We have talked a lot about the abilities that have been negatively impacted by dementia, however it is important to balance this out with those abilities that remain. Many abilities are retained long after a diagnosis of dementia, and through emphasizing these strengths, we can foster positive feelings and wellbeing. This section will talk about some of those abilities with the idea that by drawing on these strengths, you will help the participant to engage in a program. Some strategies to amplify these strengths will be described in Module 4: Approach.
Memories from the distant past are preserved better than recent or short-term memories. Drawing on these long-term memories provides the person with an opportunity to engage with others and build relationships. Memories of moments from earlier in their life can provide great conversation between participants and their friends and family, as well as amongst the group. Drawing on prior knowledge can also help to empower and engage participants.
Visual memories that have been stored are more vivid and more easily stimulated compared to our verbal memories. This may explain why looking at an art piece may suddenly stimulate a visual memory from the participant’s past which then fosters the participant’s engagement in the conversation about the art piece.
Part of long term memory is the memory for motor and cognitive skills that do not require conscious thought – things like brushing your hair, making a bed, or shaking hands. By incorporating these kinds of skills and habits along with incorporating familiar tools and repetitive tasks into the program, the participant will have an easier time engaging in an activity.
A general feeling that a person or place is familiar remains longer than a person’s ability to remember specific information. For example, the participant may not remember your name, but they may sense that you are familiar or they have been here before. This type of memory speaks to the importance of always being positive and creating a positive environment and experience for the participant. It also supports the importance of consistency of staff, program spaces and routines.
Memories that stir an emotional response or have a strong emotional connection for the person are well retained. Music and smells can be useful in helping participants to recall these memories and emotions. For example baking fresh bread may stir up childhood memories of baking with their grandmother, or a song may stimulate the happiness they felt on their wedding day. When these types of memories are stimulated, it may help the participant access previous experiences and emotions which they can then share with others.
Social skills are those highly familiar verbal and non-verbal skills we use to connect with others, and maintain dignity. Some examples include smiling, nodding your head, shaking hands, waving good-bye, and greeting someone when they pass. By encouraging these skills when a participant arrives and departs, we help to engage the participant in connecting with others.
Emotional awareness is being able to feel emotion and being aware of the emotional state of others. This awareness allows the participant to read the non-verbal messages communicated through facial expression, body position, body tension, tone of voice, and mood. If the facilitator is smiling, happy and relaxed, this will send a more positive message to the participant than if the facilitator appears nervous, anxious, angry or upset. As a facilitator, it is important to be aware of your non-verbal messaging at all times as the participant’s emotional awareness is well retained.
You can also use emotional awareness to model, emphasize and extend what you are saying. This is helpful for participants whose receptive language has been impacted.
Sense of Humour
Even though the person with dementia often has difficulty with the abstract thought needed to understand humour, they can socially respond to the light-heartedness of the situation when others are laughing, and will often join in and laugh together.
Musical aptitude and music appreciation remains. Many people with dementia can recall the tune and the words of songs from when they were younger.
When reading material is modified, a person with dementia retains the ability to read aloud into the later stages of the disease. Modifying the reading material also helps enable the person to better understand what they are reading. These modifications will be described in a later module.
A person with dementia typically retains the big movements of the body like using their arms and legs. Fine hand movements usually remain until the latter part of the disease, although tasks like writing or drawing may become more difficult especially if other underlying diseases such as arthritis are involved. There are often adaptive devices available that can help compensate for some of these problems.
Researchers believe that as a brain is being progressively affected by dementia, an individual can still experience the drive to be creative. There are also benefits like stress relief, building resilience, and new forms of expression, suggesting a link between social and creative activities, as well as the preservation of cognitive functions. Creative activities are not only beneficial for the person engaging in them, they are social activities that strengthen social ties among participants.
What this means
Each person’s abilities are unique to that person and it is vital to promote the continued use of these abilities rather than focus on their deficits. By providing opportunities to use these retained abilities, and to adapt to support changes in ability, we create the conditions for success.
Some strengths remain in all areas of the brain including cognition, language, perception, physical abilities, and mood. With an understanding of dementia and its impact, a facilitator will learn to recognize each participant’s strengths and abilities.
Our experience and previous research has shown that Artful Moments works to create meaningful engagement for persons with dementia across the disease trajectory and that even those participants who are in the later stage of the disease can engage and participate in the program.