The need for non-drug therapies in dementia

Harvard Health says that after failure after failure for a pharmaceutical solution to dementia, it’s time for more attention on ‘non-drug therapies’ to help slow its progression. Encouragingly, many of these therapies are already being used. Our ‘Brain and Soul Boosting’ sessions are a good example. They are improving cognition, reducing anxiety and increasing self-worth. And ‘Japanese Memory Groups,’ led by Dr Jennifer Bute and based on the three ‘R’s principles of Japanese Neuroscientist Professor Kawashima of Tohuku University, Japan. Residents in our care homes have a range of regular activities and sessions. What is actually meant by ‘non-drug therapies’ – and by the word ‘therapy’ itself?

In what seems eons ago, (May 2010) the Government published its first Dementia Strategy Statement. It was called, ‘Living well with dementia—development of the national dementia strategy for England’, lead author Professor Sube Banerjee. It read well, yet I found no mention of ‘treatment’ for the disease. I was about to write an article and needed that information, so I telephoned to ask where it was. There was no new pharmacological breakthrough: ‘The care the person receives is the treatment’, he said. And in the intervening years I’ve found that to be so true.

Good, compassionate care produces a state of contentment in a person living with dementia. It’s the premise of Oliver James’ book, ‘Contented Dementia’. Good care is about relationship. (In counselling the term is ‘therapeutic relationship’.) Whatever techniques are used to stimulate cognition, if the relationship is not good the person’s uptake will be poor. In our care homes our ‘hummingbirds’ help keep our residents with dementia content, with warm, frequent interactions.

Once the person is contented, what are the appropriate techniques that can help? Some researchers took a group of 32 people with mild cognitive impairment (MCI) and found they improved their memories by simply thinking about the following question when learning new information: ‘What is one unique characteristic of this item or personal experience that differentiates it from others?’ Another study found that 19 people with MCI improved their ability to remember items at a virtual supermarket by simply thinking systematically about whether the items were already in their cupboard. For people without MCI, but who forget their shopping lists (and who doesn’t?) it helps to visualise your cupboards and see the missing items. It means taking a virtual snapshot of what’s in them – a good exercise in itself.

The best non-drug therapy then, is compassion. Compassion that leads you to understanding the person with dementia as thoroughly as you can, understanding their life experiences and patterns of behaviour.