Making the Most of Fading Memory

Remembering past events is crucial for maintaining a sense of self and the relationships with the people around us. But what happens when memories begin to fade?  

In collaboration with aged care providers, Associate Professor Celia Harris from the MARCS Institute for Brain, Behaviour and Development at Western Sydney University is using her expertise about the mechanisms behind autobiographical memory — the memory for life events — to develop actionable recommendations and training modules for aged care professionals. 

"With memory, it’s easy to dwell on what’s lost, but we can also focus meaningfully on what remains of an individual’s identity," says Harris. She points out that memories from one’s youth and early adulthood, both significant periods that shape identity, tend to persist. "Many can still tap into these memories to derive meaning and self-understanding. Even if their sense of self shifts to an earlier chapter in life, we can still validate and support that."

Throughout her career, Harris has researched how we bring memories to mind, in particular how clues in the external environment can help improve access to memory. In previous work with aged couples, she found that they remember better when they are together, as they carry on conversations in ways that offer each other strong memory cues.  

For example, in an experiment in which couples were asked to list names of mutual friends, one spouse remembered the given name, while the other spouse remembered the family name. "We wanted to see if we could bring the idea of creating a memory-boosting environment through conversation into aged care, in particular the specific ways in which couples were giving cues, prompting, and acknowledging each other’s expertise," she says.  

Harris partnered with aged care providers to conduct workshops for care staff, training them on conversation techniques that led to memory sharing. For care workers who do not share memories of past life events in the way that couples do, a crucial technique was to ask open-ended questions starting with 'who, what, when, where, why, and how'.  

"It’s surprisingly challenging to do, since staff had to transition from asking how their day was, to ask something that would make them think deeper into the past," Harris says. "It can feel awkward at first, but then you build a repertoire of shared information, and it gets easier as you ask more questions."

Care staff were encouraged to think of when they could be having meaningful conversations. "Care workers have a busy and challenging job. I wanted them to think of it not as an extra task, but something they could embed in all their interactions however brief — for instance, while waiting for the shower to heat up, or as they applied moisturiser for a resident," says Harris. 

In practice, staff found the new memory-focused interactions not only enjoyable, but also beneficial. They reported that routine care tasks such as taking someone to the bathroom or shower became easier, since engaging residents in reflective conversations made them more relaxed.  

They were also able to establish a better relationship with those they were caring for. One caregiver recounted her experience with a resident who she always perceived to be in a bad mood; a simple question about a photograph of his wife prompted him to happily recount stories that he had never offered before. "These prompts helped care workers see residents in a new light through hearing their stories, and asking meaningful questions that helped them go from a stranger to creating a relationship," says Harris.  

She is now working to make the intervention applicable in more contexts. "We plan to look into people who are the most likely to be excluded from programmes in aged care — like those with significant cognitive impairment who struggle to communicate verbally."