Music & Memory 🎶 The Yellow Rose of Texas

After wheeling my mother to a table in the activity room of her care facility in Los Gatos, California, I walk to a cabinet and open a door looking for something to do. 1950’s country music fills the large room.  Shamelessly, joyfully people are singing along with Elvis.

“You don’t have to say you love me–”

Finding a box labeled “Jenga,” I carry it back to mom, pouring the blocks onto the table in front of her. Mutely she watches as I begin stacking pieces into three boxy towers–hoping she will play the game by adding blocks and then pulling them away.

She doesn’t remember how to play, yet she remember sensations.

Picking up a wooden rectangle she deftly rubs her fingers over the smooth surface. Her hand alive with feeling, seeking to turn sensory signals into words.  “Oh, this feel so–” She tries to convey but a repeating word  starts  a slippery slide off her tongue running over and over again and again, until thoughts fall to pieces.

My building project grows–without her input–as she silently continues working her fingers around two sleek wooden game pieces. Soon, the mood around us shifts as several robust voices begin singing and The Yellow Rose of Texas carries the room away.

For me, a vivid memory arises of my father and mother singing that song together in the kitchen on a Saturday morning.  My mother–her mind now broken from the sticky edges of Alzheimer’s disease–continues caressing her blocks.  Soon, my tower rises tall and her Yellow Rose of Texas blooms. Smiling, she begins clapping her wooden blocks rhythmically together and singing–“The yellow rose of Texas I’m going there to see…”  Her words clear and her tune right on target.

There are different kinds of memories and only certain memories rely on a functioning brain. Memories arise from many stimuli, like touch and sound as well as feelings and emotion.

It’s a beautiful experience watching distant memories engage through music.

Along the Path of Caring

   Caring Brings us to the Moment at Hand

Care givers are challenged daily to deal with the unexpected. Accepting change and adapting to whatever arises shapes the path of caring.  Stepping over the edge of the known and into the unknown requires courage, trust and ingenuity.  Engaging with the moment at hand with an open heart and a willing presence  Strengthens empathy, compassion and awareness.

Steps toward Compassionate Caring

• Cultivate mindfulness– As a tool to return awareness to the present.

• Trust the present moment– Accept whatever arises right now. Offer your compassionate attention.

• Stretch into the unknown– Remain flexible, adaptable and open to anything, without expectation.

 “Out of clutter, find simplicity. From discord find harmony. In difficulty lies opportunity.” –A. Einstein

Three Paths of Caring

The Path of Self-Care

“Mindfulness of the body is the body’s mindfulness.”  Yoga and meditation are valuable tools for strengthening the body, balancing the mind and recovering a spirit of joyful inquiry. Mindfulness comes from presence and a practice of self-care that increases our capacity to care for others.

A Calling to CARE

What do you care about?  Often, we see what needs to be done but are afraid to act. Caring does not ask for perfection. Doubts arise and may be investigated; but awareness grows as the mind stills. We are only asked to do the best we can with what we have. Cultivating trust in our innate gifts and acceptance of our short comings, we continue along our path, moving deeper into the journey of caring.

CARE into Action

How well do you care? Empathy is the awareness of suffering and compassion requires us to do something about it.  Action begins with intention. Change happens when we organize our energy around an intention, align our resources and focus attention on our calling to care.

 “We can not do great things in this world. We can only do small things with great love.”
–Mother Theresa

From Normal To Lost

Do you Know the Difference between Normal and Abnormal Memory Loss?

Mild memory loss with slower processing time is a part of normal aging but progressively worsening memory loss, difficulty reasoning and the inability to learn new skills, is not normal aging.

 

Stages of Change

1. Normal aging
2. Mild Cognitive Impairment
3. Pre-clinical symptoms
4. Dementia
5. Alzheimer’s Disease         60-80% of dementia is caused by Alzheimer’s Disease

Diagnosis is Difficult
Mild memory loss is a normal part of aging
Language defining memory loss and dementia is confusing
A diagnosis of “dementia” can be easily misunderstood

Nobody Knows the Cause
1.0% decline annually on neurocognitive testing is considered normal after age 65
2.5% decline annually on neurocognitve testing is seen in Alzheimer’s Disease

Signs of Normal Aging
Slower recall of information names and nouns
Increased effort to learn and store new information
Heightened susceptibility to distraction
Slower processing of new information
Greater difficulty multi-tasking
Normal cognitive testing

Early stages of Progressing Memory Loss
Silent phase: no measurable symptoms
Individual may notice changes
“Patient knows but doctor doesn’t”
Normal cognitive testing

Mild Cognitive Impairment (MCI)
Memory loss becomes disruptive
Difficulty with word recall
Missed appointments
Fully capable of daily activities: dressing, eating, walking, talking, driving
Lower scores on memory and language tests
Normal scores on testing other cognitive domains

Dementia
Significant loss of intellectual ability
Memory loss plus 1 or more other cognitive function
Interferes with daily activities
Low scores on memory testing plus one or more other areas of cognitive decline
Can be reverisble- rule out other causes
Subtypes of Dementia include: mild, moderate, moderately severe, severe

Alzheimer’s Disease
Irreversible with  symptoms continue worsening over time
Impaired thinking, speech, reasoning
Changes in behavior, mood and function

orange jellies Links to More Information:

information on types of progressive memory loss

 

The Reminiscing Connection

For those with Alzheimer’s the therapeutic effect of reminiscing is particularly important as it taps into a visceral place, far deeper than memory alone.  By bringing past experience into consciousness, “life review”  improves well being for seniors. Reminiscence techniques aid in communication. By bringing what is hidden into awareness, distress and stress behaviors begin to alleviate.

An easy to remember reminiscing activity begins with the words: Tell me about… 

The sentence can be finished with a known fact about your loved one. For example, I might ask my mother, “Tell me about the Robin Hood you painted on your wall as a teenager.”  Or  “Tell me about what it was like to sail in the San Fransisco Bay.”

And then I listen, with full acceptance of whatever she has to say.

The act of speaking and remembering improves cognition, reinforces language skills and connects with you as the listener. People with Alzheimer’s are no different from anyone else. Everybody wants to be heard and understood.   In fact, as memory fails, people begin to seek connection with others.

Social contact has been shown to decrease disease progression and prevent the harmful effects of isolation.

Next time you visit your loved-one or a friend with Alzheimer’s, ask a question that begins with the words, “Tell  me about…”

And bring along something visual, tactile or auditory–poems, stories, music, photos provide rich sources for stimulating memories.

__________________

References
Memories of a Life: A Design Case Study for Alzheimer’s Disease Tira Cohene, Ron Baecker, Elsa Marziali, Simona Mindy University of Toronto
Transformational Reminiscence: Life Story Work: John A. Kunz,