Sunday, December 4, 2011

Creating a Memory Book for Nadine

Back to my blog home page:

There are many small things therapists and family members can do to enhance the quality of life of people with dementia. One of them is to create a memory book.

I have just completed treatment with Nadine. Remember her? She was the one with severe dementia who used to yell, "What do I do? What do I do?"

I made headway with her when I realized she could read. She started reading all kinds of poetry, moved to newspapers and magazines.

The Idea
I decided when her daughters came in to see her that we needed to create a memory book that she could read. The "girls" were pleasantly surprised when they realized she still had this capability.

"If you bring me photos, I can have them scanned and we can write a simple history on each page with a picture," I told them.

The following week, they arrived with an envelope of photographs. I picked up a black and white, and found myself staring at a 14 year old Nadine. Beautiful, young lady with a confident smile!

The next was a savvy, in-love Nadine with her husband-to-be during WWII. He was a pilot, dressed in uniform. She had a snazzy 1940's updo that rocked! That gal had style!

I pulled out a photo of an elderly Nadine with her adult daughters before the twinkle in her eyes had dulled. I could see in the photograph that she was still "with it."

Lastly, a photo of her hanging her large acrylic canvases on the walls of an art gallery in northern California. She was an amazing artist! The sad thing was that she couldn't remember how awesome she had been.

One of the employees at the facility told me that it was suspected that her dementia was in part caused by lead. When she painted, she touched the brush on her tongue to wet the bristles. A lifetime of exposure to bits of lead paint had a devastating result.

The Book
I picked up a 1" binder with a pastic insert on the cover. Inside, I slid a thick paper titled "Nadine's Memory Book." Below the title was a lovely color representation of one of her paintings that I had printed from the internet.

I created a simple history for her,
something in large print that she could easily read.

Page One (photo of her youth)
 "My name is Nadine (maiden name) (married name). I was born to (names of parents) in (birthplace) on (date).  

Page Two (photo of Nadine in love)
"I married (husband's name). I called him (nickname). He was a (vocation).
We loved to (activities they had enjoyed together).

Page Three (photo with daughters)
"(Husband's nickname) and I had (# of children).
(Child) was born in (year).
(Child) was born in (year).

Page Four (hanging her paintings)
On this page, I went into simple detail about the activities that she loved. I had interviewed her daughter and found out fun details about classes she had taken, trips she had taken and lifelong friends with whom she had spent special times.

After that, I printed off her website, with a description of her life and works. I found the last article written in the local paper about her posse of artist friends who banded together and created an art presence in the town.

I slipped all these pages into plastic sleeves after having them scanned by the building receptionist.

The Presentation

I handed Nadine the book. She rubbed her hand over the cover and read the title.
"Nadine's Memory Book," she read.

She paused, then looked up.

"That's me!"

She proceeded to read page by page to the end, not realizing the story was about her except for page one, when she read her name. It was if it could have been anyone else in the world.

....and that was okay because she was fully engaged in her process!

She has continued to hold her book throughout each day, rubbing her hands over the photos and reading to staff at the nurses' station. The nurses report that her yelling behaviors have diminished substantially. This equates to an improvement in the quality of her life, and in the lives of each resident living on her side of the building!

One day, she was reading the internet article that I had printed off about her group of artist friends. She came across the name of the man who had nicknamed the group.

Just as she read his name, "Ollie," she stopped and looked up at me with big eyes and a huge smile. My heart jumped.

"Do you like Ollie?"

"Oh, yes!"

That was it! My day was made....such a simple thing can make a marked difference in the life of a person with severe cognitive impairment.

I'll write more this week on creating a memory book and tailoring once-loved activities toward a person's current cognitive functioning. For therapists, I'll review some of the cognitive assessments I find helpful in determining current cognitive levels in residents with dementia.

Check back soon!


  1. I am a new OT and I just stumbled onto your blog today. I love it! - I have read most of it in one sitting. haha Thank you for sharing! I've tampered with the idea of doing my own OT blog because they are so scarce concerning working with the older population.

    As a new grad, I have to ask you, how do you write goals to enable you to do memory books during treatments so that medicare covers it? I'm so confused about what they cover and don't cover.

    1. Hey, there, thank you for reading! In this particular case, this memory book was to reduce the resident's yelling behaviors at the nurses' station. The memory book was the vehicle to reduce the yelling, but the goal would look something like this: "Resident will utilize individualized memory book to reduce yelling behaviors by 50% in 2 weeks." There are so many ideas for particular situations that it would be best to contact me at and we can set up a time to talk when you need help. Best, Tre (sounds like "tree")

    2. thank you SO very much! I just finished a course on providing effective treatment to those with dementia and I'm excited to implement what I've seen here on your page and in the course. Thank you for being so open to questions and teaching! I love to learn new things and share ideas.