Jake Broder, an actor and a playwright, met Michael, a man in his seventies with dementia, at the Bayview Hunters Point Adult Day Health Center in southeastern San Francisco about two years ago. Broder, who was a fellow at the Global Brain Health Institute (GBHI), which had commissioned his play, Unravelling, was spending a few hours every week at Bayview speaking with people who went to the center about their favorite foods from childhood through adulthood.
“Michael didn't talk much when I first got there, but as we went on, he began to tell me about his earlier life as a chef,” says Broder. “His dad had been a chef on a Pullman car and had even served a president—maybe Roosevelt? Michael wasn't sure. His father had made more than 10,000 meals and taught Michael how to cook. Michael spoke about what being a chef meant to him and how preparing food was an act of love. He started wearing his chef's whites to the day center, and everyone began calling him ‘Chef Michael.'”
Broder, whose acting credits include the TV series Silicon Valley and The Morning Show, was asked to design a project exploring an aspect of brain health by Gloria Aguirre, community engagement manager at the University of California San Francisco's Memory and Aging Center (UCSF MAC), which runs the GBHI. He first considered doing something involving music and the arts but then got inspired by Marcel Proust's famous madeleines, small butter cakes that sparked a surge of memories in the French author's most famous work, In Search of Lost Time. “He got thousands of pages off one plate of small cakes,” Broder says. “Throughout the world, stories and memories are transmitted through food. It doesn't matter the culture; Grandma's dumplings are powerful.”
With that thought, Broder proposed holding a dinner party where Bayview community members would make their favorite recipes and share stories related to the dishes. Aguirre loved the idea. For people with cognitive changes, “we need to find nonverbal ways to engage parts of the brain that may still be working,” she says. “Food is definitely one way to connect.”
Memory Boost
Many of the people at Bayview with whom Broder engaged seemed to be in cognitive decline, but while talking about food, they were able to access long-term memories—and when prompted, they'd eagerly describe favorite meals their moms or grandmothers used to make. Five or six of them contributed dishes (including hot links, gumbo, and lemon meringue pie) and stories for the dinner party, which was attended by other people who go to Bayview, family members, friends, caregivers, and employees and fellows of the GBHI.
The centerpiece of the menu was Chef Michael's signature dish—Cornish game hens marinated in Grand Marnier and lemon juice. In the kitchen that evening, Michael delivered a rousing lecture to the “waitstaff”—other GBHI fellows, who lined up in front of him and responded “Yes, Chef!” to his instructions.
To help participants talk about the recipes and the memories they triggered, Broder wrote a few key points they'd told him on a note card, which would prompt them to relate the stories. For Chef Michael, whose vision was poor, Broder stationed himself underneath the table near Michael's wheelchair. “He'd say something and then tap me on the head, and I'd whisper to him the next little prompt,” Broder says. “Then he'd go off for a while and then stop and tap me again.” But Michael didn't need any cues for his opinion of the Cornish game hens when they were about to be served: “They are so delicious, they make you want to slap somebody!”
Aguirre enjoyed seeing how animated Chef Michael was. “There was this light in his eyes as he thought about each detail of the dish and how to put together the perfect bite,” she says. “Maybe his health and ability to do a lot of these things had changed, but that Michael was still very real.”
The special dinner was very moving, says Joel Kramer, PsyD, director of neuropsychology at the UCSF MAC, who was one of the guests. “Most of the attendees weren't cooking or sharing memories, just eating and listening,” he says. “But the act of a few people sharing deep emotion and memories brought the community together.”
Dinner Party Research
Broder has gone on to organize dinner parties at additional senior facilities nationwide as part of his research on whether such an activity could improve the quality of life for people with dementia. One dinner took place in late September at the San Francisco Campus for Jewish Living, and others are planned for the Alzheimer's Disease Research Center at the University of Wisconsin in Madison (in November) and the Cedars assisted living center in Portland, ME (date to be announced). “We want to gather data to see if there is some measurable cognitive, physical, or emotional benefit of an event like this,” Broder says.
He also hopes to create a template for how to ask questions and engage with people when facilitating such a dinner. “You don't need to be a neuroscientist to get this done. Once we come up with a feasible and replicable method, we hope to share that with others who want to do this. It's ultimately a low-cost, low-risk, high-impact intervention, and it feels good. If it can help, why not do it?”
Dementia experts agree. “This is something that comes up in my practice a fair bit. Someone who has been the matriarch, who always cooked for the family, may reach a point where the family recognizes that allowing her to cook on her own isn't safe anymore, so someone else takes over,” says James Noble, MD, FAAN, associate professor of neurology at Columbia University Irving Medical Center and author of Navigating Life with Dementia, published by the American Academy of Neurology. “Family members can discuss how to help her continue cooking without causing danger. Even if she can't remember the recipe exactly, she can talk about it with you, be your sous chef, and participate in the social aspects of making the meal and being in the kitchen.”
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Mealtime can provide opportunities to connect with someone experiencing memory loss and tap into deeply rooted memories. “If you're going to make your father's favorite meal, think about how you can delve into it as an experience,” Aguirre says. Dr. Kramer notes that several senses associated with cooking and eating dishes, including smell and taste, are closely related to memory. Both the olfactory bulb, the main receiving center for smell, and the insular cortex and frontal operculum (also called the gustatory cortex), responsible for perception of taste, are closely connected to the amygdala, an area involved in emotional learning. The olfactory nerve, which conveys the sense of smell to the brain, is also close to the hippocampus, one of the most important brain structures for memory. And the combined effect of smell and taste—what neuroscientists who study this field call “flavor”—can be especially powerful at conjuring long-held memories charged with emotion, says Joel Salinas, MD, MBA, FAAN, assistant professor of neurology at NYU Langone Health and chief medical officer at Isaac Health, a clinic in New York City for brain health and memory problems.
“Cooking favorite dishes also may trigger memories like the steps you go through to make a particular recipe,” Dr. Kramer says. “These deeply ingrained, frequently rehearsed, autobiographical memories are pretty resistant to change, and they have kinetic, gustatory, olfactory, and visual associations.”
Because such memories are stored in diffuse regions of the brain, they may be more resistant to the effects of dementia. “For example, when we think of Grandma's apple pie, the neurons that store that memory aren't necessarily in a single discrete part of the brain,” says Hadley Bergstrom, PhD, associate professor of psychological science and neuroscience at Vassar College in Poughkeepsie, NY. “All the nostalgic memory related to Grandma—the taste of the pie, the smell of the pie, the kitchen where the pie was usually eaten—that is all stored in a distributed network that spans many brain regions. Those memories are quite complex and interrelated, and preparing these kinds of foods may well reactivate them when we thought they were lost.”
Emotion Factor
The experience of cooking and eating beloved foods also may trigger memories because of its inherent emotional component. “Some of the memory may be triggered by the smell and taste of the food, but what may be even more powerful is how you felt while you were eating Mom's chocolate chip cookies after school,” says Alefiya Albers, PhD, professor of psychology at Endicott College in Beverly, MA, whose research focuses on the connection between a sense of smell and brain health.
“The emotional and memory centers in the brain are anatomically close and functionally very interconnected,” says Dr. Noble. “This may be part of the reason why, as people progress through memory loss, they tend to forget about inconsequential things, but their autobiographical memories tend to remain intact longer.”
Cooking meals together and talking about memories they inspire fall into the category of “reminiscence therapy,” says Dr. Noble, who is co-founder of Arts & Minds, a nonprofit organization promoting well-being for dementia patients and their caregivers through art-centered experiences. “It's not necessarily expected to restore memory or slow decline, but it can have significant benefits both for people with dementia and for those who care for them. It's important to have time when caregivers are not consumed with the challenges that dementia imposes, even for those few hours when they're baking cookies or listening to music.”
Broder sees efforts like the dinner party as part of a much larger movement to transform care for people with dementia. “The price of living longer in our world is that our bodies are outliving our brains for the first time in human history,” he says. “There is hope, not just for halting neurodegeneration medically, but for how to live with these conditions and how people are treated.”
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