Imagination in the world of dementia


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One group that I’ve been working with lately has been a group of people with Mild Cognitive Impairment. While there are definitely people in the group who have do dementia, MCI is considered to be its own diagnosis. MCI is sometimes pre-dementia and sometimes it’s just a marked cognitive decline below the norm.

Something that I’ve been doing a lot with this group is an imagination exercise, and I’m confident that it could be used for people in the early stages of dementia, as well as those with MCI. Your imagination doesn’t rely on your short-term memory, rather, it relies on your ability to make connections and recall past experiences and information. These are two things that people with dementia often do very well.

I sat at the circular table with my group, guiding them all through this imagination exercise. “Let’s talk about this desk we see in the middle of an abandoned office space,” I suggested. 

“Greg, what does this desk look like?” I asked.

Greg thought for a moment, and for just a second I was worried he would be confused and unable to come up with something.

“Well,” he said, suddenly, a smile crossing his face. “It’s a roll-top desk, you know, but the roll-top part gets stuck a lot.”

“One of the drawers in the desk also gets stuck a lot, and you have to pry it open with a crowbar that you keep under the desk,” Marie added with enthusiasm. 

“Matt, what is in the drawer that always gets stuck?” I asked.

Matt didn’t miss a beat. “A flask,” he said. “It’s a flask full of Old Granddad.” 

We have done numerous exercises that rely on imagination, and I can honestly say that these go better than other things that I’ve tried. 

I’m always blown away by the amount of detail and information that my group delivers. They also often deliver it in a coy, funny way. Everyone does just what I hoped they’d do: they talk about what “they see” as if it’s right in front of them. 

Their ability to create a world and then “play” in that world is a testament to how intelligent, creative, and interesting my group is. Giving them a chance to use their imaginations just lets them exercise the skills that they already have.

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Rachael Wonderlin is an internationally-recognized dementia care expert and consultant. She has a Master’s in Gerontology and is the author of three published books with Johns Hopkins University Press. Rachael owns Dementia By Day, a dementia care consulting and education company.

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