Process variables of the life review: counseling implications

Feasibility Study of Caregiver-Provided Life Review: Implementation, Adaptation, and Effects on Care Recipients' Depressive Symptoms

OBJECTIVES

This study aimed to examine the feasibility of unpaid, family/friend caregivers conducting life reviews with people with dementia in long-term care and community settings and reported on how we adapted the intervention modality under the COVID-19 pandemic.

METHODS

Twenty-one caregiver-care recipient dyads completed 6 weekly life review sessions. The intervention format was modified to accommodate COVID-19 restrictions. Primary and secondary outcome measures were analyzed based on repeated measures at baseline and post-intervention.

RESULTS

Due to the changing nature of the pandemic, we iterated the caregiver training intervention four times to accommodate caregivers' needs while having faced multiple recruitment challenges with care facility residents. Care recipients' depression appeared to have improved (p = .001).

CONCLUSIONS

Although the COVID-19 pandemic created unique recruitment challenges, all the care recipients seemed to enjoy the life review activities supported by the positive outcomes in gaining socialization opportunities. It may be beneficial to offer a more self-paced intervention modality to ease the burden on caregivers.

CLINICAL IMPLICATIONS

It appears that unpaid family/friend caregivers can provide life reviews to their loved ones with dementia. Training the caregivers on how to provide life reviews can be an easy, low-risk activity that might ameliorate depressive symptoms in the care recipients.

Predictors of Reminiscence: A Lifespan Perspective

Age (18–81 years), sex, and personality (Extraversion, Neuroticism, Openness to Experience) variables were used as predictors of four dimensions of reminiscence behaviour. Contrary to theoretical assumptions, age did not predict reminiscence frequency. Neither were there age differences in terms of emotional tone or philosophical content of reminiscence. Memory remoteness, however, was predicted by age. Personality traits, in contrast, were significant predictors for all four reminiscence dimensions. Finally, sex predicted reminiscence frequency. The results are discussed from a lifespan perspective.

Mapping the Future of Reminiscence: A Conceptual Guide for Research and Practice

Nearly 50 years after Butler’s seminal 1963 contribution, the field of reminiscence and life review is entering a more mature stage. Isolated examples of increasingly sophisticated studies have recently emerged that can serve as a sound, cumulative data base. However, the field lacks an overarching conceptual model describing emerging trends, neglected domains, and key linkages among component parts. In the present article, the authors selectively, yet critically, review prior limitations and promising developments and then describe a comprehensive, multifaceted conceptual model that can guide future research and practice. The authors initially situate their model within a particular theoretical orientation (i.e., life-span psychology). They then describe a heuristic model that identifies and discusses triggers, modes, contexts, moderators, functions, and outcomes. Finally, the authors illustrate how these interactive factors influence both theoretical and applied areas.

Reminiscence and mental health: a review of recent progress in theory, research and interventions

This article explores recent progress in theory, research and practical applications of reminiscence. It first describes the evidence for reminiscence as a naturally occurring process, and discusses the different functions of reminiscence and their relationships with mental health and lifespan processes. Three basic types of reminiscence that relate to mental health are specified: conversations about autobiographical memories and the use of personal recollections to teach and inform others have social functions; positive functions for the self include the integration of memories into identity, recollections of past problem-solving behaviours, and the use of memories to prepare for one's own death; negative functions for the self are the use of past memories to reduce boredom, to revive bitterness, or to maintain intimacy with deceased persons. It is proposed that in interventions the three types are addressed differently: simple reminiscence stimulates social reminiscence and bonding and promotes positive feelings; life review uses the positive functions to enhance personal wellbeing; and life-review therapy seeks to reduce the negative uses and thereby alleviate symptoms of mental illness. Studies of the effectiveness of interventions have provided some evidence that interventions are effective in relation to their goals. The review closes with recommended directions for future reminiscence research.

The effects of integrative reminiscence on depressive symptomatology and mastery of older adults

A quasi-experimental (non-randomized) study was conducted to study the effects of a new intervention The story of your life that combines integrative reminiscence with narrative therapy. The program consists of seven sessions of two hours and one follow-up session after 8 weeks. It is directed at community-dwelling people of 55 years and older with mild to moderate depressive symptoms. After the intervention the participants showed significantly less depressive symptoms and higher mastery, also in comparison with a waiting-list control group. Demographic factors and initial levels of depressive symptomatology and mastery were not found to moderate the effects. The effects were maintained at 3 months after completion of the intervention. Although the new program was positively evaluated by the majority of the participants there is room for improvement. Adaptations should be made, and evaluated in a randomised controlled trial.

Autobiography as a spiritual practice

In this article autobiography is defined as a dialogue of the self with itself in the present about the past for the sake of self-understanding. Spirituality involves connectedness to oneself, others, nature and to a larger meaning. It is associated with creativity, play, wisdom, faith, and a sense of oneness. Writing and reflecting on one's autobiography enhances spiritual growth and can be therapeutic freeing people from outlived roles and self-imposed images. After discussing the history of spiritual autobiography as a genre, the author compares and contrasts four approaches to autobiography: the structured life review, the guided autobiography, the intensive journal workbook, and autobiographical work in twelve step programs. For those who work with older persons these techniques should prove very useful.

The reminiscence circumplex and autobiographical memory functions

This study investigated the potential of a circumplex model to represent the functions of both reminiscence and autobiographical memory. Participants from four pre-existing data bases (i.e., Culley, LaVoie, & Gfeller, 2001; Webster, 1997, 2002; Webster & McCall, 1999) were combined, resulting in a total of 985 participants ranging in age from 17 to 96 (M age = 36.63 years). A total of 392 men (39.8%) and 591 women (60.1%), with two persons not reporting their gender, completed the Reminiscence Functions Scale (RFS) as part of the original four studies. The eight RFS factors were submitted to second-order factor analysis resulting in two orthogonal dimensions (self versus social and reactive/loss-oriented versus proactive/growth-oriented) accounting for 79.57% of the variance. Further, multidimensional scaling indicated that the original eight factors could be arranged in a circular fashion such that more closely related (i.e., more highly correlated) factors were placed closer together while factors less highly related were placed further apart. Advantages of a circumplex perspective for future theory and model development are illustrated.

Reminiscence group activities and discourse interaction in Alzheimer's disease

Reminiscence is an enriching and complex experience having many purposes and functions when used with patients with Alzheimer's disease (AD). Discourse is a component of language that has been shown to decline in patients with AD (Mentis, Briggs-Whittaker, & Gramigna, 1995). This article represents one of the first studies to examine the effects of reminiscence group (RG) activities on discourse interactions in patients with AD. This article specifically addresses the AD population within a RG setting. Observations suggested that objective ratings of conversational discourse would be better (less impaired) in patients with AD when obtained in relatively unstructured environments (e.g., during RG activity) as compared to ratings obtained in conversational environments imposing more structure (e.g., a session in which language function was being evaluated). Comparisons made of conversational and narrative discourse skills observed during different testing environments in patients with AD revealed predicted outcomes. That is, discourse elicited in an environment that was less structured yielded qualitatively better discourse patterns, particularly related to selecting and maintaining a topic, requesting additional information about a topic, changing a topic during conversation, and turn-taking. Results are discussed in terms of their relevance to gerontological nurses managing patients with AD.

Life review: preventing despair in newly relocated nursing home residents short- and long-term effects

Relocation to a nursing home places frail elders at risk for developing depression and suicide ideation. This study followed two hundred and fifty-six newly relocated nursing home residents for five years. Using a Solomon Four research design, participants were divided into four groups, two control and two experimental, one each with pretesting and all with posttesting. Participants in the control groups received a friendly visit and those in the experimental groups received the intervention of life review. Immediate short-term results showed the life review to be an effective preventive intervention for clinical depression (p = .05). Additionally, when looking at long-term effects at one year, there were significant decrease in depression (p = .05), hopelessness (p = .01), and psychological well-being (p = .02) with measurable increases in life satisfaction (p = .08). These findings support the hypothesis that life review prevents despair in frail elders newly admitted to a nursing home.

The story behind the story: the use of storytelling in spiritual caregiving

OBJECTIVES

To briefly discuss the nature and function of stories that patients tell, and offer practical tips on how to listen and make sense of these stories.

DATA SOURCES

Books and articles from disciplines in the humanities and health care professions.

CONCLUSION

Stories are a medium for assessment and intervention in areas that essentially reflect an individual's spirituality.

IMPLICATIONS FOR NURSING PRACTICE

Encouraging storytelling is an intervention nurses can use to promote spiritual health. Suggestions for eliciting and analyzing stories are offered.

Including social factors in the analysis of reminiscence in elderly individuals

Developmental psychologists have studied reminiscence in elderly individuals using widely varied conceptions of adult development. Determinist psychologists conceived of reminiscent behavior in elderly individuals as constituting the last phase in normal development. Contextualist psychologists have pointed to the historical and cultural relativity of adult development, and highlighted the variation in elderly persons with respect to reminiscent behavior. However, they do not fully acknowledge the role the environment plays in establishing reminiscent behavior in elderly people. Therefore, sociological life course theory should be included in the analyses and interpretation of this behavior.

Reminiscing: the state of the art as a basis for practice

This integrated review presents the state of the art in reminiscing and life review as derived from a review of the literature from 1960-1990. Reports, reviews, and research are categorized and critiqued with the purpose of clarifying the use of reminiscing for practice. Out of ninety-seven published articles describing reminiscing, only seven report negative outcomes; the remainder are either positive or nonevaluative. As a result, the author concludes that clinicians should use reminiscing in their practice, and researchers should continue to define the variables that lead to successful reminiscing.