Here is what the stories say: "She is riding an ostrich and singing to herself. 'Imagination is funny. It makes a rainy day sunny.'" "He's going to the land of ice cream and cookies…to the land of peppermint airplanes." "Their eyes are laughing, saying listen to me!" Based on pictures presented to them, three different groups of people with dementia created these parts of three stories.
These stories are the result of an innovative, creative storytelling project called TimeSlips, an inexpensive and effective group storytelling method that "helps people with dementia reaffirm their humanity and connect with staff, family and friends." Instead of pressuring people with dementia to remember, TimeSlips encourages them to use their imaginations, to creatively express themselves through storytelling.
I learned about TimeSlips at a networking breakfast sponsored by the Maryland Gerontological Association in partnership with Easter Seals. The presenter, Liz Nichols, has taught this innovative method to hundreds of dementia care professionals and volunteers. She is also a professional storyteller, museum educator and certified Laughter Yoga leader with wide experience in the field of creative aging.
A story usually has a beginning, middle and end but the TimeSlips approach to storytelling turns some of the typical rules on end. You have to let go of the idea of beginning, middle and end. The results are beautiful, rich language, almost like poetry.
"Stories are pieces of people," Nichols said.
During the networking information session, a video was shown of a group of people with dementia actually creating a story from a picture. It was amazing, heartwarming and inspiring to see the courage and energy of the people participating. The storytelling facilitators greeted each person individually. After the picture was shown, members of the group threw out whatever came to mind and a helper wrote down what they said.
I could see a difference in the participants once they started the storytelling. I saw them come alive. They were enjoying the storytelling, laughing, smiling and commenting to each other. The picture they were creating the story about was of a small Alaskan child. One of the member's of the group came up with the child eating sweet and sour squirrel; another said it was delivered by Meals on Wheels; another person created a whole recipe for the squirrel dish, topped with tomato sauce.
Then one of the men in the group said, "I can smell that, it really stinks." Everyone laughed. At the end of the hour session, their story was read back to them and they all applauded; and everyone was thanked for participating. The man, Roger, who made the comment about the squirrel dish, had stopped talking before he joined the TimeSlips storytelling group. Roger was asked what he thought of the storytelling and he described it as heartwarming.
"Roger is the star of the video," Nichols said.
The key to this storytelling method is the validation the facilitators give to everything the people with dementia say. They gain the trust of the participants and encourage them to share the gifts of their imaginations. There are two parts to the process, creating the story and sharing the story, all the while developing social interaction among the group of people with dementia. These people are often cut off from themselves and from each other. Storytelling brings them together and provides a means of communication for them.
Notice that I have not used the term 'patients' with dementia. This is a person-centered care project and the participants are treated as individuals, not patients. It is something that you do with the participant not for them, recognizing and honoring the person with dementia. One of the project's goals is "to inspire others to see beyond the loss and to recognize the strengths of people with dementia."
Based at theUniversity of Wisconsin-Milwaukee's Center on Age and Community, the TimeSlips Project, developed by Dr. Anne Basting in 1998, "has generated hundreds of stories, produced plays and art exhibits and rekindled the hope for human connection among people struggling with Alzheimer's disease and related dementia." Originally designed for people with dementia and their care partners to share in creative expression together, it can also be fun for anyone. TimeSlips™ is the winner of a MindAlert Award for innovation in cognitive health.
Basting had been working with people with dementia for years using acting games for the memory. She wasn't getting anywhere, and one day out of frustration she tore a picture of the Marlboro man out of a magazine and told the group that they were going to make up as story. It worked. She did it over and over again for twelve weeks and it worked each time. That's how TimeSlips got started.
There is solid research on TimeSlips that suggests this kind of creative process has significant impact on the lives of people with dementia through increased self-esteem and social engagement as well as decreased doctor visits.
Another study shows that TimeSlips improves the quality and quantity of engagement between staff and residents on dementia units. It also improved the attitude of the staff toward people with dementia. In another study, medical students, who participated in TimeSlips with persons affected by dementia, improved their attitudes toward this patient population.
Here are some comments from people that eloquently summarize the value of the storytelling process to people with dementia and their caregivers.
"I have seen how profound an effect TimeSlips can have on individuals with a wide range of memory abilities – from somewhat intact to rather poor. Their ability to have fun and make meaningful contributions to the group's story was inspiring to see," Dr. Judah Ronch said. "It made me re-think (again) how much more people can do when we engage their strengths."
Lisa Gwyther, MSW, added: "TimeSlips gives participants the chance to shed the present, to focus on the story, and join fellow travelers in a journey through time, place and person,"
Jolene Hansen, a volunteer at Luther Manor Adult Day Center, in Milwaukee, said "TimeSlips stories are creative outlets – chances to imagine and build stories. But even more, they are chances to laugh, share, and remember."
A self-paced TimeSlips™ facilitator training is available online, if you are interested. Register at http://www.timeslips.org. You will learn the basics of person-centered care and watch the storytelling process in detail. You can also become a TimeSlips certified facilitator by working one-on-one with a trainer to become proficient. You can then facilitate the TimeSlips method in your community one-on-one or in a group setting.
If you work at a facility, such as a nursing home, adult day care or even a senior center, the organization can be certified by training staff in the TimeSlips method and subsequently make the method part of its programming. Using this method should increase the quality and quantity of interaction between staff and residents.
Just as creative engagement is a plus for people with dementia, creativity in general plays a role in healthy aging and quality of life. Improvisational storytelling can provide an opportunity to let your imagination soar. It gives you permission to play. There are no wrong answers and you can say what you want. Get a picture and try it, with another person or with a group. You will have fun.