When Familiarity Remains: Procedural Memory, Symbolic Anchors, and Digital Engagement in Dementia Care

Abstract: INTRODUCTION: Older adults with early-stage dementia often retain procedural memory, enabling continued use of familiar technologies. Additionally, symbolic anchors such as photos or personalized content may serve as memory cues to reinforce digital engagement. This study explores how these mechanisms support technology use in dementia care within the South Korean context. METHODS: We conducted in-depth interviews with 11 professional caregivers of community-dwelling older adults with cognitive decline. Grounded theory methods guided the analysis, using iterative coding and constant comparison to identify emergent themes. RESULTS: Caregivers reported that familiar digital routines (e.g., taking photos) persisted through procedural memory. Symbolic anchors such as family photos or recognizable icons enhanced interaction and emotional engagement. However, unfamiliar or anthropomorphic technologies often triggered fear or symbolic resistance. DISCUSSION: Findings highlight the dual role of procedural memory and symbolic anchors in sustaining digital engagement. Designing culturally responsive and cognitively accessible technologies may enhance autonomy and well-being in dementia care. Keywords: procedural memory, symbolic anchors, dementia care, digital engagement, older adults, cultural adaptation, caregiving technologies