Memories to Medicine: The Case for Reminiscence Therapy in Dementia Care
What if memories could become a form of medicine? Reminiscence therapy uses meaningful memories to support individuals with dementia, but its mixed evidence and ethical, socioeconomic, and caregiving challenges raise questions about whether it is ready to become a standard of care.
By CHLOE FUNG
A Growing Need for New Treatments
A staggering 6 million Americans currently live with dementia, a figure expected to more than double by 2050. However, despite our increasing need for adequate care development, the current pharmacological interventions for dementia generally only have modest and temporary effects. With limited medication effectiveness, focus has shifted to non-pharmacological approaches prioritizing quality of life over disease eradication. One of these alternatives is reminiscence therapy: a popular psychosocial intervention that encourages dementia patients to recall positive memories through conversation, music, photographs, or other sensory cues.
While some promising results have been found, the evidence overall is mixed, questioning the effectiveness of reminiscence therapy in a potential standardized setting. Given the rising rates of dementia and its increasing strain on the healthcare system, this raises a critical question: is reminiscence therapy ready to become a standardized practice in dementia care in the United States?
Where Reminiscence Therapy Seems To Work, and Where It Doesn’t
While short-term memory deteriorates rapidly in dementia due to damage in the hippocampus and temporal lobe area of the brain, long-term and emotionally significant memories, especially those from adolescence and early adulthood, tend to remain intact well into the disease's progression. Reminiscence therapy leverages this preservation, as it assumes that remote memory remains intact until later stages of dementia. Dementia can also cause feelings of depression and dissonance, as patients feel increasingly disconnected from both themselves and the people around them. Reminiscence therapy can reduce these negative feelings and improve self-integration by evoking feelings of pleasure, security, and belonging.
However, though personal accounts suggest positive effects, data-based research presents less conclusive results. For example, observations of a data-based study on the therapeutic role of reminiscence therapy on loneliness (a major factor of elderly dementia patients’ well-being, or lack thereof) found that its effects were inconclusive. Therefore, the strength and relevance of reminiscence therapy as an option for standardization remains debatable.
The Cost & Equity Gap
Annual dementia care expenses currently exceed $81,000 per patient and are expected to reach $92,000 by 2030. As the economic burden of dementia continues to grow, cost-effective interventions are more important than ever. Reminiscence therapy is considered a cost-effective therapeutic intervention, for it requires minimal costly resources. However, the implementation of reminiscence therapy as a standardized practice must be examined within the context of existing healthcare disparities, as access to reminiscence therapy differs across socioeconomic classes due to the disproportionate burden of dementia in minority groups.
Although more people of Caucasian descent live with Alzheimer’s disease and other related dementias than any other ethnic group in the U.S., the Latino and African American elderly are disproportionately more likely to have Alzheimer’s, with rates of Alzheimer’s being 2.5 times higher in African American men compared to Caucasian men, and Latino elderly are expected to have the largest increase in dementia cases in the coming years. Furthermore, African American patients with dementia are more likely to be undiagnosed or misdiagnosed compared to Caucasian patients, and Latinos and Asians face similarly significant challenges with delayed diagnosis and limited access to specialist care. Far more resources are needed to address racial inequities in healthcare, as dementia numbers among Caucasian individuals are predicted to double over the following four decades, while rates among African American individuals are predicted to triple.
What About Caregivers?
One of the most substantial implications of a standardized implementation of reminiscence therapy is the burden that it will have on caregivers. Caregiving includes necessities like dressing, eating, and mobility assistance, which demand an average of 62 hours per week. However, the time and effort that caregivers dedicate are almost always unpaid, given that more than 11 million Americans provide unpaid care for a relative or friend with dementia.
In addition to these financial struggles, 59% of dementia caregivers also report high to very high emotional stress of caregiving, while 38% report high to very high physical stress of caregiving. Some studies on the therapy’s effects on caregivers suggest positive outcomes, reporting that family caregivers faced a decreased burden following reminiscence therapy implementation. However, the additional time and emotional investment required to facilitate sessions could potentially increase caregiver responsibilities, particularly if standardized without adequate support resources.
Ethics of Patient Consent
The need for ethical patient consent and autonomy is unique in dementia treatment, as dementia complicates autonomy since patients gradually lose the ability to make informed decisions. Studies show that nearly all patients with mild Alzheimer’s were impaired in decision-making, and that they can make decisions about preferences related to daily care but not about complex treatment choices. As reminiscence therapy has the potential to accidentally trigger negative memories or cause distress just as it can trigger positive memories, there is a valid worry about informed ethical consent with cognitively impaired patients.
Another factor that complicates patient consent is the common instance in which the dementia patient is not aware that they even have dementia or any cognitive deficiencies, a phenomenon labeled as anosognosia. Dementia-specific anosognosia affects 10% of patients with mild dementia, and this number increases up to 80% in patients with severe dementia. Given the prevalence of anosognosia, impaired decision-making, and other cognitive limitations, prioritizing patient autonomy and consent when standardizing reminiscence therapy can be challenging. However, failure to involve patients in their care planning violates patient autonomy and undermines trust.
The Answer: More Time
Reminiscence therapy offers a rare combination of psychological grounding and cost-effectiveness. Yet, despite its potential, it is not currently ready for nationwide standardization. The scientific evidence, as well as the long-term benefits, remain inconsistent and unclear, and significant socioeconomic and unique ethical challenges must first be addressed. Any standardization effort must address how reminiscence therapy can be adapted to serve diverse populations equitably, particularly considering the projected tripling of dementia rates in African American communities compared to doubling in Caucasian communities.
Therefore, rather than rushing to standardize, a more thoughtful approach is needed, taking both diverse patient backgrounds and utmost quality in mind. With further research and infrastructure, reminiscence therapy may one day become a meaningful part of dementia care nationwide.
Sources & Further Reading
Alzheimer’s Association. “Alzheimer’s Disease Facts and Figures.” Alzheimer’s Disease and Dementia, 2024.
Aranda, María P., et al. “Impact of Dementia: Health Disparities, Population Trends, Care Interventions, and Economic Costs.” Journal of the American Geriatrics Society, 2021.
Chiang, Kai-Jo, et al. “The Effects of Reminiscence Therapy on Psychological Well-Being, Depression, and Loneliness among the Institutionalized Aged.” International Journal of Geriatric Psychiatry, 2010.
Chiong, Winston, et al. “Ethical Considerations in Dementia Diagnosis and Care.” Neurology, 2021.
Cotelli, Maria, et al. “Reminiscence Therapy in Dementia: A Review.” Maturitas, 2012.
Hegde, Soumya, and Ratnavalli Ellajosyula. “Capacity Issues and Decision-Making in Dementia.” Annals of Indian Academy of Neurology, 2016.
Hsieh, Hsiu-Fang, and Jing-Jy Wang. “Effect of Reminiscence Therapy on Depression in Older Adults: A Systematic Review.” International Journal of Nursing Studies, 2003.
Ismail, Sanda, et al. “The Content of Nostalgic Memories among People Living with Dementia.” The International Journal of Aging and Human Development, 2021.
NYU Langone Health. “United States Dementia Cases Estimated to Double by 2060.” NYU Langone News, 2025.
Olivari, Benjamin S., et al. “The Public Health Road Map to Respond to the Growing Dementia Crisis.” Innovation in Aging, 2020.
Subramaniam, Ponnusamy, and Bob Woods. “The Impact of Individual Reminiscence Therapy for People with Dementia: Systematic Review.” Expert Review of Neurotherapeutics, 2012.
Tondelli, Manuela, et al. “Anosognosia in Early- and Late-Onset Dementia and Its Association with Neuropsychiatric Symptoms.” Frontiers in Psychiatry, 2021.
Woods, Bob, et al. “Reminiscence Therapy for Dementia.” Cochrane Database of Systematic Reviews, 2018.
Zuckerman, Ilene H., et al. “Racial and Ethnic Disparities in the Treatment of Dementia among Medicare Beneficiaries.” The Journals of Gerontology: Series B, 2008.
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