Forget About Memory, Focus on Imagination!
Yesterday, I had a conversation with a contact from a Quality Improvement Organization (QIO) in my home state of Montana who was seeking advice on how to drive dramatic changes in dementia care practices in the state’s nursing homes. (QIO’s are independent state organizations chartered by the Centers for Medicare and Medicaid to advocate for high quality health care by providers receiving federal funding.)
She had seen Alive Inside and heard about my connection to the film (my mother runs one of the larger nursing homes in the state and has helped boost the film). Like so many other culture change advocates she saw this film as a clarion call for action.
She called asking for advice about how best to leverage the film to get nursing homes to adopt new practices of dementia care that will help dramatically reduce the use of anti-psychotic prescriptions to treat Alzheimer’s and dementia statewide.
Alive Inside has made it powerfully clear that the least — THE LEAST — providers can do is adopt the Music and Memory program and provide personalized music to those they serve. I don’t see how you can watch that film and not conclude that it is a criminal civil rights abuse to deny people living with dementia access to music.
But music is just the beginning, the most basic, no-brainer approach. Beyond music there is an entire world of creative, arts-based and experiential models of dementia care and culture change that have potential to radically improve the wellbeing of people living with dementia, in nursing homes or any other environments.
I shared a few ideas with my new friend and she promised to send me some new programs and ideas she had been investigating. Below are my top three suggestions and I would LOVE to hear other suggestions from readers:
1) Connect with The Eden Alternative and begin trainings in Dr. Al Power’s Dementia Beyond Drugs. The QIO can’t do that alone, but I recommended she look into the CMP-funded statewide trainings The Eden Alternative recently provided in Kentucky, Tennessee and Mississippi.
2) There is no substitute for the organization-wide culture change outlined by Eden’s and Dr. Power’s approach, but there are some amazing programs that providers can easily implement with life-changing results. One of my favorites is Anne Basting’s Timeslips. It’s a simple story-telling activity that provides a radical paradigm shift for participants away from a focus on memory and towards a focus on imagination. Coincidentally, Anne is in the final days of a major IndieGogo fundraiser to expand Timeslips and I urge all of our readers to visit her fundraiser page and chip in.
3) Third, I suggested getting the community involved by visiting the I’m Still Here Foundation to learn about dozens of other innovative, community and arts-based movements nationwide providing non-pharmalogical approaches to living with dementia (including programs like this here in Seattle).
That’s just the tip of the iceberg. What other programs would you suggest?
Shortly after publishing this piece I had the opportunity to interview someone who has implemented the Music and Memory program in two small homes for people living with dementia. She would beg to differ with my characterization of implementing the program as “basic” and “no-brainer”. The training for Music and Memory is only about eight hours, but the process of setting up individualized play lists is quite demanding. She spent many weeks following up with families and compiling music before she could launch the program. The good news that there are efforts underway to crowdsource the music lists organizations are developing as they roll out Music and Memory.
You can also read my review of the documentary Alive Inside, about my experiences with Implementing the Music and Memory Program in Denmark, and my post about Coloring as a Purposeful Activity.