Editor’s note: This article originally appeared in Early Alzheimer’s, a newsletter of the Santa Barbara Alzheimer’s Association, and is used with permission.
Conversations, a new interactive booklet, can best be described as a tool that becomes a photo album story; the booklet is designed to facilitate the creation of a life story. This article discusses how the uses of Conversations can be particularly significant for someone in the early stages of Alzheimer’s disease (AD) or a related disorder, as the person can be highly involved in the project. In the mid-to-late stages of AD, the caregiver or others must primarily complete Conversations.
The Philosophy Behind Conversations
Everyone’s life story is unique. Specific sets of events, experiences and people have helped shape our identities. Each time we have an opportunity to relate a personal anecdote to another individual, we are reconstructing and reinforcing who we are. Thus, we maintain our individuality by sharing our lives with others.
The body of literature in reminiscence and life-review tells us that these are very valuable activities for maintaining well-being as we progress through life. “Through reminiscence, we continually structure, maintain, and reconstruct our self-identities.” (Chaudbury, 1999)
When someone has AD or a related progressive memory disorder, there will inevitably come a time when deficits in recall, recognition, and communication skills will seriously impact the ability to impart personal information to others. At this point, one’s sense of self, one’s “personhood” (Kitwood, 1997) is at risk.
In the early stages of the illness, however, both long term memory and the ability to communicate are still highly functional. The person with AD has the capacity to participate in planning for the future. Typically, we stress legal and financial planning. Why no include in the process of planning for the future the recording of one’s life story.
Immediate and Future Benefits
Creating an autobiography has immediate benefits as well as benefits for the future. First of all, it can be fun. It is a form of reminiscence and rediscovery of the past. It is a reason to peruse old family photographs, which frequently evoke forgotten memories of important people and events. It is an opportunity to make decisions about the impression a person would like to leave behind. There is the satisfaction that a personal legacy will exist for future generations. Also, it is an activity that could engage other family members in addition to a spouse. It can be an intergenerational project with participation by adult children and grandchildren.
As for the future, there may come a time when the needs of someone with AD can best be served by attending a day program or moving into an assisted living facility or other long-term care settings. Having a recorded life story can ease this transition. Because staff are provided with significant personal information, meaningful connections may be formed more quickly. Recreational activities can be planned in a more personal way, based on past interests and talents. Having personal histories available permits staff to encourage reminiscence and help trigger memories when the memories are less available. Communication can be supported by focusing on photographs and other biographical information and will certainly help in the preservation of “personhood.”
Creating an autobiography is not always easy. Conversations provides a structure and format that guide the user through the earliest memories to the present day. The book becomes a personal history through the use of photographs and the recording of significant life-events. The text encourages the inclusion of personal anecdotes, which adds a colorful and frequently humorous dimension to the project. Conversations also contains suggestions for activities based on personal preferences, and illustrations to further encourage talking. The preface includes suggestions and step-by-step instructions on how to use this book most effectively. Individual families and professionals in group settings are currently using Conversations. For more information about Conversations contact Susan Goldfein at 203-227-4852