Memory Boxes are taking hold and gaining popularity amongst trainers, therapists and care homes.
I have taken a very personal approach to researching how to put together a memory box and how it might be used. This has been a very self indulgent exercise and one which has thrown up as many questions as answers.
A memory box is a container in which memorabilia, meaningful items and representative things are put. Anecdotal evidence shows a therapeutic benefit for the elderly and people with dementia when the box is used to stimulate memories, feelings and conversation. But how do you put together a memory box? What should you put in it? I decided to make my own memory box and share that experience and what I have learnt.
(There are other types of memory boxes. Themed boxes on a subject like 'make do and mend' or 'school days' are more of a generic reminiscence aid. Some care homes are using wall mounted 'memory boxes' which are put outside each resident's room to help them locate themselves. This post is looking at very personal and unique memory boxes which are used on a 1:1 basis.)
A white cardboard box for me, it's plain and boring but does the job. What are the options? Really anything you can put your hands on. I love the idea of someone's memory box being their old picnic hamper or briefcase, but really anything will do. I would bear in mind that if it is a large container don't be tempted to fill it to the brim or you won't be able to rummage or ever feel like you have looked at everything before attention starts to wane. Much of the advice I have read elsewhere suggests using a box small enough to fit on someone's lap. I disagree as I find a box of items on the lap of someone with dementia can be overwhelming and confusing. I have found that having a box nearby, on a neighbouring table allows you to draw attention to it and present one or two items at a time.
Collecting for my memory box - what didn't make the cut
When I first thought about make my own memory box I wrote a list of things I thought would go in. My first surprise was that some of the items on that list didn't actually end up in my box. For example I love cooking and have done since I was a child. When I came to my book shelf none of my cookery books sparked any kind of emotional feelings, even books I've had for 35 years. In a similar way my art and craft supplies were also bypassed and in their place I chose a selection of stickers bought when I was a child. These remind me of going in "itty bitty shops" where I would buy stickers, erasers and pencils with my mum. This was my second lesson ; ideally the choice is an emotional and personal one. It might not be the items that signify events or interests in someone's life, but more the things with a story or specific memory attached to them that will evoke the most feeling.
It worries me that this isn't a helpful lesson for me to share. If you are putting together a memory box for someone else you may not have their emotional and personal perspective to directly draw from. However if you can recall stories that your loved one has shared with you, or things that you have repeatedly laughed or cried at these are more likely the ones that will elicit the best reminiscence rather than everyday experiences that hold little emotional draw.
How would my memory box change over time if I had dementia?
While I created my memory box I was very aware that it is a snapshot of my life as I see it and feel it now. For example new hobbies and interests don't feature as they didn't feel important enough, and people who who have passed away feature more heavily. I think because I am used to relying on physical reminders of those loved ones, such as things my late father made, they have a greater 'feeling' to them. This makes me wonder how you might need to adapt someone's memory box as their recollections change and memories are harder to reach. So my third lesson is that memory boxes should change as the memory of the person they are for also changes. If your friend or relative no longer recalls her days as a teacher then her class register might cause confusion. Instead swap it for a photo of her uncle that she now regularly refers to.
Using a sensory approach
Amongst my treasures are things to look at such as photos and letters and things to touch like my old doll and a wooden toy. I would also like to add a bottle with the scent of aviation fuel ... weird I know but having lived on military airbases for the earlier years of married life I associate the smell with a special time. I would also like a recording of my son's communication aid that he uses to talk; maybe saying "Mummy cuddle", and a copy of Don McLean's 'American Pie'. If you are interested in using music for reminiscence take a look at the late Oliver Sacs' wonderful book, Musicophilia, in which he looks at the beneficial effect music can have on people living with dementia. To address the sense of taste think it would have to be Cadbury Dairy Milk! We know that sensory approaches to working with people with dementia are very valuable and I think a memory box is no exception. Lesson four is therefore to take a multi sensory approach and include things that stimulate as many senses as possible.
What about putting valuables in your memory box?
Almost every other source of advice that I have found about memory boxes suggests that you don't put in anything of value. I can understand this if the box is to be left in a care home for all to access. If it were my memory box, however, I would be sad not to have the silver bracelet that my Mum bought for me in a posh jewellers in Kensington for my 18th, or the costume jewellery Christmas tree brooch the elderly lady next door gave me when I was 7. My solution is to have a special memory box that you can bring out at home to look at together and then put away again safely afterwards, or take it with you when you visit someone in a care home and take away again afterwards. That way you can share memories about treasured and maybe valuable items without fear of them going astray. So please don't be put off making your memory box a real treasure trove, just be mindful where it is kept.
Might a memory box cause distress to someone with dementia?
Possibly, and so my final lesson is that we must be attentive, sensitive and willing to adapt. Into my box I have put a wooden duck that my Dad made and a ruler that he used, and signed his name on (my father died when I was 7). Right now those items make me feel comfortable and happy as they are a connection with someone I lost so long ago. It is entirely possible though that if I was living with dementia and experiencing the world differently those things might be quite upsetting for me. In this case we can react straight away by removing those object from the memory box and replacing them with something else. I'd like to explore a caveat here though. I think there is a danger in trying to avoid all negative feelings when we are working with or spending time with someone with dementia. The "please don't cry", "please don't be upset" reaction. But feelings, even sad ones are valid, and need to be acknowledged, so finding a balance is my aim. A little sadness as we remember people lost to us is normal and healthy. But of course more extreme distress, anger or confusion caused by any reminiscence would be counterproductive.
I would recommend you all to explore the idea of memory boxes, if only to think about or hopefully create your own. From a professional stand point I think it is even more valuable to have a personal experience of putting a memory box together to allow you to really engage with the ideas behind what reminiscence is all about. If you are reading this as a relative or friend of someone living with dementia I hope that this has given you a different and more personal perspective to read alongside some of the other advice on memory boxes and that it will inspire you to create one and, most importantly use it!