Introduction

Spaced Retrieval (SR) is a memory-training strategy that is used to

teach people with memory loss new or previously known information.
The objective of SR is to help people with cognitive impairment store
information in their long-term memory so that they can better recall im-
portant details, such as when to take medications or how to use a walker.
This objective is achieved by working with the person to practice re-
membering information until the information can be easily accessed and
retrieved when needed. SR emphasizes setting the person up for suc-
cess by beginning with short time intervals between practices and then
systematically increasing the time between each practice as the person
successfully recalls the details he or she needs to remember. The suc-
cess of SR is based on exposure to, and practice of, specific information.
It is both the exposure and the practice that increase the probability of
remembering. The best part about SR is that any care partner can use
this strategy. Care partners can be family members, speech-language
pathologists, physical therapists, occupational therapists, nurses, social
workers, and home health aides. The fact that a wide range of people can
use this multidisciplinary approach contributes to its effectiveness. This
book is meant to be accessible to all care partners—family, healthcare
professionals, and friends.

Why Is Spaced Retrieval Important?

According to global estimates, 47.5 million people are living with de-
mentia (World Health Organization [WHO], 2015). The statistics are ex-
pected to double every 20 years to 66 million by 2030 and to 115 million
by 2050 (Alzheimer’s Disease International, 2013). Dementia has been
referred to as a worldwide epidemic.
Currently, there is no cure for dementia. As researchers continue
to search for a cure and develop pharmacological treatments to lessen
the impact of dementia-related symptoms, care partners need to put
evidence-based interventions into practice now to ease the challenges
that are confronting people with memory loss conditions. Care partners
have used SR to eliminate repetitive questioning, reduce anxiety, improve
recall of important facts, and increase safety for people with memory loss
of varying causes. SR has proven effective as a behavioral treatment

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xviii    Introduction

for improved independence, safety, and quality of life by enhancing

recall of functional information to successfully complete tasks. Spaced
Retrieval has also become a leading intervention by improving cognitive-
linguistic function for individuals with memory loss. The American
Speech-Language-Hearing Association (ASHA) has recognized SR as
an evidence-based practice for people with mild to severe cognitive-
communicative impairments (ASHA, 2012). Although SR methodologies
are variable, research has found that SR can help improve the
acquisition, retention, and generalization of trained information and
skills. These improvements can be retained for up to several months
following the completion of training (Hopper et al., 2005; Hopper et al.,
2013).

How Can This Book Help?

Unfortunately, many care partners often focus on the losses and disabil-
ity related to dementia rather than on the abilities that are spared and
that can still be enhanced. Many people assume that people with mem-
ory and cognitive impairments cannot succeed in learning new or previ-
ously known information. If care partners know how to support and en-
hance memory by helping the person to remember needed information,
however, the person can experience successful outcomes rather than live
with continual challenges and frustrations that affect his or her safety
and self-esteem. By building on a person’s abilities, we can compensate
for the deficits associated with memory and cognitive loss.
The authors, as well as clinicians and numerous researchers, have
used SR successfully with many people, including those with Alzheim-
er’s disease, Parkinson’s disease, traumatic brain injury, aphasia, and
other conditions that cause memory loss. We are excited to bring this
life-changing strategy to you. Our hope is that this book will allow you to
implement SR successfully as a care partner and that this intervention
will enhance the memory, well-being, safety, and independence of those
in your care who are living with memory loss.

About the Book

Several features in this book are designed to assist the reader. At the
end of this Introduction is a useful Glossary of Terms. Throughout the
book, icons are used to call attention to topic categories so the reader can
quickly locate examples of how to implement the strategy for a specific
 Introduction    xix

need. The topic categories are defined in an Icon Key that follows the
Glossary of Terms. Preceding Chapter 1 is an engaging timeline of the
published research on SR. Helpful case studies are interwoven through-
out the book to demonstrate real-world examples of SR in action and
provide the reader with a practical model to follow. Finally, Chapters 2
and 3 include sample forms that are discussed in the text. The forms are
suitable for copying for ease of use and are also available for download as
PDF files by logging on to www.healthpropress.com/benigas-downloads
(use password [case sensitive]: SjnE3Nxq).
Readers of this book will find step-by-step guidance on how to use
SR procedures to increase safety, support independence, and enhance
cognitive-linguistic function for any person who struggles to remember.
Chapter 1 discusses the theoretical foundation of memory and why SR
works. In Chapter 2, we provide practical approaches for care partners
with an emphasis on helping them to put SR into practice. The reader
will learn how to identify the person’s needs and desires, create the SR
format of lead question and response that will support and address the
person’s needs, implement the protocol for SR practice, and make modi-
fications to increase success. Chapter 3 introduces tools to support SR
practice, including physical supports, such as continuous visual cues
and external memory aids, as well as social and environmental supports.
Chapter 4 presents practical case examples that illustrate how to imple-
ment and personalize SR for a variety of individuals. Finally, Chapter 5
provides a chronological summary of many published studies related to
SR. This comprehensive outline of research illustrates the breadth and
depth of the evidence in support of the SR strategy.