[Comparison of digital and conventional life story books on mood, communication, cognition and quality of life in people with dementia in nursing homes: A pilot study]

INTRODUCTION

Person-centered care (PCC) includes life story, a form of reminiscence therapy that can be useful in the treatment of dementia. We compared the efficacy of using a digital or conventional life story book (LSB) on depressive symptoms, communication, cognition, and quality of life.

MATERIAL AND METHODS

Thirty one persons with dementia living in 2 PCC nursing homes were randomly assigned to receive reminiscence therapy based on the Neural Actions digital LSB (n=16) or a conventional LSB (n=15). Both groups performed 2 weekly sessions of 45min for 5 weeks. Depressive symptoms were evaluated with the Cornell scale (CSDD); communication with the Holden scale (HCS), cognition with the Mini Mental State Examination (MMSE) and quality of life with the quality of life scale for Alzheimer's (QoL-AD). The results were analyzed using ANOVA of repeated measures with the jamovi 2.3 program.

RESULTS

Both LSB improved communication skills (η2=0.115; p<0.001), with no differences between groups. No effects on quality of life, cognition, or mood were found.

CONCLUSIONS

In PCC centres digital or conventional LSB can be useful in the treatment of people with dementia by facilitating communication. Its role on quality of life, cognition or mood is uncertain.

Lifespan effects of current age and of age at the time of remembered events on the affective tone of life narrative memories: Early adolescence and older age are more negative

The affective tone of autobiographical memories may be influenced by age in two ways-by the current age of the remembering individual and by the age of the remembered self at the time of the remembered event. While aging has been associated with more positive autobiographical memories, young adulthood is remembered more positively than other parts of life. We tested whether these effects also show in life story memories and how they act jointly on affective tone; also, we wanted to explore their effects on remembered lifetimes other than early adulthood. We tested effects of current age and age at event on affective tone with brief entire life narratives provided up to five times across 16 years by 172 Germans of both genders, ages 8 to 81 years. Multilevel analyses found an unexpected negativity effect of aging for current age and confirmed a "golden 20s" effect of remembered age. In addition, women told more negative life stories, and affective tone dipped in early adolescence for current age and was remembered as such up to mid-adulthood. Thus, the affective tone of life story memories is jointly influenced by current and remembered age. The absence of a positivity effect in aging is explained by the specific requirements of telling an entire life. We suggest the turmoil of puberty as a reason for the early adolescence dip. Gender differences are potentially explained by differences in narrative style, in depression rates, and in real-life challenges.

Older adults recall memories of life challenges: the role of sense of purpose in the life story

Late life is still often characterized as a time of loss and decline. The current study moved beyond this view, using both the resilience framework and the life story approach to highlight the rich life experiences of older adults. Doing so created an opportunity to explore perspectives on sense of purpose in life, from the vantage point of old age. The study had two central questions. That is, how have older adults drawn on their sense of purpose across their lives, and what factors led to the development of a sense of purpose? Following guidelines for the consensual qualitative research method (CQR; Hill et al., The Counseling Psychologist, 25(4), 517-572, 1997; Hill & Knox, 2021), in-depth, semi-structured interviews were conducted with 18 older women and men (aged 60 - 100 years) and transcribed for analysis. The CQR method revealed seven domains in the interviews. Three domains were relevant to the first research question, including: overcoming life challenges to pursue purpose, perspective-taking to maintain purpose, and purpose as part of one's religion. Four domains provided insights on the second research question: life background influencing purpose, shifts in purpose across life, fulfilling purpose across life, and obstacles to pursuing purpose in life. Findings highlighted how older people use sense of purpose as a guide in the face of life's inevitable challenges. They also revealed the unique life story paths that lead to the development of purpose across individuals' lifetimes. The implications of maintaining a sense of purpose in life, across the later years, are discussed.

Analyzing suicide life stories on Wikipedia with Highway_star and other textual visualization tools

Being responsible for a death every 40s, suicide is a major public health concern (Brunier et al. 2019). Even if many of its risk factors are social (Van Orden et al. 2010), there are surprisingly few qualitative sociological studies about the phenomenon. This study aim is to provide a life-story sociological analysis of suicidal trajectories. Two challenges are identified: gathering suicidal narrative and maintaining a quantitative foreground in order to deepen and rationalize the interpretation of data. They are both faced using a self-made, free to use, open access, algorithm: Highway_star (https://github.com/matheo-daly/highway_star). Two corpora of Wikipedia biographies of people who died by suicide in the 1920s (N = 82) and 2020s (N = 49) are gathered. Following an application of Fritze Schütze's methodology (Schütze, 2014), classical textual visualizations are produced. A Hierarchical Descending Classification, a Factorial Correspondence Analysis and a Similarity Analysis reveal five narration categories centered around different topics: cinema, death, family, poetry and politics. As none of those visualizations focuses on the developmental aspect of the biography, they offer limited interest for a life-story investigation. The second functionality of the Highway_star tool, which represents a narrative's unfolding with a Sankey Diagram, allows completing the analysis. It shows interesting differences between decades or gender. An example of the last being that men narratives tend to be more complex and achievement focused, while the women ones are more linear and family centered. The study's range has limitations. A major one is related to the corpus and the inability to identify clearly which parts of the narratives are associated to fame and which to suicide. Another one is linked to the Highway_star tool that sometimes lack of flexibility.

Narrative recognition and identification: a qualitative pilot study into reading literary texts with advanced cancer patients

Purpose

Patients with advanced cancer can experience their disease as a contingent life event. The sudden interruption of their life stories can obscure life goals and disrupt meaning making. In the context of the research project “In search of stories,” we aim to investigate the reading and discussion of selected stories which present ways of dealing with a contingent life event. In addition, we examine the use of a newly developed guide for reading these exemplary texts together with advanced cancer patients.

Methods

This qualitative study describes the experiences of five patients with advanced cancer who participated in a guided reading and discussion about selected literary texts. The intervention consisted of reading a selected story, after which each patient was interviewed, using the reading guide as a conversation template. The interviews were then thematically analyzed for their conceptual content using a template analysis.

Results

All five conversations showed some form of recognition in reaction to the chosen text, which led to personal identification of experiences of contingency, such as loss of life goals, impending death, or feelings of uncertainty. Besides the important role of identification, revealed by the responses to the questions in the reading guide, the discussion of the text helped them articulate their own experience and sources of meaning. Diverse worldviews came to the fore and concepts of meaning such as fate, life goals, quality of life, and death.

Conclusions

First experiences with our newly developed reading guide designed to support a structured reading of stories containing experiences of contingency suggest that it may help patients to express their own experiences of contingency and to reflect on these experiences.

Implications for Cancer Survivors

The intervention tested in this study may contribute to supportive care for survivors with advanced cancer, but further research is needed to evaluate its effect on quality of life.

More Vulnerable? The Life Story Approach Highlights Older People's Potential for Strength During the Pandemic

Objectives

Older adults have repeatedly been referred to as more physically vulnerable during the COVID-19 pandemic. The pandemic, however, is not only about becoming physically ill. It has many psychosocial aspects: people are exposed to myriad life challenges. The life story approach does not ignore physical status but also emphasizes psychosocial strengths. It highlights that older people are likely to have developed resilience through experiencing life challenges and living across history.

Method

We used the narrative method to review research on three strengths: tendency toward life reflection, adaptive use of personal memory, and temporal focus encouraging generativity.

Results

For each, we (a) present evidence that this strength manifests in the second half of life, and (b) identify how it may specifically be applied in dealing with the challenges of the pandemic. In considering their life stories, the picture that emerges is one of older adults as having the potential to show considerable psychosocial strength despite the adversities of the pandemic.

Discussion

We conclude that during this period of sweeping change in the lives of individuals of all ages, our older citizens may act as valuable societal anchors.

Narrative Identity and Personality Disorder: an Empirical and Conceptual Review

PURPOSE OF REVIEW

Identity is one of the key domains that is disturbed in people manifesting personality disorder (PD). Within the field of personality psychology, there is a robust approach to studying identity focused on narrative identity which has been largely overlooked in studying PD. In this paper, a systematic review was conducted of studies published in the past decade that focused on how individuals manifesting personality pathology craft their narrative identity.

RECENT FINDINGS

This review revealed disturbances related to several motivational/affective themes (e.g., negative valence/valence shifts and thwarted themes of agency and communion), autobiographical reasoning (negative self-inferences), and structural elements (e.g., low coherence and fewer life script events) within the narrative identity of people who manifest PD. Narrative identity is disturbed in people experiencing personality pathology and may have crucial implications for enhancing our conceptual understanding of PD and for PD interventions. This review also points to several research limitations and gaps that we encourage the field to pursue in the future.

Explaining change in content of life narratives over time

Aiming to further the understanding of stability and change of the life story, we investigated memory age and valence of life events as possible factors influencing life narrative stability. Additionally, we examined personal memories that 145 participants ranging in age from 16 to 69 years had told four years earlier but omitted from their current life narratives. In particular, we tested the accessibility of these omitted memories and explored the reasons for omission from life narratives. Younger age of memories but not valence predicted omission. Further, omitted memories could be remembered when aided with memory prompts. Both remembering and including life events in the current life narrative appeared to be related to personal relevance at the time of telling, supporting prior research that emphasises the role of motivation, ongoing goals, and concerns for the construction of personal narratives.

Understanding the self of people with dementia : Psychological and philosophical considerations

Background

The ability to create and maintain an ongoing life narrative is a key characteristic of what makes us human; however, people with dementia lose this ability in the course of the disease. If the notion of having a self is intimately linked with being able to create and maintain a life narrative and if people with dementia tend to lose this ability, what kind of self do people with dementia still possess?

Objective and methods

Recent theories developed in psychology and philosophy suggest that at least two notions of the self have to be distinguished: the experiencing self and the remembering self. This distinction is applied to people with dementia.

Results

While the remembering self is impaired in people with dementia, their experiencing self remains relatively intact. Critically, the experiencing self is a self with inner depth, mirroring the life history of the individual. Thus, the self of people with dementia is not unextended in time. Although people with dementia may have lost the ability to tell a story about their life, they are still able to express this story in their behavior.

Conclusion

Understanding the structure of the self of people with dementia can help guide interactions as well as the designing of appropriate interventions and environments. Moreover, realizing the inner depth of the self of people with dementia may help acknowledge their dignity and personhood.

Meaning and potential of interview data in depiction of life stories: interviews of three mothers caring for children with severe disabilities

[Purpose] This study aimed to review the meaning and potential of interview data for life story depiction. [Participants and Methods] The participants were three mothers who appeared to have positively accepted their daily lives while raising children with severe disabilities. Semi-structured interviews of these mothers were performed. By reference to Trajectory Equifinality Model, noteworthy experiences were extracted for individual cases from the complete records of the interviews. [Results] After the narration of their life stories, the mothers reached the following points: “Strange sense of satisfaction with living with this child,” “Both the child and I are happy,” and “The presence of this child allowed us to save our marriage.” [Conclusion] When one talks about oneself, the past is arranged in a form that explains the present, omitting or ignoring past experiences that are not related to the present. In other words, the present condition is not the point that the mothers has reached through the narration of their life stories, but the life story has been created to explain the present condition. This means that the life story will continue to change with each new context. This is the conclusion of this study with regard to the meaning and potential of interview data.

Does life story work improve psychosocial well-being for older adults in the community? A quasi-experimental study

Background

Previous studies have demonstrated that life story work has positive effects when used on older adults. This study aimed to examine the effect of life story work on the general mental well-being, self-esteem, and life satisfaction of older adults by comparing two groups – one with and one without depressive symptoms.

Methods

A quasi-experimental design was adopted in this study. One hundred and twenty-three adults aged 60 or above were recruited from community centers through convenience sampling. They were allocated into two groups based on their level of depressive symptomatology as measured by the Geriatric Depression Scale (GDS). The intervention was to produce a written life story with pictures and memorabilia in four to six semi-structured sessions facilitated by trained volunteers. The outcome measures included general mental well-being (General Health Questionnaire, GHQ), life satisfaction (Life Satisfaction Scale Index A, LSI-A), and self-esteem (Rosenberg’s Self-esteem Scale, RSES). Data were collected at baseline (T0), immediately post-intervention (T1), and at the 3-month follow-up (T2). Generalized estimating equations were used to examine the effect of the intervention on the outcomes.

Results

There was a significant interaction effect between the two groups at T1 (β = 0.244, p < 0.05) with improvements in the GHQ observed in the group with depressive symptomology. No significant time and interaction effects were seen on the LSI-A and RSES. The Friedman test was also used to examine whether the intervention itself would have any effects on the GDS score, with two groups combined. A reduction in the mean GDS score was found to be close to reaching a level of significance (χ² = 5.912, p = 0.052).

Conclusion

The findings of this study provided some preliminary evidence that life story work was effective at improving the general mental well-being of community-dwelling older adults with depressive symptomology. Because older adults with different levels of depressive symptoms might respond differently to life story work interventions, our findings offer interesting directions for future studies – for instance, on what population would benefit the most from Life Story Work and what would be the mechanism that renders Life Story Work effective.

Life story resources in dementia care: a review

PURPOSE

Life story work has a relatively long tradition in the caring sciences and is recognised as an important component of dementia care and practice. However, to date, there has not been a review of accessible life story resources. The paper aims to discuss these issues.

DESIGN/METHODOLOGY/APPROACH

Following a systematic approach to identification and inclusion, 11 life story resources were reviewed to ascertain areas of commonality and divergence between the materials.

FINDINGS

The authors were able to group the analysis under eight areas and at the end of this process, it was uncertain if life story work is a formal staff intervention or an informal activity that people with dementia and their families could engage in. Resources also varied in terms of whether the life story information was organised in a chronological way, or with topics of interest/discussion or with a combination of both. Life story evaluation and its impact on the life of the person with dementia is in need of development.

PRACTICAL IMPLICATIONS

Across the resources the authors identified four reasons to do life story work which the authors have named as: emotional connections; interactional connections; building new connections and practical care connections.

SOCIAL IMPLICATIONS

There was limited guidance aimed at helping people with dementia to develop and compile their own life story.

ORIGINALITY/VALUE

This paper provides new insights into the usefulness, future directions and content of life story resources in dementia care. It will be of interest to those in health and social care as well as people living with dementia.

Multilingualism and later life: a sociolinguistic perspective on age and aging

In this paper, I contribute to subjective accounts of aging by focusing on a population that has been largely overlooked in social gerontology: individuals in later life who are multilingual. How do such individuals experience and make sense of their multilingualism? What role does language play in the way they experience and make sense of their lives? To answer these questions I take a life story approach to three women who experienced similar sociohistorical circumstances but arrived at different linguistic outcomes: born in Spain around the time of the civil war (1936-1939), they migrated to Paris in the 1960s to pursue social and economic mobility. Although they arrived in France as monolingual Spanish speakers, they have since acquired French and now practice their multilingualism in distinct ways. I juxtapose their life stories to illustrate how the acquisition and use of language are informed by a confluence of personal, social, and historical factors. Focusing on the linguistic dimension of the life course I thus introduce a new perspective on the heterogeneity obtained among individuals at this stage of their biographical trajectories.

"Gratitude is with me all the time": how gratitude relates to wisdom

Objectives.

This study investigated the relationship of gratitude to wisdom. Both constructs are conceptually related to self-reflectivity, but they differ in their emphasis on extrapersonal resources. Previous wisdom research has focused mainly on intrapersonal capacities.

Method.

In Study 1, 47 wisdom nominees and 47 control participants were interviewed about their most difficult and best life event and filled out a questionnaire on sources of gratitude. Study 2 was a quantitative study (N = 443) of the relationship between a wisdom scale and scale measures and individual sources of gratitude.

Results.

Significantly more wisdom nominees expressed feelings of gratitude spontaneously in their interview. Wisdom nominees reported gratitude for their life in general, religion, and partner more often than control participants. In Study 2, wisdom was related to all gratitude scales and to similar sources of gratitude as in Study 1. Both studies found gender differences in gratitude but not wisdom.

Discussion.

Two important implications of these findings are that wisdom entails an appreciation of life and its experiences, especially the growth opportunities that may result from negative events, and that there may be substantial differences between male and female pathways to wisdom.