were you when this happened?" (Lindbergh
kidnapping; Pearl Harbor bombing; whatever.) This can sometimes click open
a latch somewhere.
- Music holds a million keys like this. Unfortunately, in the nursing home
settings where I usually work, music seems mostly to be the domain of "activities programs"
which exist for reasons completely different than the sorts of therapeutic goals I think you're
asking about. Unless you have a lot of time and privacy, it is hard to work with music in 1:1
settings.
Superficially the entire life-review process sounds a lot like "jogging the memory" but I tend to think it is much more profound than this. Cf. Proust, etc. Of course, when you're dealing with a person who is demented,"simply" to stimulate recall and expression to re-establishconnectedness can be a very important goal in itself.
But for senior clients as a whole, if I may generalize, I'm very impressed by the power of sensory and cognitive stimulation.
My only caveat would be this: like any "technical" approach, it is not of much use unless there is a respectful, permissive, spiritually playful alliance, where the course of the therapy can be steered, gently but firmly, towards questions like "so what is this [final] phase of life for, do you think?" That involves a lot of work, and often a lot of time, and a lot of self-questioning on the part of the therapist about what the whole exercise is for. Mostly, I think, it's to facilitate resolution, peacemaking and the laying down of very old and very heavy burdens...