Some years ago now I arrived at the home of a woman who had quite advanced dementia. This caused significant problems with her speech, memory and ability to carry out even some of the simplest of household tasks independently. She was normally quite troubled which was the reason that I was working with her. However on this day she greeted me enthusiastically with a huge smile on her face. News coverage was full of a successful international rescue mission that had taken place in the country that she had grown up as a child. ‘Isn’t it wonderful!’ she exclaimed. ‘They’re alive!’ Not only had she established the link between her homeland and the rescue but she was also demonstrating recall for the story that was considerably beyond the norm for her.
This incident caused me to think about the link between emotion and memory for people with dementia. In the general population it is well established that emotionally charged events are remembered better. This woman taught me that this might be the case for people with dementia too.
In researching this article I came across a small study that has some parallels with what I saw. Researchers told participants with dementia the same story twice. The tale was identical apart from one passage. An emotionally charged version of the story was found to be remembered more vividly than its neutral counterpart. Interestingly the level of improved recall was similar to that found in a control group of subjects who underwent the same testing but didn’t have dementia. Most of the active group had mild dementia so maybe the differences might not have be expected to be marked. But my own example suggests that this phenomenon might extend into the later stages of the disease.
I’ve come across other research in the general population that suggests that experiences that elicit positive emotions are usually remembered more clearly than those that trigger unpleasant feelings. Does this have implications for care? Can participation in activities carefully chose to provide an individual with joy promote their cognition and improve independence?
Another piece of research looks at the relationship between memory and emotion from a different angle. In this subjects with Alzheimer’s disease were shown film clips around the themes of sadness and loss. Even though their memory of what they had recently seen was impaired the emotions triggered by the clips persisted when tested after 10-15 minutes and again at 20-30 minutes. Interestingly subjects with the most memory impairment retained feelings of sadness for the longest time after the viewing.
I am sure that achieving a pleasant or, at the very least, neutral emotional landscape is something that empathic carers are aware of consciously or subconsciously. But maybe this is a subject that deserves overt discussion in formal training to inform those with less skill, insight or experience. It should be made clear that the effects of a harsh word or inconsiderate treatment for a person with memory deficits may be much more long lasting than expected. Similarly exposure to pleasurable situations may promote joy and wellbeing well beyond the duration of the activity. Perhaps the potential for reducing distressing behaviours over an extended time frame as a consequence of this needs to be highlighted.