Reminiscence App Could Reduce Grief, Improve Relationships | USC Gerontology
Source: https://gero.usc.edu/2026/04/22/digital-reminiscence-dementia-caregivers
Archived: 2026-04-23 17:13
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Digital Reminiscence App Could Reduce Grief and Improve Relationships Between Dementia Patients and Caregivers
“Living Memory Home for Dementia Care Pairs” web tool helps people with mild to moderate dementia share memories and journal with their caregivers. Clinical trial results show reduced feelings of pre-death grief as well as the potential for improvements in relationship quality.
By Beth Newcomb
|
April 22, 2026 |
Print
A web tool designed to spark reminiscence could help people with dementia and their caregivers feel more connected to each other and less impacted by feelings of pre-death grief, according to a
clinical trial co-led by USC and Weill Cornell Medicine
that was published in JAMA Network Open.
With features such as photo albums, autobiographical questions, and journaling prompts, the Living Memory Home for Dementia Care Pairs (LMH-4-DCP) website is a customizable virtual space that facilitates collaborative and interactive reminiscence therapy for both dementia patients and caregivers, said lead author
Francesca Falzarano
, assistant professor at the USC Leonard Davis School of Gerontology.
Reminiscence therapy for dementia includes guided conversations about past experiences and can involve music, art, familiar objects, or other sensory items. The goal is to lessen anxiety and promote well-being and connection, Falzarano explained.
“The idea is that getting them talking about those memories will promote the relationship between the person with dementia and the caregiver, which can improve numerous outcomes. If the caregiver has a better relationship with the person with dementia, they are more likely to keep them at home, and they’re less likely to transition into long-term care,” she said. “We also want to nurture the personhood and dignity of the person with dementia, document their memories while we still can, and alleviate pre-death grief.”
Pre-death grief, which includes both current and anticipated losses prior to a loved one’s death, is a common phenomenon for patients and families affected by dementia, Falzarano said.
“Even while the person with dementia is still alive, that relationship that once existed – whether it was a husband and wife, or mother and daughter – it can be transformed overnight,” she said. “For caregivers, everything that you knew about the person could be gone; you lose that existing relationship and support. Patients who are aware of their diagnosis can be grieving the loss of independence, skills, and memories. You lose a future you might have planned, and then you also are anticipating all of the losses that are going to unfold because of the disease.”
Promising early results
Trial participants included 34 pairs consisting of people with mild to moderate dementia and their caregivers, or caregiving dyads. Dyads were randomly assigned to either the full LMH-4-DCP app, complete with reminiscence therapy activities, or to a limited version of the app without access to reminiscence features. Each dyad used their assigned version of the app at least two times per week for two weeks and completed baseline and post-intervention surveys regarding usability of the app as well as on feelings of grief and relationship quality.
Study results not only indicated that the LMH-4-DCP app was feasible and acceptable for caregiving dyads to use; it also showed that using the full version of the app was associated with significant reductions in feelings of pre-death grief. In addition, there were minor increases in relationship quality after the two-week period for the users with access to reminiscence features versus those without access. While not quite reaching statistical significance in this small trial, the trend toward significance may indicate that a larger study sample or a longer period of usage may provide more improvement and shows the need for further study, Falzarano said.
“I feel like we got a lot closer”
Beyond the encouraging survey scores, caregivers shared their positive experiences with LMH-4-DCP in feedback to investigators. An open-ended question asked respondents about what they noticed regarding memory recall, interpersonal engagement, and relational closeness while using the app with their loved one.
“It was an awakening of the memories my mom had never spoken about before, and I enjoyed learning about her.”
“Surprised how much [care recipient] engaged with LMH-4-DCP. It brought a light to him seeing photos of himself on the application and being able to retell stories of his past.”
“It was very nice hearing my mom talk about things she has never told me, I feel like we got a lot closer. … I also was able to find resources and outlets to help her so I was not feeling all of the stress of not doing enough! I enjoyed all of the resources and being able to talk on a deeper level with my mom!”
“I appreciated the prompts for engaging my dad in conversation and learned things I had not known before.”
When participants were asked whether they would continue to use the app after the study:
“Yes, I would because my mom does not interact a ton with me, but this was the first time she really showed a lot of emotions!”
“Yes – it opened a different memory building connection and bonded us closer.”
“Yes, I would like to; it will be nice to have these memories when [care recipient’s] condition becomes worse so we can reminisce.”
LMH-4-DCP Home Page
The Living Memory Home for Dementia Care Pairs (LMH-4-DCP) is a customizable virtual space that facilitates collaborative and interactive reminiscence therapy for both dementia patients and caregivers.
Writing Room
Reminiscence and Writing Rooms guide participants in reminiscence therapy activities, including autobiographical journaling, photo uploads, and conversation prompts.
Journaling
The app includes prompts for collaborative journaling for both the individual with dementia and their caregiver.
Memory Lane
Participants can upload their own photos and captions based on reminiscence prompts.
Reading Room
Participants can find resources, tips and other information in the app's virtual Reading Room.
The power of sharing memories
LMH-4-DCP is modeled after the original Living Memory Home (LMH) web app, a digital bereavement platform for individuals grieving the death of a loved one developed by collaborators at Weill Cornell, including Holly Prigerson, co-director of the
Center for Research on End-of-Life Care
and senior author of the current study. Previously, LMH showed that its reflective journaling prompts and other bereavement activities reduced prolonged feelings of grief.
“People may not be aware of how severely distressing and disabling grief is,” Prigerson said. Pre-death grief is remarkably similar to post-death grief, which has been more extensively studied for its role in Prolonged Grief Disorder. Unlike natural grief that diminishes over time, Prolonged Grief Disorder involves pervasive and profound distress, hopelessness and impaired daily functioning, she explained.
“We have found grief to be the strongest predictor of suicidal thoughts and behaviors; it is also linked to serious medical outcomes such as heart attacks and cancer,” Prigerson added. “Detecting and addressing grief will help reduce these related risks.”
The similarities between bereavement and reminiscence therapy activities inspired the researchers to adapt the web tool for use with caregiver dyads, Falzarano explained.
“In the original Living Memory Home website, recently bereaved individuals would journal and do different activities to honor, reflect and reminisce on the deceased. This had really positive effects on bereavement adjustment; the severity of their post-death grief was significantly reduced,” Falzarano said. “A lot of the terms they were using were very bereavement-focused, but the concepts were exactly the same as in reminiscence therapy. Reminiscence therapy is widely used for people with dementia in general and can trigger memory recall, but there hasn’t been a ton of rigorous research into the effectiveness of it.”
Looking to the future, Falzarano aims to take advantage of the LMH-4-DCP’s scalability and conduct larger and more in-depth clinical trials. She also wants to develop new tools that can provide a more comprehensive and inclusive picture of how the app can help everyone involved.
“The next step is not only testing the efficacy of this reminiscence therapy tool with a very large, nationally representative sample, but also the inclusion of the person with dementia. I hope this establishes a line of research that we should be targeting both the caregiver and the care recipient, and that includes measurement,” she said. “We can’t just give the same questionnaire that we give to a caregiver to a person with dementia. What are the best ways to develop effective measures for people with dementia so we can know whether this is something that can help alleviate some of the stress or grief that they’re experiencing? To have a tool to assess that – and then an intervention to address that – could be really powerful.”
About the study
The study, “
Digital Reminiscence for Pre-Death Grief in Dementia Family Caregivers: A Pilot Randomized Trial
,” appears April 22, 2026 in JAMA Network Open. Falzarano and Prigerson’s coauthors include Annabelle Greenfield of the USC Leonard Davis School; Sydney Saviano, Sindhu Kolla, Sosi Korian, Francesco Osso, Joseph Miller, and Paul Maciejewski of Weill Cornell Medicine; and Heather Whitson of Duke University.
This research is supported by National Institute on Aging (NIA) grants R21AG077144 (Falzarano/Prigerson), P30AG072958 (Whitson), and R00AG073509 (Falzarano); National Cancer Institute grant R35 CA197730 (Prigerson); and National Center for Advancing Translational Sciences award UL1TR002384 supporting the Weill Cornell Medicine Clinical and Translational Science Center.
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Digital Reminiscence App Could Reduce Grief and Improve Relationships Between Dementia Patients and Caregivers
8 min read
Home
»
Digital Reminiscence App Could Reduce Grief and Improve Relationships Between Dementia Patients and Caregivers
“Living Memory Home for Dementia Care Pairs” web tool helps people with mild to moderate dementia share memories and journal with their caregivers. Clinical trial results show reduced feelings of pre-death grief as well as the potential for improvements in relationship quality.
By Beth Newcomb
|
April 22, 2026 |
A web tool designed to spark reminiscence could help people with dementia and their caregivers feel more connected to each other and less impacted by feelings of pre-death grief, according to a
clinical trial co-led by USC and Weill Cornell Medicine
that was published in JAMA Network Open.
With features such as photo albums, autobiographical questions, and journaling prompts, the Living Memory Home for Dementia Care Pairs (LMH-4-DCP) website is a customizable virtual space that facilitates collaborative and interactive reminiscence therapy for both dementia patients and caregivers, said lead author
Francesca Falzarano
, assistant professor at the USC Leonard Davis School of Gerontology.
Reminiscence therapy for dementia includes guided conversations about past experiences and can involve music, art, familiar objects, or other sensory items. The goal is to lessen anxiety and promote well-being and connection, Falzarano explained.
“The idea is that getting them talking about those memories will promote the relationship between the person with dementia and the caregiver, which can improve numerous outcomes. If the caregiver has a better relationship with the person with dementia, they are more likely to keep them at home, and they’re less likely to transition into long-term care,” she said. “We also want to nurture the personhood and dignity of the person with dementia, document their memories while we still can, and alleviate pre-death grief.”
Pre-death grief, which includes both current and anticipated losses prior to a loved one’s death, is a common phenomenon for patients and families affected by dementia, Falzarano said.
“Even while the person with dementia is still alive, that relationship that once existed – whether it was a husband and wife, or mother and daughter – it can be transformed overnight,” she said. “For caregivers, everything that you knew about the person could be gone; you lose that existing relationship and support. Patients who are aware of their diagnosis can be grieving the loss of independence, skills, and memories. You lose a future you might have planned, and then you also are anticipating all of the losses that are going to unfold because of the disease.”
Promising early results
Trial participants included 34 pairs consisting of people with mild to moderate dementia and their caregivers, or caregiving dyads. Dyads were randomly assigned to either the full LMH-4-DCP app, complete with reminiscence therapy activities, or to a limited version of the app without access to reminiscence features. Each dyad used their assigned version of the app at least two times per week for two weeks and completed baseline and post-intervention surveys regarding usability of the app as well as on feelings of grief and relationship quality.
Study results not only indicated that the LMH-4-DCP app was feasible and acceptable for caregiving dyads to use; it also showed that using the full version of the app was associated with significant reductions in feelings of pre-death grief. In addition, there were minor increases in relationship quality after the two-week period for the users with access to reminiscence features versus those without access. While not quite reaching statistical significance in this small trial, the trend toward significance may indicate that a larger study sample or a longer period of usage may provide more improvement and shows the need for further study, Falzarano said.
“I feel like we got a lot closer”
Beyond the encouraging survey scores, caregivers shared their positive experiences with LMH-4-DCP in feedback to investigators. An open-ended question asked respondents about what they noticed regarding memory recall, interpersonal engagement, and relational closeness while using the app with their loved one.
“It was an awakening of the memories my mom had never spoken about before, and I enjoyed learning about her.”
“Surprised how much [care recipient] engaged with LMH-4-DCP. It brought a light to him seeing photos of himself on the application and being able to retell stories of his past.”
“It was very nice hearing my mom talk about things she has never told me, I feel like we got a lot closer. … I also was able to find resources and outlets to help her so I was not feeling all of the stress of not doing enough! I enjoyed all of the resources and being able to talk on a deeper level with my mom!”
“I appreciated the prompts for engaging my dad in conversation and learned things I had not known before.”
When participants were asked whether they would continue to use the app after the study:
“Yes, I would because my mom does not interact a ton with me, but this was the first time she really showed a lot of emotions!”
“Yes – it opened a different memory building connection and bonded us closer.”
“Yes, I would like to; it will be nice to have these memories when [care recipient’s] condition becomes worse so we can reminisce.”
LMH-4-DCP Home Page
The Living Memory Home for Dementia Care Pairs (LMH-4-DCP) is a customizable virtual space that facilitates collaborative and interactive reminiscence therapy for both dementia patients and caregivers.
Writing Room
Reminiscence and Writing Rooms guide participants in reminiscence therapy activities, including autobiographical journaling, photo uploads, and conversation prompts.
Journaling
The app includes prompts for collaborative journaling for both the individual with dementia and their caregiver.
Memory Lane
Participants can upload their own photos and captions based on reminiscence prompts.
Reading Room
Participants can find resources, tips and other information in the app's virtual Reading Room.
The power of sharing memories
LMH-4-DCP is modeled after the original Living Memory Home (LMH) web app, a digital bereavement platform for individuals grieving the death of a loved one developed by collaborators at Weill Cornell, including Holly Prigerson, co-director of the
Center for Research on End-of-Life Care
and senior author of the current study. Previously, LMH showed that its reflective journaling prompts and other bereavement activities reduced prolonged feelings of grief.
“People may not be aware of how severely distressing and disabling grief is,” Prigerson said. Pre-death grief is remarkably similar to post-death grief, which has been more extensively studied for its role in Prolonged Grief Disorder. Unlike natural grief that diminishes over time, Prolonged Grief Disorder involves pervasive and profound distress, hopelessness and impaired daily functioning, she explained.
“We have found grief to be the strongest predictor of suicidal thoughts and behaviors; it is also linked to serious medical outcomes such as heart attacks and cancer,” Prigerson added. “Detecting and addressing grief will help reduce these related risks.”
The similarities between bereavement and reminiscence therapy activities inspired the researchers to adapt the web tool for use with caregiver dyads, Falzarano explained.
“In the original Living Memory Home website, recently bereaved individuals would journal and do different activities to honor, reflect and reminisce on the deceased. This had really positive effects on bereavement adjustment; the severity of their post-death grief was significantly reduced,” Falzarano said. “A lot of the terms they were using were very bereavement-focused, but the concepts were exactly the same as in reminiscence therapy. Reminiscence therapy is widely used for people with dementia in general and can trigger memory recall, but there hasn’t been a ton of rigorous research into the effectiveness of it.”
Looking to the future, Falzarano aims to take advantage of the LMH-4-DCP’s scalability and conduct larger and more in-depth clinical trials. She also wants to develop new tools that can provide a more comprehensive and inclusive picture of how the app can help everyone involved.
“The next step is not only testing the efficacy of this reminiscence therapy tool with a very large, nationally representative sample, but also the inclusion of the person with dementia. I hope this establishes a line of research that we should be targeting both the caregiver and the care recipient, and that includes measurement,” she said. “We can’t just give the same questionnaire that we give to a caregiver to a person with dementia. What are the best ways to develop effective measures for people with dementia so we can know whether this is something that can help alleviate some of the stress or grief that they’re experiencing? To have a tool to assess that – and then an intervention to address that – could be really powerful.”
About the study
The study, “
Digital Reminiscence for Pre-Death Grief in Dementia Family Caregivers: A Pilot Randomized Trial
,” appears April 22, 2026 in JAMA Network Open. Falzarano and Prigerson’s coauthors include Annabelle Greenfield of the USC Leonard Davis School; Sydney Saviano, Sindhu Kolla, Sosi Korian, Francesco Osso, Joseph Miller, and Paul Maciejewski of Weill Cornell Medicine; and Heather Whitson of Duke University.
This research is supported by National Institute on Aging (NIA) grants R21AG077144 (Falzarano/Prigerson), P30AG072958 (Whitson), and R00AG073509 (Falzarano); National Cancer Institute grant R35 CA197730 (Prigerson); and National Center for Advancing Translational Sciences award UL1TR002384 supporting the Weill Cornell Medicine Clinical and Translational Science Center.
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Alzheimer's and Dementia
Featured
Research
Technology
How AI and Advanced Computing are Accelerating Alzheimer’s Research
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Caregiving
Featured
Podcast
Policy
New Podcast Shares Practical Approaches to Family Caregiving and Financial Well-Being
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Alumni
Community Service
Featured
As a Long-Term Care Ombudsman, Beverly Gianna Helps Nursing Home Residents Find Their Voice and Spirit
As a Long-Term Care Ombudsman, Beverly Gianna Helps Nursing Home Residents Find Their Voice and Spirit
USC Leonard Davis Communications
April 8, 2026
Share
Share
Share
Share
Visit Us
Leonard Davis School of Gerontology
3715 McClintock Avenue
Los Angeles, CA 90089
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Notice of Non-Discrimination
Digital Accessibility
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ldsgero@usc.edu
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What is Gerontology?
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© 2026 USC Leonard Davis School of Gerontology.
Close Menu
About
About Us
Our mission to promote healthy aging for all people, communities and societies is more vital than ever.
Our School
Overview
History
Leadership
Partnerships
Honors and Awards
Cultural Affairs
Board of Councilors
Our Field
Overview
What is Gerontology?
Gerontology Careers
Our Gerontology Expertise
Our Impact
Our Building
Overview
Andrus Gerontology Center
Sophie Davis Art Gallery
Facilities
School Resources
Administrative Staff
Gerontology Directory
Employee Resources
Faculty & Staff Portal
Jobs at USC Leonard Davis
Contact Us
Admission
Admission
Our students come from around the world and from many walks of life, and they’re all here for unique, important reasons.
Overview
Undergraduate Applicants
Master’s Applicants
PhD Applicants
Graduate Certificate Applicants
Doctorate of Longevity Arts and Sciences Applicants
International Applicants
Online Education
Resources
Request Information
How to Apply
Newly Admitted
Tuition and Financial Aid
Frequently Asked Questions
Office Hours
Academics
Academics
At the USC Leonard Davis School, you can earn an undergraduate gerontology degree, an accelerated five-year undergraduate or graduate degree program, a doctoral degree, or a minor in aging.
Undergraduate Programs
Human Development and Aging (BS)
Lifespan Health (BS)
Minor in Gerontology: Individuals, Societies, and Aging
Minor in Gerontology: Science, Health, and Aging
Minor in Geroscience
Master’s Programs
Aging Services Management (MA)
Applied Technology and Aging (MS)
Gerontology (MS)
Gerontology (MA)
Long Term Care Administration (MA)
Medical Gerontology (MA)
Senior Living Hospitality (MA)
Aging Biology (MS)
Specialized Master’s Programs
–
Master’s Programs in Nutrition
Foodservice Management and Dietetics (MA)
Nutrition, Healthspan and Longevity (MS)
Lifespan, Nutrition and Dietetics (MS)
Nutritional Science (MS)
Additional Programs
Graduate Certificate in Gerontology
Doctorate of Longevity Arts and Sciences
Professional Education
–
PhD Programs
PhD in Gerontology
PhD in Geroscience
Academic Resources
Academic Advisement
Career Development
Advisement FAQs
Online Education
Students
Students
Students of the USC Leonard Davis School of Gerontology share a deep compassion, an inspiring enthusiasm and a vision of an improved quality of life for older adults.
Overview
Undergraduate and Graduate Students
PhD Students
Internships
MSNHL Supervised Practice
Research Opportunities
Academic Conduct
Student Life
Student Organizations
Study Abroad
Alumni Stories
Career Development
Finding Support
Student Resources
Resources Overview
Student Handbooks
Course Catalogue
Schedule of Classes
Academic Calendar
USC Student Affairs
USC Student Health Center
Faculty
Research
Research Overview
Institutes and Centers
Projects and Initiatives
Cores
Multidisciplinary Colloquium Series
Research Opportunities
Research Funding Awards
Research Events
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Publications
Resources for Journalists
Stay Connected
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Stay Connected
USC FightOnline
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Contact the Development Office
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