Introduction: The Past at the Service of the Present
In Alzheimer’s’s disease and other dementias, a paradox strikes observers: while recent memories fade quickly, old memories often persist remarkably. A person who cannot remember what they had for lunch can accurately recount their wedding 50 years ago, describe their childhood home, or sing the songs of their youth.
Reminiscence therapy exploits this relative preservation of old memory to enhance the well-being of people with cognitive disorders. By evoking positive memories from the past, it creates moments of connection, pleasure, and recognition that can soothe anxiety and reduce behavioral disorders.
In this comprehensive article, we will explore the scientific foundations of reminiscence, its different forms, its practical applications in behavioral disorders, and the conditions for its successful implementation.
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Understanding Memory in Dementias
The Different Types of Memory
To understand why reminiscence works, it is necessary to distinguish the different memory systems.
Episodic memory stores memories of personally experienced events, situated in time and space. It is the one that is affected early and massively in Alzheimer’s’s disease.
Semantic memory contains general knowledge about the world, vocabulary, and concepts. It resists better but eventually becomes affected as well.
Procedural memory retains skills and automatisms. It remains relatively preserved until advanced stages.
Autobiographical memory groups memories related to our personal history. Remarkably, the oldest memories (childhood, adolescence, young adulthood) are often better preserved than recent memories.
The Temporal Gradient: Why Old Memories Persist
The “temporal gradient” described by Ribot explains this phenomenon: in dementias, old memories are better preserved than recent memories. Memories of childhood and youth can remain accessible while recent events are immediately forgotten.
Several hypotheses explain this phenomenon: old memories have been consolidated more deeply, they are stored in different brain regions (less affected by the disease), and they have been recalled more often throughout life.
The “Reminiscence Bump”
Studies show that adults of all ages tend to remember events that occurred between the ages of 10 and 30 better. This period of life, rich in “first times” and identity-forming events, leaves particularly robust memory traces.
This is why reminiscence often targets this period: it is the most likely to evoke accessible and meaningful memories.
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The Foundations of Therapeutic Reminiscence
Definition and Origins
Therapeutic reminiscence is defined as the systematic evocation of personal memories, usually with the aid of supports (photos, objects, music), in a structured and caring setting, with a therapeutic goal.
Psychiatrist Robert Butler formalized this approach in the 1960s, showing that life review in elderly people is not a sign of regression but a natural and beneficial process of making sense of existence.
The Functions of Reminiscence
Reminiscence serves several psychological functions: the identity function, as remembering one’s history maintains the sense of continuity of self; the social function, as sharing memories creates bonds with others; the emotional regulation function, as evoking positive memories generates pleasant emotions; and the transmission function, as recounting one’s life allows leaving a trace.
Reminiscence and Behavioral Disorders
In behavioral disorders related to dementias, reminiscence can act on several levels.
It reduces anxiety by creating a sense of security and familiarity. It decreases agitation by positively occupying attention and generating pleasant emotions. It improves mood by activating positive memories. It facilitates communication by providing an accessible topic of conversation. It restores self-esteem by valuing the person’s history and identity.
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The Different Forms of Reminiscence
Simple (Unstructured) Reminiscence
The simplest form involves spontaneously encouraging the evocation of memories during daily conversations: “Do you like this music? Does it remind you of something?” “Tell me about your job.” “What was your hometown like?”
This “informal” reminiscence can be practiced by all professionals and family caregivers, without specific training.
Structured Group Reminiscence
Group sessions, led by a trained professional, offer thematic evocation of memories: school, jobs, celebrations, travels, fashion, etc.
Supports (period photos, old objects, music, film excerpts) facilitate evocation and stimulate participation.
The group setting encourages exchanges and socialization.
The individual reminiscence
In individual settings, reminiscence can be more personalized, relying on the specific life history of the person: their family photo album, cherished objects, the music they loved.
This form is particularly suited for people who have difficulties participating in groups.
The “life review”
A more elaborate form, the life review involves systematically reconstructing the narrative of existence, often with the creation of a support (life book, album). It is more commonly used with individuals presenting mild cognitive disorders.
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The Supports of Reminiscence
Photographs
Photos are the most commonly used and often the most effective support. Personal photos (family, life events) have the greatest impact. Period photos (daily life from the 1950s-1960s, personalities, historical events) can stimulate collective memories.
Objects
Old objects (tools, kitchen utensils, toys, clothing) have a strong evocative power, particularly through touch and manipulation.
“Memory trunks” or “memory boxes” containing thematic objects are frequently used tools.
Music
Music is a particularly powerful support. Songs from youth often remain accessible even in advanced stages of dementia. They can trigger intense memories and emotions.
Smells and flavors
The olfactory and gustatory senses have direct connections to areas of emotional memory. The smell of lavender, fresh bread, or coffee can instantly evoke childhood memories.
Films and audiovisual archives
Film excerpts, period television shows, and historical news can stimulate memories of collective events.
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Reminiscence and Behavioral Disorders: Practical Applications
Soothing agitation
When a person is agitated or anxious, suggesting the recall of a pleasant memory can have a calming effect. “Tell me about your beach vacation.” “Do you like gardening? What was your parents’ garden like?”
Attention is diverted from the source of anxiety to a familiar and reassuring territory.
In response to repetitive questions
Repetitive questions (“Where is my mother?”, “When are we eating?”) often express underlying anxiety. Reminiscence allows for the welcoming of emotion: “Are you thinking about your mom? Tell me what she was like.”
In response to wandering
A person who wanders can sometimes be engaged in a conversation about their history: “Are you looking for something? Where did you live before?” The evocation of memories can create a pause in the wandering.
Preventing disorders through regular sessions
Beyond one-time interventions, regular reminiscence sessions contribute to overall well-being and can prevent the emergence of behavioral disorders by maintaining self-esteem, a sense of identity, and social connections.
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Implementing Reminiscence
Preparation: knowing the life story
To propose relevant reminiscence, it is essential to know the person’s life story: place of birth, family, occupations, passions, significant events.
Gathering the life story, done with the family and the person themselves (if possible), is an indispensable prerequisite.
Conducting a session
Create a favorable environment: calm setting, small group (ideally 4-6 people), circular arrangement to encourage exchanges.
Introduce the theme: present the subject of the session and the supports used.
Encourage participation: open questions, attentive listening, valuing each contribution.
Respect the pace: allow time for evocation, do not rush.
Manage emotions: memories can sometimes bring up difficult emotions. The facilitator must be able to welcome these emotions with empathy.
Conclude positively: end on a pleasant note, thank the participants.
Precautions and contraindications
Some memories can be painful (bereavements, traumas). The facilitator must be attentive to signs of distress and know how to redirect the conversation if necessary.
Reminiscence is not suitable for everyone: some may prefer to live in the present and can be disturbed by evocations of the past.
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Training Professionals and Families
Training teams
Conducting structured reminiscence sessions requires specific training: animation techniques, emotion management, knowledge of supports.
DYNSEO offers comprehensive training on behavioral disorders that addresses reminiscence among non-pharmacological approaches.
Access training for professionals
Supporting families
Family caregivers can naturally practice reminiscence with their loved ones: looking together at the family album, listening to favorite music, cooking traditional dishes.
DYNSEO offers training for families with practical tools for daily life.
Access training for families
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Combining Reminiscence and Cognitive Stimulation
A natural complementarity
Reminiscence and cognitive stimulation complement each other harmoniously. Reminiscence mobilizes autobiographical memory and emotions; cognitive stimulation works on other functions (attention, language, reasoning).
The SCARLETT Program
The SCARLETT program from DYNSEO offers cognitive stimulation activities that can be articulated with moments of reminiscence.
Discover the SCARLETT program
The CLINT Program
For adults, the CLINT program offers a variety of cognitive exercises.
Discover the CLINT program
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The Evidence of Effectiveness
The scientific studies
Recent meta-analyses confirm the effectiveness of reminiscence on several parameters: improvement of mood and reduction of depressive symptoms, improvement of quality of life, reduction of certain behavioral disorders (agitation, apathy), improvement of social interactions, and temporary improvement of certain cognitive functions.
The limitations
The effects seem more pronounced in the short term than in the long term. The heterogeneity of the protocols makes comparisons difficult. The effects vary according to individuals and contexts.
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Conclusion: Honoring History to Soothe the Present
Therapeutic reminiscence reminds us that people with cognitive disorders are not blank pages. They carry within them a rich history, precious memories, an identity forged over a lifetime.
By accessing these preserved treasures, we create moments of connection, recognition, and pleasure. We remind the person that they are someone, that they have lived, loved, worked, and dreamed.
This recognition of personal history soothes present anxieties and reduces the resulting behavioral disorders.
DYNSEO Resources:
- SCARLETT program for seniors
- CLINT program for adults
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This article was written by the DYNSEO team, specialists in cognitive support and training for behavioral disorders.
