Evaluating the
Impact of Reminiscence
on the Quality of Life of Older People
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Background
Since Butler's(1) work on
the concept of `life review`, there has been growing interest
in the benefits of reminiscence for older people's quality of
life (QoL). A review of the small number of empirical studies
indicate contradictory findings, whilst the sheer weight of anecdotal
support, from participants, observers and health professionals,
indicates the need for a substantive evaluation. There is a lack
of clarity as to what exactly constitutes reminiscence and little
work on the degree of overlap between reminiscence, life review
and disclosure.
Reminiscence activities may serve different functions,
for example, the function served by life review may be primarily
intrapersonal and concerned with identity maintenance, whereas
reminiscence may serve primarily interpersonal functions. Thus
the contexts in which life review and reminiscence occur (group,
one-to-one or alone) may well impact on QoL outcomes.
Cognitive impairment is often seen as a barrier
to reminiscence work, particularly life review. However, the past
decade has seen a growth in psychotherapy with people with dementia.
The approaches in psychotherapy of story telling and exploration
of meanings, share many of the characteristics of reminiscence
work, and a review of therapeutic intervention must include disadvantaged
and cognitively impaired older people.
Aims and Objectives
The study has the following aims:
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To determine whether disclosure, reminiscence
or life review have different impacts on QoL for older people.
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To evaluate the context (one to
one, group, alone) and activity form (writing, verbal) in
developing appropriate therapeutic activities for older people. |
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To analyse how cognitive impairment
moderates the influence of these activities on QoL, and so
inform therapeutic interventions for frail and disadvantaged
older people. |
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To explore the role and benefits
for informal carers and care staff in facilitating in reminiscence
therapy, and thus contribute to a therapeutic care giving
relationship. |
Study Design
The study is a mixed factorial design involving
older people from residential and community care settings to take
part in an evaluation of reminiscence type activities. Older people
will participate in reminiscence activities. Aspects of a person's
QoL will be assessed during and immediately after each of the
reminiscence sessions. A baseline QoL assessment will be carried
out one week before the first reminiscence session and a final
assessment one month after the last session. Multivariate analysis
of data will indicate main effects and interactions.
Semi-structured interviews and focus groups will
be conducted with family carers, older people and care staff,
to understand what kind of reminiscence occurs informally. Barriers
to and benefits of reminiscence-type activities will be identified.
Policy Implications
A formal evaluation will produce clear evidence
concerning the potential therapeutic values of reminiscence activities,
thus empowering care staff, informal carers, and all older people,
including those who may be cognitively impaired.
Dissemination will take place through a variety
of channels involving public health, community health, primary
care, social service and advocacy networks and will include a
mini conference aimed at those in the public and private sectors,
voluntary organisations, health and social care professionals,
and older people advocacy and support groups.
1. Butler, R.N. (1963). The life review: an interpretation
of reminiscence in the aged. Psychiatry , 26, 65-75.