The Use of Clinical Hypnosis to Improve the Quality of Life of People Living with Dementia
by Dr. Daniel Nightingale (Dementia Therapy Specialists)
It was while I was training in Hypno-Psychotherapy that I had this idea; an idea that the majority of the professional dementia community scoffed at. Oh yes, they thought he was well and truly on the way to Crazyville!
The idea? That hypnosis might just be an effective way of helping people to live more positively with the everyday challenges brought about by dementia.
Now, when people get to know me, they soon learn that I never accept a negative attitude. Oh no, to me this is something to be taken, dismantled and rebuilt into a positive. So this is what I decided to do.
Would this be controversial? Yes, highly probable. Would I be pushing the boundaries? That was certainly my aim. Would it work? Well, there was only one way to find out.
I teamed up with my best friend Dr Simon Duff, a Chartered Psychologist. At the time he was based at the University of Liverpool. The deal was that as a clinician I would do the clinical work and as an academic my collaborator would take charge of that side of the project.
Almost 4 years later, we have had three publications about our work in the European Journal of Clinical Hypnosis and Alzheimer’s Care Quarterly in Chicago (see reference section) Not bad then for an idea that nobody would even discuss, let alone support.
Since then, I often use clinical Hypno-psychotherapy in my practice and teach others to do so.
So, what happened and what were the benefits of hypnotherapy for individuals living with dementia?
Firstly, I managed to persuade Duff that working with me would serve to further develop both his career and himself as an individual! His cursory glance at that comment indicated that he didn’t believe his esteemed colleague – can’t understand why!
Anyway, Duff agreed and we proceeded to move forward with the project that was backed, both financially and with resource support, by John Murphy, who was the Chief Executive of Highfield Care, a UK based care home operator with 199 care facilities in England, Scotland, Northern Ireland and Wales. I was later to be appointed as their Dementia Consultant
We decided to concentrate on measuring the outcomes of 7 key areas that were implicated in enjoying a good quality of life while living in a residential or nursing facility. Each participant received a weekly hypnosis session lasting between 45 – 60 minutes. Our hope was that these areas would be improved in some way after therapy. We didn’t know for how long, nor did we know to what degree we would see improvement, if at all. The areas we monitored were:
- Activities of Daily Living
- Immediate memory
- Memory for significant life events
Acceptance onto the program required participants to be able to give consent to taking part in the project and prior to each weekly session. The ability to give consent was determined as per the Mental Capacity Act; the ability to comprehend the aims of the project; a baseline score of 4 –5 on the Global Deterioration Scale (GDS) equating to moderate or moderately severe cognitive decline; the absence of any medical conditions that would preclude the individual from receiving hypnosis and the absence of any medication that would contra-indicate hypnotherapy.
Each individual’s family doctor was notified and asked whether they were aware of any medical grounds as to why that person may not have been suitable to participate – no negative responses were received and only one wrote that he was not qualified to make that decision and referred it back to myself to make the final decision. Each individual was screened with the above acceptance criteria in mind.
As a small study, only six people were selected to receive active hypnotherapy. To ensure we were able to measure outcomes appropriately, we also assigned 6 people to a discussion group and 6 people to a treatment as usual group.
The hypnosis group consisted of four males and two females with a mean age of 77.2 years. Four people had a diagnosis of vascular dementia, one of Parkinson’s disease and related dementia and one of ‘dementia’. Prior to the first hypnosis session, each participant received one-hour consultation and interview to customize the terminology used during the hypnosis sessions. This ensured that the language used was familiar and personalized for each participant and to ensure comprehension of suggestions that were to be used.
Participants were also introduced to the process of progressive muscle relaxation (PMR) to ensure they were able to engage with this process. PMR relates to a gradual process of relaxation from the top of the head, through the body and down to the feet.
The procedure involved obtaining consent for hypnosis before each session, followed by induction via PMR. The therapeutic stage allowed participants to listen to suggestions made through the use of direct suggestions, relating to the 7 key areas, along with additional CRC suggestions (Calmness, Relaxation and Confidence). Hypnosis sessions initially lasted approximately one hour.
Long term benefits of hypnotherapy for the participants have been measured and documented and I continue to provide this form of therapy to people living in the residential and nursing facility.
Our work demonstrates that hypnotherapy for some people living with dementia may be a valuable form of therapy in enhancing their quality of life. The therapist must be trained in this particular technique as it does require a vast amount of knowledge about dementia and great skill and technique in hypnotic procedures for this particular client group.
So, what is happening? How can we explain these phenomena? The authors have forwarded the following hypothesis. Perhaps, through hypnotically induced relaxation people had more cognitive resources available for engaging in the activities that contribute to the measures of psycho-social quality of life considered in this study?
Duff, SC & Nightingale, DJ (2005). The efficacy of hypnosis in changing the quality of life in patients with dementia. A pilot study evaluation. European Journal of Clinical Hypnosis, 6 (2), 20-29
Duff, SC & Nightingale, DJ (2006). Long term outcomes in hypnosis in changing the quality of life of patients with dementia. European Journal of Clinical Hypnosis, 7 (1), 2-8
Duff, SC & Nightingale, DJ (2007). Alternative approaches to supporting individuals with dementia: Enhancing Quality of Life through hypnosis. Alzheimer’s Care Today.