By Holly J. Bean, PhD, LCPC, CTRS
Kate, a TEP, shared a success story where the process of life review offered positive outcomes for more than just the client. Kate noted that one of her clients is a 101 years old female with significant hearing impairment and short-term memory loss. Ms. XYZ has lived a remarkable life; born in California in 1920 to parents who were Japanese immigrants, she grew up working on the family farm with her five sisters. Her father sensed international tensions were rising in the late 1930s and moved the family back to Japan where Ms. XYZ spent the post-war era working in banks as well as for the military as a translator. On returning to the United States ten years later, she worked at the Pentagon, then moved to Guatemala for two years where she worked as an assistant to the military attaché at the American Embassy there. Ms. XYZ did not marry and was a world traveler.
Ms. XYZ’s TEP felt strongly that she would be a candidate for Life Journey Books. Crystal partnered with Naomi Grossman who developed an online platform where seniors are asked thoughtful questions about their lives and subsequently can record and print their life story as a book, preserving memories, historical content, and cherished pictures. Over several Thoughtful Engagement sessions, Kate posed the Life Journey questions to Ms. XYZ about her childhood, career, travels and aspirations, but between her hearing challenges and intermittent memory loss, answers weren’t always forthcoming. Kate utilized creative problem solving skills to work through this barrier and created a PowerPoint presentation with the questions in large print for Ms. XYZ to review. This became the breakthrough in recording the rich details of her life story as she remembered them over several sessions. It also helped to orient her to the purpose of our visits. Repeating the questions over time, going at the pace for the client, and listening promoted even more stored memories to surface.
This process has been a joy, and soon Ms. XYZ be holding her Life Journey Story in her hands. Fellow residents and caregivers at her assisted living facility are eager to see the finished product!
Reminiscing is often used as a therapeutic technique with older adults. Reminiscing consists of recalling events of one’s life through daydreaming, storytelling, or nostalgia by oneself or with others present (Haber, 2006). Research on the effects of older adults when the techniques of reminiscing had been utilized identified positive outcomes for older adults with depression or depressive symptoms (Karimi, et al, 2010), increased self-esteem (Wu, 2010), an increase in coping strategies (Shellman, Mokel, & Hewitt, 2009) or increased feelings of life mastery (Bohlmeijer, et al, 2009).
Thoughtful Engagement Specialists provide what is known in the field of caregiving as a non-pharmacological approaches to increase the quality of life of those we serve and their families. A meta-analysis that researched the outcomes of reminiscing as an intervention demonstrated that reminiscing, a non-pharmacological intervention, significantly reduced depressive symptoms and offered “a valuable alternative to psychotherapy or pharmaco-therapy” (Bhohlemeijer, Smit, & Cuijers, 2003, p. 1088). Reminiscing serves a positive purpose.
In conjunction with reminiscing therapy, Life Review, as an intervention, developed by Tabourne (1991) has seen success for our older adults with such issues such as frustration, handling stress, depression, low self-esteem, well-being, isolation, and other symptoms attributed to aging (Tabourne, 1991, 1995; McKenzie, 2003).
Both reminiscing and life review have contraindications (the ability to increase discomfort or negatively impact a client) especially for those who may have Post-Traumatic Stress Disorder, a history of abuse, or those who have served in the military. Being mindful is important and having the ability to tune into your client.
Yet, the outcomes are typically positive and offer the client, the caregiver, the family, and others the ability to make connections.
References
Haber, D. (2006). Life Review: Implementation, theory, research, and therapy, International Journal of Aging and Human Development. 63(2), 153-171.
Bohlmeijer, E., Kramer, J., Smit, F., Onrust, S., & van Marwijk, H. (2009). The effects of integrative reminisce on depressive symptomatology and mastery of older adults. Community Mental Health Journal. 45, 476-484.
Bohlmeijer, E., Smit, F., & Cuijpers, P. (2003). Effects of reminiscence and life review on late-life depression: a meta-analysis. International Journal of Geriatric Psychiatry. 18(12), 1088- 1094.
Karimi, H., Dolatshahee, B., Momeni, K., Khodabakhshi, A., Rezaei, M., & Kamrani, A. (2010). Effectiveness of integrative and instrumental reminiscence therapies on depression symptoms reduction in institutionalized older adults: an empirical study. Aging and Mental Health, 14(7), 881-887.
McKenzie, S. (2003). The efficacy of a culturally relevant life review program: Effects on life satisfaction and psychological well-being of community-dwelling African American elders. Unpublished doctoral dissertation. University of Minnesota.
Shellman, J., Mokel, M. & Hewitt, N. (2009). The effects of integrative reminiscence on depressive symptoms in older African Americans. Western Journal of Nursing Research, 31(6). 772-786.
Tabourne, C. (1991). The effects of a life review recreation therapy program on confused nursing home residents. Topics in Geriatric Rehabilitation, 7(2), 13-21.
Tabourne, C. (1995). The effect of a life review program on disorientation, social interaction and self-esteem of nursing home residents. International Journal of Aging and human Development 41(1), 251-266.
Wu, L. (2011). Group integrative reminiscence therapy on self-esteem, life satisfaction and depressive symptoms in institutionalized older veterans. Journal of Clinical Nursing, 20, 2195-2203.