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$38.95 Stock #29227 (ISBN 978-1-932529-22-7) approx. 144 pages 11" x 8.5" papercover © 2007
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Excerpted from the Introduction of Memory Books and Other Graphic Cuing Systems: Practical Communication and Memory Aids for Adults with Dementia by Michelle S. Bourgeois, Ph.D., CCC-SLP Copyright © 2007 by Health Professions Press. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the author. Introduction Ours is a busy, fast-paced world full of names, faces, places, facts, and figures to remember and use. We have appointments to keep, phone numbers to call, important facts to remember-so many that we often experience memory overload. How many of us can function without our memory aids-calendars, appointment books, shopping lists, Post-it notes, small scraps of paper in a coat pocket or at the bottom of a purse? Many manufacturers are taking advantage of our inadequate memories by offering us technological substitutes, such as computers, calculators, personal digital assistants, and cell phones. In this age of computers, we depend on technology to augment our memory capacity. If the average person is overworking his or her memory just to get through the day, imagine the challenges facing individuals for whom memory loss is one symptom of a larger problem. The purpose of this book is to describe the use of a memory strategy-the use of written cues-that has evolved as it has been researched with a variety of individuals and in various formats from memory wallets, memory books, and memory boards to reminder cards. The original motivation for the development of memory wallets and memory books was to enhance conversation. Persons with dementia reported having difficulty remembering words, the names of familiar persons and places, and the topic of a conversation. Their family added observations of withdrawal and depression, frustration and anger, and avoidance of conversational interactions in group situations. The apparent solution was to provide a collection of pictures and sentences that the person could read and that would remind him or her of specific people, places, and events to discuss. As reported in Bourgeois (1990, 1992b), individuals with mild to moderate dementia demonstrated immediate changes in the content of their conversations when reading aloud the memory wallet or book pages and elaborating on the topic. These improved conversations continued over time and in some cases for up to 24 and 30 months, despite continued cognitive decline. Serendipitously, caregivers reported the usefulness of a memory book page to resolve difficult behaviors such as repetitive questioning. This led to providing written answers to questions in a variety of places, from the memo board on the refrigerator to an index card carried in a purse to a self-adhesive note on the car dashboard. As the idea of using written text to cue memory has spread, professionals have adopted this strategy for the functional goals addressed in therapy with their clients with memory loss. Goals related to orientation; communication of wants, needs, and safety; increasing activity and engagement in activities; and reducing challenging behaviors have been addressed successfully with a variety of written cues. Speech-language pathologists are spreading the word among their colleagues in physical therapy, occupational therapy, and nursing. Nursing assistants, in particular, have been the focus of specific training programs designed to provide them with a tool to make their interactions with the resident with dementia more satisfying and successful. As this strategy continues to be used and adapted to solve a variety of problems, the technology will evolve. In the meantime, this text is designed to provide the most current information about how to make and use written cues for a range of memory-related problems. Chapter 2 Choosing the Information for the Memory Aid The information chosen for the aid must be facts that are important to the client, that he or she wants to talk about, and that he or she often gets confused. The memory aid should also contain facts that are important to the caregiver, such as activities of daily living and common topics of conversation. Several forms for gathering pertinent information from family or staff informants are included in Appendix C1 and C2. Some examples of useful information to include in memory aids: Biography:
Nursing home or assisted living residents may not have family available to provide information and pictures, but memory aids can include information about other topics important to the resident, such as: People
I live with: My roommate's name is Helen Cargill. Writing the Sentences Persons with dementia usually demonstrate relatively preserved reading skills, although not necessarily at the same level as prior to their illness. To maximize reading success, do the following:
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