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Wednesday, 12 October 2016

Memory Boxes for people with Dementia



Memory Boxes are taking hold and gaining popularity amongst trainers, therapists and care homes.

A memory box is a container in which memorabilia, meaningful items and representative things are put.   

Anecdotal evidence shows a therapeutic benefit for the elderly and people with dementia when the box is used to stimulate memories, feelings and conversation. 

But how do you put together a memory box?

What should you put in it?

I decided to make my own memory box and share that experience and what I have learnt.

The first thing I learnt was that they need to be personal, thought needs to put in on how it might be used.

At our Pilot Provider they are using wall mounted ‘memory boxes’ to aid each resident’s ability to ‘locate themselves’, this post however, is looking at the personal side and making each memory box unique.

I started making mine using an old shoe box, it’s all most plain and boring but it will do the job.  What are the options? Really anything you can put your hands on. I love the idea of someone's memory box being their old picnic hamper or briefcase, but really anything will do. I would bear in mind that if it is a large container don't be tempted to fill it to the brim or you won't be able to rummage or ever feel like you have looked at everything before attention starts to wane.

I have read many articles and sought advise through those I have met along the way, and the best advice I received was to use a box small enough to fit on someone’s lap – a bit like the “good bye” box I put together for my twins.

The “good bye” box is where all their favourite and broken bits’ n bobs go, like yesterday when Archie found an old snail shell and couldn’t be parted from it.  The snail was long gone and only his home was left but Archie wanted to preserve it and keep it safe for when the snail returns so in the “good bye” box it went.  While we were looking in the box we found his old friend pebbles, so we had a good play with pebbles and remembered finding him on the side of the park.

I find a box of items on the lap of someone with dementia like with a toddler can be overwhelming and confusing.  I found that having a box nearby, on a neighbouring table allows you to draw attention to it and present one or two items at a time.  This initiates discussion and draws memories to the forefront.

Memories for my memory box

When I decided to write this article I made a list of all the items I thought I would be putting into my box, I even draft wrote a memory for each item.  However, to my surprise most of my list didn’t actually end up in my box.  For example, I love cooking and have done since I was a child.  When I came to my book shelf none of my cookery books sparked any kind of emotional feelings, even books I've had for years.  In a similar way my postcard collection was also bypassed and in their place I chose a selection of stickers bought when I was a child.  These remind me of going in "tat shops" where I would buy stickers, erasers and pencils with my Dad or Grandmother.

This was my second lesson; ideally the choice is an emotional and personal one.  It might not be the items that signify events or interests in someone's life, but more the things with a story or specific memory attached to them that will evoke the most feeling.

If you are putting together a memory box for someone else, you may not have their emotional and personal perspective to directly draw from.  

However, if you can recall stories that your loved one has shared with you, or things that you have repeatedly laughed or cried at these are more likely the ones that will elicit the best reminiscence rather than everyday experiences that hold little emotional draw.

How would my memory box change over time if I had Dementia?

While I created my memory box I was very aware that it is a snapshot of my life as I see it and feel it now.

For example, new hobbies and interests don't feature as they didn't feel important enough, and people who have passed away feature more heavily.

I think because I am used to relying on physical reminders of those loved ones, such as things my niece made for me, they have a greater 'feeling' to them.

This makes me wonder how you might need to adapt someone's memory box as their recollections change and memories are harder to reach.

So my third lesson is that memory boxes should change as the memory of the person they are for also changes.  If your friend or relative no longer recalls her days as a teacher, then her class register might cause confusion.  Instead swap it for a photo of her uncle that she now regularly refers to.

Sensory Items

Amongst my treasures are things to look at such as photos and letters and things to touch like my old ted (a frog my grandad made me) and a wooden oven my grandad also made me.

I did ask my dad for the smell of the RAF Bases we lived on growing up, because I find I actually miss this smell, and it conjures up happy memories of growing up in Germany.  My dad told me it was a mix of diesel and aviation fuel and that it wouldn’t be likely I’d get a bottle of that.

I’d also like to place a recording of my two young son’s laughing and giggling together or when they use “twin speak” to plot against their father and I.

A copy of Billy Joel’s ‘Scenes from an Italian Restaurant’, because I have such brilliant memories linked to just one lyric – ‘Bottle of red, bottle of white’.

In a later article we will look at the beneficial effects music can have on people living with Dementia.

And of course a bar of Nestle White Chocolate.  We know that sensory approaches to working with people with dementia are very valuable and I think a memory box is no exception.  Lesson four is therefore to take a multi-sensory approach and include things that stimulate as many senses as possible.

Should you put valuable in your memory box?

Almost every other source of advice that I have found about memory boxes suggests that you don't put in anything of value.  I can understand this if the box is to be left in a care home for all to access.

If it were my box, I would be sad not to have my Charm Bracelet in there, I collected charms from nearly every country I have been to and over 30years have really built it up to be quite the memory.

My solution is to have a special memory box that you can bring out at home to look at together and then put away again safely afterwards, or take it with you when you visit someone in a care home and take away again afterwards.  That way you can share memories about treasured and maybe valuable items without fear of them going astray.  So please don't be put off making your memory box a real treasure trove, just be mindful where it is kept.

Distress

Might a memory box cause distress to someone with dementia?  Possibly, and so my final lesson is that we must be attentive, sensitive and willing to adapt.

Into my box I have put a hair band that my niece designed and decorated (my niece died when she was just 13 and it’s only been 3years).  I also placed our Rainbow Baby Poem in the box, my twins are our Rainbows and brought light to our dark world, but without this poem I don’t think I’d physically be here today.  Right now those items make me feel comfortable and happy as they are a connection with someone I lost so long ago.  It is entirely possible though that if I was living with dementia and experiencing the world differently those things might be quite upsetting for me.  In this case we can react straight away by removing those object from the memory box and replacing them with something else.  

I'd like to explore a caveat here though.  I think there is a danger in trying to avoid all negative feelings when we are working with or spending time with someone with dementia.  The "please don't cry", "please don't be upset" reaction.  But feelings, even sad ones are valid, and need to be acknowledged, so finding a balance is my aim.  A little sadness as we remember people lost to us is normal and healthy.  But of course more extreme distress, anger or confusion caused by any reminiscence would be counterproductive. 

I would recommend you all to explore the idea of memory boxes, if only to think about or hopefully create your own.

From a professional stand point I think it is even more valuable to have a personal experience of putting a memory box together to allow you to really engage with the ideas behind what reminiscence is all about.  If you are reading this as a relative or friend of someone living with dementia I hope that this has given you a different and more personal perspective to read alongside some of the other advice on memory boxes and that it will inspire you to create one and, most importantly use it!
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