Memory, Music & Emotion in Dementia Care | TCHD

Music, photographs and familiar images can have an extraordinary ability to bring memories back to the surface. In dementia care, these connections can help us think differently about the environments we create and the visual and emotional cues we provide for residents.

But why can a song we haven't heard for forty years feel instantly familiar, while something that happened yesterday can be difficult to recall?

Memory is an incredible thing when you stop and think about how it works, how much information we can recall at some indeterminate point in the future and, perhaps most importantly, what triggers that memory.

How Do We Find a Memory?

One question you might consider is: why do we need to remember so much?

Wouldn't it make sense to have a relatively short, uncluttered memory so we can function more efficiently?

If I were a computer hard drive, maybe that would make sense because I might eventually run short of storage space. The human brain, however, appears to have an extraordinary capacity for storing information.

Recall, on the other hand, is an entirely different matter. I guess we need search references of some kind to bring memories back from this vast archive of 'everythingness'.

Perhaps our brains are a bit like my dad.

He could look at just about any item and imagine it "might come in useful one day", then store it away somewhere neatly.

From time to time, one of these items would be perfect for a purpose that had arisen and he knew he had it somewhere. He just needed to remember where he'd stored it.

Maybe there's a useful analogy here. As our ability to recall information changes, perhaps we sometimes need more clues and cues to help us find a memory and bring it back to the surface.

Given how important reminiscence can be as we grow older, the things that provide those cues can become particularly valuable.

Why Can Music Trigger Such Powerful Memories?

One astounding-yet-easy example to demonstrate is the memory recall associated with music.

This has genuinely fascinated me for years, long before I had any involvement with dementia care.

In my personal experience as a teenager in the 1970s — the greatest era for musical creativity and innovation in the history of mankind... in my opinion — I had a mate whose older brother had a huge and ever-growing record collection.

I spent a lot of time listening to his eclectic range of albums — remember those? — during my all-important formative years.

All these years later, I can listen to something I haven't heard for maybe 40 years — Ronnie Laws' Pressure Sensitive (funky and very cool), or Betty Blue by the Ozark Mountain Daredevils (who???) — and it's as though I only listened to it yesterday.

I remember the bridge, the key change, every note of that sax solo.

It's mind-boggling.

Yet I can forget the name of the TV programme I watched yesterday.

Now I'm no expert, but I suspect part of the power of these memories comes from how closely music can become associated with emotion.

Perhaps music is pure emotion when it touches us, whether it's a tear-jerking emotional train crash or an all-out rocker.

Even if we don't particularly like a piece of music, when there's a strong memory associated with it, that connection can remain incredibly powerful.

Pictures, Emotion and Memory

If music can create such strong connections between emotion and memory, can images do something similar?

A simple example might be a photograph of someone we've been close to who is no longer around.

The picture reminds us of them and can bring emotions and memories back with it. A photograph can become much more than an image; it can be the starting point for remembering a person, place, event or conversation.

Walk into many care homes and you'll hear music playing, often music 'of an era' intended to provide familiarity and nostalgia.

If we recognise the value of those connections with music, then surely we should think about artwork, photographs and other visual elements within a care home in a similar way.

I am convinced there is a great deal of similarity between our relationship with pictures, emotion and memory and our relationship with music, emotion and memory.

What Does This Mean for Dementia Care Environments?

Music of almost every type is now quite literally available on tap.

I don't buy much music anymore, which is a bit of a shame on a nostalgic level. Instead, I use an app. I can get whatever I want, whenever I want.

If I want something to sing my head off to in the car when no one else is around, I can. If I need three or four hours of dinner-party background music, I can search for a collection and off we go.

Meaningful visual material can require more effort.

Finding imagery that is relevant to an individual, a generation or a particular experience takes time and thought. But the material is out there.

The important thing is choosing imagery because it has meaning, rather than simply because there's an empty wall that needs decorating.

This is one of the principles behind the way we approach dementia-friendly environments at The Care Home Designer.

Photographs, artwork, personal possessions, memory boxes, destination points and other familiar visual cues can all contribute to an environment that feels more personal and provides opportunities for reminiscence and conversation.

Designing Around the Individual

Creating a dementia-friendly environment isn't simply about making a space look attractive.

The images, objects, colours and displays we introduce can all carry meaning.

Just as a familiar piece of music can transport us back decades, the right photograph, image or object may provide a connection with a person, place or moment from someone's life.

That's why we believe care home environments should, wherever possible, be designed around the people living within them.

A visually attractive care home is important, but creating an environment filled with relevant, familiar and meaningful cues can offer something much more valuable — opportunities for recognition, reminiscence, conversation and personal connection.

Memory boxes are one practical way of bringing these personal stories, familiar objects and visual cues into the care home environment. Read about the role of memory boxes in dementia care