What is the experiential self?
One of the most important things for us to understand as dementia caregivers is the difference between the remembering self and the experiential self. For some reason, it’s easier for us to grasp having a remembering self and harder for us to imagine the experiential self – that part of us that continues on despite dementia.
However, when someone is experiencing dementia, although they are losing memories and the ability to remember, they are not losing awareness of the present or the ability to experience what takes place in the present.
The remembering self.
I think of my remembering self as the part of me that has memory skills, such as the ability to use recall to search for and retrieve things that I’ve experienced in the past. It is also the part of me that feels nostalgia and familiarity and likes to reminisce with loved ones about the good times that we’ve enjoyed together. I have other memories that are not as fun to recall, but those are a part of my remembering self as well. My remembering self is the sum of my memory skills, all my experiences and memories from the past, and the good and bad feelings I have about them.
For people with healthy brains, the remembering self is alive and well – as is the experiential self.
Our experiential selves are the part of us that exists in the present and takes in the diverse information our senses are providing. I may jump at a loud sound, feel a surge of pleasure when a song I love comes on the radio, realize I am feeling hunger pangs, feel a sneeze coming on – myriad stimuli may be occurring in the present and I will experience them.
With a healthy brain, if I were to jump at a loud noise, I could use memory or rational thought to identify or interpret the reason for the noise. I could recall the sound of a whistling kettle or door slamming and not feel alarmed. With a healthy brain, I could also choose to tune out the present and the sensory data coming at me there and focus on a memory instead or on something I anticipate happening in the future.
For someone experiencing dementia and losing memory and rational thought, it’s not as easy to escape the present. Their remembering selves with their memories and memory skills are fading. Their rational thought skills are failing, making them increasingly unable to interpret the sensory data their experiential selves are delivering moment by moment.
But the data keeps coming in. That’s why it’s so important that we, as their caregivers, understand what the experiential self continues to do. The experiential elf continues on, in the present, experiencing.
Living with the experiential self alone.
Although our loved ones and clients are not able to recall, interpret or express ideas regarding their experiences, they are still having experiences. Their experiences are causing them pain and relief, happiness and sadness, fear and anger, just like ours are causing us. They, however, are less able to choose to leave the present for a happier memory or hopeful future.
When someone is experiencing dementia, we need to be careful that we treat them respectfully and kindly at all times. They will become unable to describe how they feel, but they are not unable to feel.
When you must move someone who has dementia (Part 2)
In my last blog I wrote about the value of being able to use automatic thinking, and how it rarely survives a move into a new living situation. Now let’s consider the mindlessness tool muscle memory.
The value of muscle memory
When you wake up in the night, do you think consciously of which way to turn when you head for the bathroom? Have you ever moved to a new home and then months later found yourself driving toward your old address deep in thought, or reaching for a mug in the direction it would have been in your previous home? That happened because you were not being mindful – not thinking consciously – and muscle memory took over.
Although it’s not a terribly helpful tool for those of us with healthy brains, muscle memory can be very useful when someone is experiencing dementia. People who are living in a home of many years do numerous tasks and activities using muscle memory. When they develop dementia, muscle memories can enable them to continue to function effectively for quite some time. Here are a few tips for preserving the benefit.
Don’t rearrange things in the current home
When someone has dementia and is unable to use memory or rational thought to learn new patterns, avoid rearranging the furniture or contents of cupboards and drawers.
One of our clients was living in a home she and her husband had bought decades earlier. Her daughters lived in the Midwest but wanted their mother to remain in her own home as long as possible. Thinking it would help, the two of them arranged an extended visit and set about making her home safer and easier to live in. They rearranged the bedroom furniture so her side of the bed was closer to the bathroom. They rearranged the kitchen cupboards and cleaned out the closets and spare rooms so there was less clutter and everything she needed was in reach.
However, after they left, their mother was lost. Her home no longer looked or felt familiar to her. She no longer had automatic thinking scripts or muscle memory to guide her to the bathroom in the night or through her daily tasks. Although her daughters intended to be helpful and kind when they cleaned up and reorganized her home, the result was detrimental. It’s always best to try to keep the home and living space unchanged when someone has dementia.
Recreate the old home in the new home
When a move is necessary, try to create spaces and views within the new home that match the previous one. Take photos of dresser tops, counters, picture arrangements, and china cabinets so you can recreate surfaces and entire walls of rooms so they look exactly the same. Arrange furniture so getting out of bed and heading for the bathroom requires going around the bed or around the corner in the same direction. Orient the living room so the front door or exit is in the same direction from the couch.
When we recognize the value of the mindlessness tools automatic thinking and muscle memory, we can enhance our loved ones’ functioning even when a move is necessary. Next week, let’s think about other ways to make transitions and moves easier for people experiencing dementia.
Boost your memory by eating right
How diet can help—or harm—your cognitive fitness.
Before you cut into a big T-bone steak with French fries, here is some food for thought: Research suggests that what we eat might have an impact on our ability to remember and our likelihood of developing dementia as we age.
Take that steak you’re about to slice into, for example. It’s loaded with saturated fat, which is known to raise blood levels of unhealthy low-density lipoprotein (LDL) cholesterol. Other kinds of fats, such as trans fats, do the same thing to LDL.
LDL cholesterol builds up in, and damages, arteries. “We know that’s bad for your heart. There is now a lot of evidence that it’s also bad for your brain,” says Dr. Francine Grodstein, associate professor of medicine at Harvard Medical School and associate epidemiologist at Brigham and Women’s Hospital… ➡ Read the entire article at Harvard Health Publications