European Reminiscence Network

European Reminiscence Network

2 day training course ‘Remembering Yesterday Caring Today’

Camden Carers Centre

17th and 18th January 2019

Next in a small group we had to come up with a basic plan for running a reminiscence session on the theme of ‘babies’. We thought about discussion topics - being pregnant, giving birth, looking after a newborn, toddler years, mother and toddler groups, health clinics, men’s role in childrearing. Then we thought of resources we might use - photos of old prams, baby toys, baby clothes, dolls, teddies, nappies and pins, books, albums, tins of milk, rattles, pram blanket, christening gown, birth certificate. We thought about food which might relate to our theme - mashed banana, rusks, baby milk, baby rice. We thought about activities we might be able to do in relation to the theme - act out a christening, take baby for a walk in the pram, wash baby, put a nappy on baby, sing to baby, give baby a name, pretend to be pregnant. We thought how we might like to start a session by starting with sharing a photograph of ourselves as a baby.

Other groups then shared their ideas for their themes - childhood - which included going a visit to the childhood home walking around and describing the home; handing round a plate to help people to remember their favourite meal as a child; schooldays - taking a register of names, playing playground games, ringing the school bell, chanting tables, singing a hymn, going to assembly. We then discussed the possible structure for a session - warm up activity, exploring objects and photos, practical activity, opportunity for discussion and remembering, summary of session and memories shared. At this point I was buzzing with ideas for how to improve the reminiscence sessions I run incorporating some more ‘active remembering’!

Our next activity we did in pairs. One person spoke about their weekend and the other had to try to act as if they were not listening. My partner was Sue and this was a really tough activity, Pam then asked us to share how this made us feel - discounted, not valued, ignored to name a few. Then we had to change tact and actually listen whilst sharing a childhood memory of our weekends. Sue told me about her weekends at home with her Mum, Dad and grandparents, baking with Mum, going to Sunday school and visits from Grandparent’s who brought winkles and cockles to eat! My memories were centered around my Nan’s house where my Aunties and cousins all came on a Saturday, the ladies would be smoking and drinking tea in the kitchen and me and my cousins Jimmy and Cathy played Doctors and Nurses or Mums and Dads under the stairs in the shoe cupboard - happy days!

Building on this we then had to draw our partner’s memory, encouraging them to give us more detail about the memory in their mind’s eye. This I immediately panicked at, not being a very good artist, but Sue was happy with my effort of drawing her in front of her fire creaming butter and sugar with a wooden spoon in a big mixing bowl. We then looked at each other’s drawings and discussed some of the memories together. Drawing the memories slows down the process of remembering and presents a way of remembering/recalling for someone who may be struggling with memory.

Pam then divided us into 3 groups and we had to choose in a group a memory we would like to act out. My group chose my memory of my Saturdays at Nan’s so I played myself playing Doctors and Nurses with Annie who played my cousin Cathy under the stairs! It was really good fun and pressed my memory on the detail of certain things, some of which I’d forgotten. We then had a discussion on the value of dramatising and interpreting a person’s memories for them and the benefits in terms of making a person feel valued, giving them power, doing something fun and lighthearted.

After lunch we shared objects we had brought to the course on the theme of ‘weddings’. There were some fascinating things brought along such as wedding favours, a ring, a hat, photograph albums, gloves and pressed flowers from a bouquet. I brought along a photo of my Nan and Grandad on their wedding day cutting their cake and one of my Mum getting into her wedding car. It was evident that there were mixed emotions in the group about the loss of loved ones or relationships and a mixture of happy and sad memories in relation to weddings. ‘Don’t be afraid of emotion’ Pam told us.

We then did a brilliant activity of acting out a wedding. Everyone had a role to play, we moved the furniture around the room to create the right environment for a wedding and quickly found some props! Pam took the role of celebrant. I was the mother of the bride! Everyone really got into their role and after the bride walked down the aisle and the marriage was performed Pam asked everyone to address the bride and groom and take a present to them - physical or virtual.

Pam talked about the RYCT project and how it works in practice, in depth work over 12 weeks - different themed 2 hour sessions each week with participant and family member with one-to-one and group activities. There are usually around ten couples, 2 facilitators, 4-6 apprentices and 2-3 volunteers at every session. The facilitators meet before and after the session to plan and evaluate. Couples are recruited through Camden Carers who work in partnership. The programme is a safe place to come together for the person with dementia and their family member. They remain together for the whole programme apart from one or two small group opportunities where the family members separate off. rememberingtogether.eu

At the end of the day we had a general discussion of the benefits and challenges of the approach. Here are some of my reflections:

Reminiscence is a great way to get to know each other - commonality between life experience.

Importance of slowing down to give people time to respond. Speaking up so everyone can hear.

Referring back to the person to make sure they are able to participate.

Not speaking about the person as if they are not there.

People seeing themselves as ‘helpful agents’ - purposeful - not simply receivers of care.

Being non-judgmental.

Taking into account what is happening outside the activity - their situation outside.

The worries and concerns they may arrive to a session with.

Making eye contact and not being afraid.

Giving the person reassurance and making them feel valued.

Thinking of ideas of activities which are inclusive and people can do if they have limited or no speech.

Pleasure of ‘ooh I haven’t thought of that for ages’ - power of memory and surprise of recall.

Day Two

We started with a group activity in threes, one person had a delay for ten seconds in their speech with 2 people talking across them about a celebration they’d like to plan for them.

We had to reflect on how the activity felt and we all agreed the person with the delay felt excluded. We then had another scenario where one person had dementia, one person was the family carer and one the professional, with the carer and professional talking over the person with dementia about their care. We then all had to plan an activity with the person with dementia using a reminiscence of their childhood.

Errollyn gave a presentation on dementia. Dementia can be defined as changes in behaviour that cannot be explained by other causes such as infection or drugs. It’s not necessary to have a diagnosis of dementia to engage in reminiscence work. She gave examples of what things worse for people with dementia ie; talking to the person as if they are a child. Our focus in reminiscence should be on what is still retained, not what is lost. Music for example is stored in a different part of the brain to speech, people may still be able to sing or hum a tune even if speech is lost or confused.

V - valuing people whatever their disabilities

I - treating people as individuals

P - understanding their perspective

S - appreciating social interactions

Recent memories are not stored effectively unless influential ie; related to pain. The effects of dementia can be - impaired memory, reasoning, emotional control and judgement as well as vulnerability and helplessness. In dementia the flower (Tom Kitwood) becomes diminished. What can be done to help a person with dementia? Do things that help people feel understood and included. Respecting and showing the person they are valued by reminding them what they’ve done in their life and celebrate what they can do rather than focus on what they can’t. Slowing down so that the person has time to consider and respond. Steven Sabat suggests communication strategies in his book ‘Life through a tangled veil’ - focus on what people can do, provide a supportive faliure free environment in which a person can perform their best, being close, being there and giving attention matters most for people who may have limited communication.

David Woodhead talked about the evaluation of the RYCT programme which had been done through the method of participatory observation as well as interviews with participants and facilitators. Findings included: - the importance of the quality of relationships in making people feel safe and connected and therefore able to share their memories, - building social circles - giving power to people whose power is diminishing because rather than being told ‘you don’t remember’ with suitable support and stimulus the person with dementia can. - brings joy in the moment - increase in confidence - willingness to take risks. Outcomes measures should be viewed with caution, some research has indicated they are not accurate in this field as too many other factors are at work. Close observation and qualitative evaluation must more reliable than qualitative.

Rosie, a former RYCT apprentice (apprentices attend all 12 weeks of a programme and gain a qualification at the end in reminiscence practice) talked about her experience of the RYCT programme and highlighted the importance of the facilitator to help making connections between people, funding common ground and shared experience. We then had a discussion about the importance of structure in a reminiscence session and the facilitators role to direct the group, call for attention when needed, the importance of short meaningful participatory and multi-sensory activities within the session. Role of the facilitator to stimulate and draw the person out, to share their contribution if appropriate.

We finished the day by watching some short videos of RYCT in action to see its impact and then talked about what we had taken from the two days and how we would be embedding what we’d learnt into our own practice in the future. I was reflecting on how I could incorporate some of Pam’s fantastic training techniques into my own training methods for work I do with museum volunteers. Pam is very inspirational, she is clearly a very experienced trainer and the whole two days were completely participatory and interactive. We learned the reminiscence techniques and principles by doing the activities ourselves. I’ve learnt a lot over the last two days and really had my eyes opened to the wide range of ways a person can reminisce, even without the ability to share coherent spoken memories.

European Reminiscence Network

Programme Week 8 ‘Remembering Yesterday Caring Today’

Argenta House, Camden

11th March 2019

Today I attended Week 8 (of 12) of the Remembering Yesterday Caring Today Programme run by the European Reminiscence Network. The programme is for people with dementia and their carers. I’m really excited to see the programme in action after spending 2 days on the RYCT course back in January.

The facilitators, including volunteers and apprentices meet before the session starts to consolidate plans and prepare the room. Pam leads and gets everyone warmed up and energised with a few exercises for the body and voice. The theme this week is ‘The Next Generation’. Each facilitator agrees a specific role to take during the session today. Sue is greeting people as they come in, Barbara is writing notes on the flipchart, Annie is doing a recap on last week, Pam an introduction and Sue the summary at the end. The room is set up with chairs around in a circle with small low tables for objects and photographs which relate to the theme.

As the participants arrive we welcome them at the door with a doll and ask them if they’d like to give the baby a name. Lots of chat then ensues about names - where our own names come from, what they mean and so on. It takes a while for everyone to arrive and settle and there is a nice energy in the room as the group are now well established as this is week 8 of the programme. Pam introduces the session and ask us to do an action related to ‘bringing up baby’ - there was lots of movement in the room with people pushing prams, winding baby, rocking baby to sleep, singing to baby, changing baby’s nappy and so on! Pam then invited everyone to give the baby a gift and she went around in the circle and asked ‘what would you like to give to baby?’. Barbara wrote up the gifts which ranged from a mobile, to blanket, book, rattle, knitted cardigan, patience, cheerful nature and a star! Annie then gave a recap on last week’s session and the memories that people had shared relating to the theme of ‘jobs in the home and garden’ - Annie told us how Billy remembered polishing the floor and Annie and Caroline then gave an action to it.

We then broke into small groups to look at some of the objects and photographs in more detail which was an opportunity to find out more about some of the participants. I asked a lady I sat beside ‘were your children born at home or hospital?’ and she told me that she had three children, one at home and two at hospital. We then looked at the terry toweling nappy together and worked out how it should be folded and came up with some different designs for day and night nappies whilst talking about the how men didn’t used to be able to come in the room whilst their wife was in labour. I also talked to a family carer about her own birth experiences and we shared the gory details of our labours together! I asked her if she and her Mum were enjoying the programme and she said ‘Mum really loves it here, she likes the fuss and attention she is given, that people are interested in her and her life. She might not remember what we’ve done tomorrow but that doesn’t matter’.

After delicious home made cakes and coffee which everyone enjoyed we did a practical activity of giving baby a bath. Basins were filled with warm water, there was soap, sponges, flannels, talcum powder and towels so that baby could be properly bathed, have a clean nappy and then be nicely dressed. All the participants joined in with this activity in their own way, some of them with limited verbal communication being able to participate fully in this ‘doing’ activity. For people who did not want to join in with this there were a selection of games which could be played as an alternative.

In pairs we were then asked to talk about our own children or nephews and nieces and have a ‘boast’ about them. This was a really interesting activity for the participants who come to the group with their own children. One lady said she was proud of one son who is a chef, another son who manages the farm and her daughter of whom she is proud of everything and you could clearly see the impact on her daughter who was sitting beside her. It was a touching moment of lucid memory.

Then back into the larger group we shared sayings, songs and rhymes we’ve sung to our babies. This was a lovely opportunity for all the cultural backgrounds in the group to be explored - we had traditional English lullabies, as well as songs in German, Bengali and Spanish. Everyone joined in with singing or humming along and along with ‘Que Sera Sera’ it was a nice way to end the session. Sue then did a short re-cap for everyone about what we had done today and some of the memories that were shared. It was nice that some of the apprentices and volunteers spoke out to the whole group on behalf of some of the participants so that their memories could be listened to by everyone. Next week’s topic of food and cooking was introduced and then everyone said goodbye. Once all the participants had left the facilitators had a de-brief to discuss the session. This was a great opportunity to reflect on how well it had gone for participants and carers, if any issues had come to the fore, how engaged people were, the interaction between the group, formation of friendships, challenges that arose and good news stories. There was also planning for next week’s session.

Some of my observations and reflections of the session:

• ‘Children and babies’ can be a tricky topic if a person has no children of their own or a limited experience of babies and children but there were still opportunities for recollection of one’s own childhood within the session.
• This seemed a challenging group with very differing needs; one participant was very deaf, another had suffered a stroke, another spoke no English and needed her daughter to translate, another had recently suffered a bereavement. Sometimes these challenges can make it harder for people for engage but the needs of everyone had been considered and accommodations and adjustments were being made accordingly to enable people to fully engage.
• The structure of the session was excellent and the short and concise sections made the time go very quickly but at the same time it didn’t feel rushed.
• The opportunity for people to engage was there in different ways - one-to-one, small group and whole group, so people could join in how they wished/needed to.
• The personal sharing of memories in the re-caps at the beginning and end of the session was fantastic to validate and give value to the memory and therefore the person.
• The ‘doing’ activities were really effective because no verbal communication was needed, people enjoyed remembering by doing and it was also a lot of fun.
• The high ratio of facilitators to participants means that everyone has someone to be with them all the way throughout the session, this I felt was a crucial element to how well the session worked and how well people engaged because they were so well supported and encouraged.

European Reminiscence Network

‘Theatre of Memory’ Conference - Dublin

1st-3rd May 2019

Day One

Arrived in Dublin on Wednesday afternoon and went to an evening reception at Howth Yacht Club, treated to live Irish music and dancing, introduced to delegates attending from Canada, USA, Czech Republic, Spain, France, Netherlands, Finland, Sweden, Singapore. Delegates working in all areas of reminiscence, life story work, oral history - range of projects, organisations and practioners. Very welcoming and many of the delegates are well known to each other.

Day Two

Introduction from Karen Meenan, conference organiser. Key points included: dementia will affect us all at some point in her lifetime, need to find other ways to connect with the person with dementia - museums, theatre, music, dance. Let’s get talking, share ideas and practice. Overview of the conference programme.

Pat McCloughlin Anthony Lavin - welcome and overview of provision in Ireland for dementia, more can be done as dementia grows, more government support required.

Pam Schweitzer - history of ERN, Age Exchange, origins in making theatre using memories verbatim, using direct testimony, RYCT came from this as a way to support family carers, placing importance on the person and their intact life memories and not the deficits. Using imaginative methods to revisit crucial stages of life over 12 week programme, reminding the person with dementia of their own value. In 2010 Remembering Together’ a new project including visual and expressive arts in reminiscence, apprentice programme set up 2 years later. Want to continue conferences biannually. New interest in the work of ERN worldwide from fields of dementia, oral history, reminiscence, visual arts, music and theatre. New directions need to be explored, hopefully conference will contribute to this.

Performance of ‘Take off your Cornflakes’ - a couple’s journey through being diagnosed with dementia, exploring levels of places you can connect.

Czech Republic - reminiscence in hospital programme - long stay hospital geriatric patients, different research methods and interventions both group and individual, fundings showed people doing reminiscence had better cognition score than those who did not. Involved in RYCT from 2015 with funding from Erasmus, dilemmas in practice contraindications and some people who do not benefit and find difficulty in engagement.

Singapore - ‘Take off your cap’ - Patricia is an oral historian, who has set up and funded her own RYCT programme using reminiscence to build, keep friendships, grow communities, KNOW:REACH:TOUCH. Training has equipped carers to do one to one reminiscence and collect life stories. Evaluation - impact hard to measure especially quantitative. Challenges - finding the right volunteers, future funding.

Canada - Trudy - concept of arts in health, creating environments where people can thrive, programme with undergraduate drama students and older people in care homes, students using life story transcripts and choose themes within to create tableau. ‘Dobsons approach’ good for confidentiality, fictionalising the real but capturing the sense of the person and their story.

Canada - Christy - ‘Life is Art’ - working with 25K grant to explore life stories through art, including musicians writing songs based on personal memories and visual arts, residents as artists, made music, a book and CD

UK - Anita and Kate - family carers and participants in RYCT at Camden, both work in health, explored the care triad and Butterfly care home model (love, belonging, safety). Reminiscence uses power of creativity to access emotions through music, storytelling, objects, enactments and images. Enactments (use of body - salutogenesis) very important. Helps people to be seen again as a whole person (not diminished) that others can relate to. Curiosity/a natural interest in others essential to compassion. RYCT an intervention for a relationship, enhancing and deepening the relationship.

UK - Sally Knocker, Dementia Care Matters and 3 nurses from an Irish Butterfly Home - discussion of the butterfly care model, based on ridding home of institutional features to create a sense of family, being with as opposed to being done to, still giving and feeling useful. Only 40 worldwide. Nurses showed their memory aprons and own personal objects and photos they share with residents. Eating and drinking improved, less falls, more family members visiting.

Netherlands - Anne Marie ‘Dementie en herinneringen’ an app which contains sound, video and pictures as well as popular, classical and religious music, soundclips of noises such as typewriter, birds, popular jingles.

France - video presentation centenarian project, filmmaking with person with dementia and his family about feelings related to dementia, very poignant black and white film with colour at selected points.

Catalonia - umbrella of person centered care, personhood = identity, comfort, occupy. Working with multi-disciplinary teams in the community (physios, nurses, OTs, carers) and training those individuals with skills in reminiscence. Evaluation - observation of being engaged passively/actively, articulation, interaction, expressive

France - ‘Memory of my Bones’, intergenerational project exploring memories of refugee camps, children verbalise older people’s testimony in the film.

We ended the day with a music session with Jane who works in a hospital as a music therapist and uses reminiscence in her music therapy. Music and rhythm are our first reminiscence - we are hearing even before we are born.

Evening entertainment was music from the Forget-me-Nots dementia choir, Irish youth band and School of Irish Dancing. Lots of opportunity to get to know delegates, share ideas and discussion.

Day Three

A wide range of presentations included:

USA - ‘Aliceheimer’ a graphic novel based on Dana’s Mum Alice and her journey through Alzheimer's. Healing through story, making focus on the magic and strength not the loss. Visual aspect of graphic novel makes up for loss of language. We also associate comics with laughter which can give respite.

Sweden - creative aging, inclusion and active participation, based in libraries once a month sharing memories, pictures, objects, music and then doing improvised theatre. Transferred model to care home based on the idea of a train holiday but focused on the places where participants grew up/came from. Together the pieces formed a production - bit/ly/20NwmRw

Denmark - Fire Engine House theatre, using improvisation methods, sharing memories of older people and choosing stories for a production. Local schools and older people making memory boxes, older people visiting school on bicycles for intergenerational activities ‘cycling without age.

Denmark - Peter- ‘Stellar Moments’ amateur theatre/dementia ambassadors, Alzheimer Association working together creating theatre for and with people with dementia.

Denmark - Charlotte - ‘Nursing home with a view’, collaboration with health and social care colleges, families, residential homes and theatre. 3 year project subject for healthcare students developing a new method for their learning - pedagogic and theatre combined. Why theatre such a valuable method? What does it mean to perform memories?

Participatory workshop with Leoni and Varpu from Finland. They gave an overview of their work first - ‘Those were the days’ - working with older people around the subject of their childhood memories. Start with general reminiscence sessions and then improvised rehearsals for 3 months and script development, premier in the library and then toured care homes. Very positive feedback received around accessible nature of project for people with dementia as focus on earliest memories. We were then split into groups and explored a wide range of interesting objects which had been carefully arranged in a display on the carpet. We did a simple warm up song and dance in a circle. We were then asked to choose a photo or object which linked to a memory we had from our childhood. I chose a woollen stocking as I still have the one given to me as a child which I hung up every Christmas Eve which was in actual fact my Grandad’s old woollen fishing sock, my brother having the other one to the pair. In our group we chose the most interesting memory and acted it out which was Shannon’s memory of lambing. The wider group had to guess what we were acting. It was fun and a lighthearted way to work together as a group and everyone seemed to enjoy it.

We then watched a short performance of the Making Hay theatre group ‘A play with me in it’ which explored experiences of older people in hospital.

After lunch Pam and Natasha gave a presentation on the memory box project ‘Making Memories Matter’ which began in 2005 with European funding. Artists worked with older individuals from minority ethnic backgrounds to create an individualised memory box exploring the person’s life story. 140 boxes were created and 60 went on tour. in 2017 the boxes came to the University of Greenwich where students and older people came together and shared their reactions. Students then selected boxes to use as creative stimulus for a dramatic production. Positive impacts on students mental health, learning and attitudes.

We then took a coach to Dublin where we had a tour of the Mayor’s house and a visit to the Little Museum of Dublin with a special guided tour focused on the history of significant women of Dublin.

Thoughts and feelings on my return journey home.....where do I start?! How inspirational some of these speakers were! So many ideas to think about and be inspired by. How can I make some of these things happen on the Isle of Wight? How can I incorporate reminiscence, life story work, oral history and then creatively and respectfully interpret these precious individual memories? I’ve met some very interesting and passionate people through the course of the conference and found out about projects I’d never heard of. The hospitality of the Irish has been fantastic and ERN is a wonderful group - I’m so glad I came!