As a first step toward helping a loved one with dementia, it’s important to understand how Alzheimer’s disease and other types of dementia affect memories. Caregivers will likely feel more confident and comfortable when interacting with a loved one with dementia when they have an idea of what to expect during routine daily activities.
In this blog, discover how memory is affected by dementia and learn tips on creating successful moments with your loved one.
Understanding How Dementia Affects Memory
Procedural and declarative memory are the two basic categories of long-term memory. The way our brain and memory functions is complex. But, if we can understand the basic differences between procedural and declarative memory, we can better assist our loved ones with dementia.
Procedural memory is also known as implicit memory, and it refers to remembering how to perform certain actions and skills that you learned earlier in life. Simply put, this type of memory comes from doing something repeatedly.
They are things you’d likely remember how to do even if you hadn’t tried in years. Common activities using procedural memory include walking, opening doors, riding a bike, swimming, driving a car, writing with a pen, tying your shoes, or preparing a recipe that you learned a long time ago.
These tasks are typically carried out automatically without being conscious of each step. Connections are made between synapses in the brain when procedural memories are formed. The more times the same action is performed, the stronger the synaptic routes become — resulting in the actions themselves becoming more automatic.
Those with Alzheimer’s disease or another type of dementia can still normally tap into procedural memories in daily life. This helps explain why someone with dementia may still be able to play the piano, pick up an old hobby, or sing a song they learned as a child.
Declarative memory, also called explicit memory, requires you to recall a fact, event, or another memory that you can consciously recall. Examples include remembering that you have an upcoming appointment, knowing your phone number, or recalling what items you need from the grocery store.
Memory impairment for those with dementia is related to declarative memory, which requires a conscious effort to be retrieved. Someone with dementia may have difficulty recalling what they had for breakfast or who they spoke with a few hours ago.
Using Procedural Memory to Positively Support Your Loved One With Dementia
There is some truth to the phrase ‘if you don’t use it, you lose it.’ When working with a loved one with dementia, concentrate on things that the person can do and then provide support for the items they exhibit difficulty with.
You should do so in a way that encourages the person to try on their own first. For example, when assisting with getting dressed, a prepared environment is the key to success. Here are examples of what a prepared environment looks like:
- Is the room bright enough so that the person can see well?
- Is there privacy - blinds drawn, door closed?
- Is the room warm enough so that the person is comfortable to disrobe?
- Is it quiet so that they can hear the simple instructions you give them in a calm, quiet, patient voice?
As a caregiver, there are many ways you can be prepared to set your loved one up for success with activities that use procedural memory. Here are some tips to help you get started:
- Demeanor. Your demeanor means a lot. Moving at a calm, even pace creates a relaxed atmosphere. If you are rushing about, it can create an unwanted stimulus.
- Time. Ensure you have the time needed for a person with dementia to get ready. As the disease progresses, they may require more time.
- Organization. Have all items needed ready so there is no room for confusion. By organizing and simplifying choices, tasks are more easily understood and less overwhelming.
- Preparation. Prepare the closet so that the shirt and pants are a matched set and ready to go. You can provide independence when asking the person which outfit they want to wear and simplifying the choice between “the blue outfit or the green outfit.”
- Consistency. Have clothes set up on a chair or bed to pick up in the order they normally get dressed. If your loved one normally starts with their underclothes, begin by having those clothing articles first followed by pants, belt, shirt, and then socks last.
You are working with procedural memory (muscle memory), so you’ll want to try to mirror the rituals they’ve had throughout their life. As your loved one completes tasks, voice support by stating positive phrases such as, “That’s it!” or “Looks good.”
- Encouragement. It is important that we encourage our loved ones to actively participate as much as they can in what they can do, especially activities that have been repeated consistently over their lifetime. Hand-over-hand movements can trigger muscle memory, and you may see your loved one begin to complete a task.
- Guidance. An example of hand-over-hand is simply taking your hand, standing on the dominant side of your loved one and gently grasping your loved one’s hand, and starting the task. After a moment, they will often begin to take over the task, and you can let your hand gently move away.
Using Declarative Memory to Positively Support Your Loved One With Dementia
You can also try activities with your loved one using declarative memory. An example of a positive exercise using declarative memory can be as simple as reminiscing with your loved one. Here is something you can do with a loved one that taps into their declarative memory:
Creating a Photo Album of Family Members
- On one page, put a picture of the relative from the past and a recent photo of the same person
- Label with their name and relationship in large bold letters.
- Sit and have a nice conversation, reminiscing about the past for as long as your loved one is comfortable.
We all like to talk about past events that we thought were fun or eventful. Think of how wonderful it must be to remember an experience when you struggle with confusion and memory loss throughout the day for more recent events.
Considering Your Loved One’s Feelings
Considering your loved one’s feelings when they’re presented with challenging tasks is a crucial step. Setting them up to create successful moments can help limit frustration and boost your loved one’s confidence and self-esteem.
Helping With Daily Tasks: A Caregiver’s View
As caregivers, it can be very easy to take over. We may think:
- The person is struggling, so let me help.
- This is taking too long.
- They can’t do one thing, so they probably can’t do a lot of other things.
- This is how I show I am there for them.
Attempting Daily Tasks: A Loved One’s View With Dementia
In reality, we may be causing more harm than good. In fact, we may be creating an instance of learned helplessness.
Put yourself in your loved one’s shoes: when someone takes over a task you are attempting, how does that make you feel?
- Am I not good enough?
- Am I not quick enough?
- I have no independence.
- Why bother - they will do it for me.
It’s important to understand that while a person with dementia has problems with their memory, they still have feelings. Their ability to make sound decisions also diminishes, and your intended goal may be perceived differently than you intended.
However, not all situations are the same. You’ll want to observe closely to ensure your loved one doesn’t get overly frustrated or overwhelmed. If this occurs, it’s likely best to offer assistance in a calm, helpful manner.
If we can create successful moments throughout the day, it stands to reason that the day will be brighter for both the caregiver and the person with dementia. Working with the knowledge that a person with dementia lives in the moment, let’s do our best to make each moment a successful one.
Accessing Additional Caregiver Resources
Would you like to view more resources on caring for a loved one with dementia or Alzheimer’s? Here are additional resources for caregivers, including how to help loved ones in the early stages and coping with an Alzheimer’s or dementia diagnosis.