Creative storytelling breaks silence of dementia

John Allen with speech and language therapy student Alicia Posthuma

Former naval officer John Allen has dementia, but the memory book he is perusing with Massey University Speech and Language Therapy students has prompted the usually silent man to talk.  

While the conversation might seem limited to an outsider, his responses and comments are a breakthrough, say Ben Matthews and Alicia Posthuma. They are in their third year of the four-year Bachelor of Speech and Language Therapy programme offered through the Institute of Education at Massey’s Auckland campus.

Mr Allen, at Aria Gardens’ Home and Hospital in Albany, is one of several individuals with dementia receiving regular visits from Massey’s Speech and Language Therapy students as part of their training. They bring patience and empathy along with knowledge, skills and props (such as memory books) and other innovative communication techniques to break through the language and memory blocks caused by dementia.

Pictures that spark words

To create the memory book that is successfully engaging Mr Allen’s attention, Ms Posthuma collected photos of Mr Allen – as a young Naval officer in the Royal British Navy and of his later life as a family man. She has added images of naval warships, and men in different naval uniforms in the hope these will trigger memories and words. They do.

Ms Posthuma makes comments and gently fishes for Mr Allen’s thoughts on types of warships. His comments lead to other conversational tangents, such as ‘what it must be like on board those ships’. And though it is a slow and painstaking process, he is able to offers his thoughts and recollections between pauses.

Ms Posthuma says it is important not to pressure a person with dementia with a barrage of questions. “Often people with dementia can’t answer questions,” she says. “Our work is about getting to know a person and building a rapport with them. Often when they come to see us, they will open up quite a lot. They know we will listen and wait for a response.”

Another tool they use at Aria Gardens is TimeSlips, or creative group storytelling. Conversations are prompted by a photo or image to elicit a story. It might be partly true, partly made up. It doesn’t matter, says Alicia. “With TimeSlips, there are no wrong answers.”

Mr Allen with Alicia and Ben Matthews, as they talk about Mr Allen’s memory book

Creative storytelling to unlock memory and imagination

Annabel Grant, a clinical educator for Massey’s Speech and Language Therapy programme, says the TimeSlips concept – founded by American dementia scholar Dr Anne Davis Basting in the late 1990s – provides a “failure-free environment for communication, which supports feelings of self-worth and encourages social connectedness.”

TimeSlips works by opening up storytelling to everyone by replacing the pressure to remember with the freedom to imagine, she says. “Residents become storytellers, and the students find that the level of social interaction and conversation increases during and after the sessions.”

It has enlightened students too. One told her; “my feelings towards people with dementia changed as the weeks we delivered TimeSlips progressed. I saw the creative sides of individuals come out and their ability to enjoy themselves.”

As TimeSlips creator Dr Basting says; “People with dementia are sewn into figurative straightjackets by institutions that tell them they are diseased, inappropriate, challenging, passive objects in need of care – ‘the living dead’. And somehow, a black and white picture, a marker, a flip chart, and someone asking them what they think and writing down their answers is enough to break those seams.”

As New Zealand’s ageing population burgeons and with it, the incidence of dementia and Alzheimer’s disease, the demand for trained professionals using these techniques to enhance the quality of life for the elderly will increase, says Mrs Grant.

There are currently just over 53,500 people with dementia in New Zealand – up from 40,746 in 2008, according to health statistics on Alzheimers New Zealand website. By 2050, it’s expected the numbers will tip nearly 150,000 – about 2.6 per cent of the population.

Working with dementia patients is just one aspect of speech and language therapy, however. Graduates work across a wide spectrum of disabilities including babies and children with speech and swallowing difficulties; with brain-injured people and those recovering from strokes; as well as elderly people affected by memory loss, or loss of muscle control as in Parkinson’s Disease.

Mr Matthews, who sought a new career direction after working as chef in Wellington, says he finds it rewarding seeing tangible effects and improvements in the elderly people he works with. “When you lose the power to communicate, you’ve lost an essential part of being human. I want to work as an advocate for the needs of people like John.”

Find out more about studying Speech and Language Therapy here.



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