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Exercising memory
Posted: Saturday, October 12, 2019 9:40 PM
Joined: 10/2/2019
Posts: 4

Is it good to constantly or regularly talk to patients about thing to help them remember from their past?

Posted: Saturday, October 12, 2019 10:57 PM
Joined: 10/21/2016
Posts: 2700

Of course it's a good idea to engage people with dementia in conversation.  However, since the brain is not a muscle, you can't exercise the brain and have it result in improving the disease.


Eric L
Posted: Sunday, October 13, 2019 12:26 AM
Joined: 12/5/2014
Posts: 1286

I do believe that keeping folks with dementia & engaged is good for their emotional well being. Many of the symptoms of dementia aren’t related to memory. Changes in mood, disposition, eating habits, and sleep patterns are often part of the dementia experience. Activity & engagement does seem to help with those symptoms.

However, the progression of the disease will march on. We can’t do much to halt it. Activity & engagement won’t stop or even alter the progression. That said, if it brings a sense of contentment in the moment, it’s probably worth doing. 

Posted: Sunday, October 13, 2019 3:38 PM
Joined: 7/17/2017
Posts: 400

Social interaction is important for memory-impaired folks; just being there is reassuring usually.  My Mom liked to look at old photo albums (and I enjoyed this activity with her).  I knew she recognized people, not always the names, but it brought a smile to her face and it made me happy as well.  It's important for you to know that there is no new learning for most memory-impaired/Alzheimer's patients.  You need to work with their abilities on their level; exact words and names don't always come easily (if at all), and you can't expect your loved one to react or interact in socially appropriate ways reliably any longer.
Posted: Friday, November 1, 2019 5:52 AM
Joined: 10/2/2019
Posts: 4

My question with regards to memory was along the lines of trying to understand how memory works for patients.  Where are new facts or information stored. For example: If in 1998 they had knowledge of a certain thing but has since forgotten, can reintroducing the information be stored in a different place in the brain or perhaps refresh the old data. It seems that sometime they remember new information that is important to them.  Just trying to understand.
Posted: Friday, November 1, 2019 8:13 AM
Joined: 10/24/2018
Posts: 1482

It's my (un-expert!) impression that working memory is the first to go. Working memory is how the here-and-now is transferred to long-term memory. 

There is a technique out there called Spaced Retrieval. There are textbooks and workbooks Etc. I read a bit about it and it seems to be something that would create considerable animosity in a relationship, but that's just my opinion, strongly colored by my own learning style. 

Social interaction, otoh, is almost always good for making my LO PWD feel good, which is what it's all about. Mom will carry the happiness of a good visit for hours, and maybe even remember a good feeling the next time that visitor shows up. 

Posted: Friday, November 1, 2019 8:21 AM
Joined: 3/6/2017
Posts: 2823

It's complicated. 

Most often it is working memory and short term memory that are impacted first in a typical Alzheimer or Vascular Dementia presentation. What you would expect to see is LIFO- last in is first out. Early on this might look like forgetting what was for lunch or suddenly struggling with their cell phone or TV remote while recalling the address of their first apartment. This generally makes it impossible to learn new things although some studies have been done using errorless learning strategies could help some people learn in the early stages of dementia.

Sometimes a PWD will hold onto new information that has a strong emotional content when they don't seem to recall other information learned around the same time. In the middle stages, dad could recall that a doctor told him he could not longer drive- were heard about that daily for over a year. But he didn't remember the doctor telling him he had mixed dementia and wasn't allowed to drink anymore. 

Another common glitch in memory are confabulations. Some PWD will backfill gaps in their recall of an event or story with details from another event. When dad did this early on it seemed almost as if he was rewriting family history to put a polish on it. Sometimes the stories made sense logically and could have passed as reality for someone unfamiliar with what actually happened. I recall a tale he once wove for a car salesman that was a mishmash of a date night with my mother that combined elements from 1962, 1976 and 2008. 

Because of the LIFO nature of memory loss, it sometimes seemed as if dad was time-traveling. He spent several months in the mid-1970's talking about people he knew and things he did. Sometimes he would ask my mother for specific clothing he had during that era. He often threatened to ground my sister and I, who he believed to be teens, in this phase for various bad behaviors like staying out late and shacking up with that tall guy; FTR, the tall guy was my husband of 30+ years and my sister had been dead for 25 years. And he would sometimes tell my mother that she looked like h*ll because he expected her to be in her late 30s rather than her late 70s. 

That said, it could be a good idea to share memories with them so long as they enjoy it and can avoid making them feel badly if they don't recall. Some people will dig out old photo albums or home movies as a way to introduce this. My dad couldn't remember whether my sister was alive or not. Some days he'd recall she was sick and say "she's dead isn't she?" She'd been his mini-me and favorite and I feel on some level he knew he was losing her. I would take those opportunities to share a funny or positive story about her which he seemed to enjoy hearing.
Posted: Friday, November 1, 2019 10:53 AM
Joined: 10/2/2019
Posts: 4

What is the opinion of the experts with regards to confabulations? Should the patient be corrected or leave it as is because in their world it is correct, yes?


Posted: Friday, November 1, 2019 12:51 PM
Joined: 3/6/2017
Posts: 2823

Mskaczmarek wrote:

What is the opinion of the experts with regards to confabulations? Should the patient be corrected or leave it as is because in their world it is correct, yes?


Most people I know suggested letting them stand uncorrected. Dad had two on repeat that I shut down. One related to him committing a crime of a sexual nature which could have gotten him arrested and the other was related to my mother divorcing him. He argued about the first but was pleased to be corrected about the second. 

But if he wants to believe I left my kids in a bar for him to pick up while I left with some random dude or that he owned several identical houses in the same community I can be OK with that. 

Posted: Saturday, November 2, 2019 7:05 AM
Joined: 6/5/2014
Posts: 1587

An interesting and informative conversation. I think memory (even in healthy brains) is a complex process scientists still don't fully understand; throw in varying types & degrees of degenereration and you can only explain some of it. 

Two things I've read: 

1. Never say "Do you remember..." because it can lead to frustration/depression when they can't. Instead say "I remember when you..." and see if they can fill in any details. 

2. Don't argue about or correct mistaken or confabulated memory (unless the memory is traumatic to them). This falls under the "live in their world" philosophy. 

My DW has FTD, in which even short term memory is largely unaffected until the late stages. This can create a whole different set of challenges for caregivers, entirely different than those familiar to AD caregivers.

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