Reminiscing An Approach To Help Older Adults Stay Connected

The elderly have stories to tell and it is important for care givers to know their residents, their stories, and what is meaningful to them. Susan, an RN in a nursing home, was listening as Mrs. Cass shared how she met her husband. Susan had just read some articles about reminiscing and life review, and asked herself whether Mrs. Cass was reminiscing?

Reminiscing is an intervention that has been used independently with different populations for many years. Reminiscing, as an intervention, is an interaction between two or more people that involves eliciting memories of one or more persons. These memories do not necessarily imply recent events or experiences.

This article discusses the main components of reminiscing and its subset, life review and how they can be utilized in care practices. The intent is to demonstrate how reminiscing could be introduced to staff in a long term care facility as a useful intervention. Suggested guidelines for introducing reminiscing in a long term care facility will be briefly described.

Reminiscing is considered a key intervention especially with the elderly to help them stay connected with their past and with living meaningful lives in the present. Through remembering the past, individuals may come to terms with their regrets and realize, acknowledge and appreciate their achievements.

Susan mentioned to her nurse manager that Mrs. Cass was sharing information which she had not been aware of. She noted Mrs. Cass had been in their home for 2 ½ years and she had never seen her so enthusiastic. Susan had learned that Mrs. Cass had been a science teacher and that she had loved to go dancing with her husband. Susan expressed an interest in getting to know all the residents better and to see them as animated as Mrs. Cass had been. Susan shared the articles that she had read on reminiscing and life review with her nurse manager. Susan explained that two nurses, Burnside and Haight (1992), who have written extensively about reminiscing and life review, hold that reminiscing is a way of thinking and talking about one’s life. Reminiscing is the umbrella term for remembering events, people and feelings from the past. Life review is a subset of reminiscing. Life review is a structured approach to reviewing and looking for meaning in one’s life.

The goals for reminiscing and life review are somewhat different. Reminiscing offers a basis for socializing and as it often occurs within groups it can reduce isolation, facilitate the making of new friends and improve quality of life. On the other hand, life review tends to be done on a one-to-one basis with a trained professional who is able to guide a person through a step-by-step chronological process of the events that have occurred throughout their life. Haight and Dias (1992), in a study that looked at five different ways of reminiscing including life review, found that the opportunity for older adults to evaluate or talk about how they felt about a given life event, contributed to a greater success from the life review process.

Susan expressed an interest in trying reminiscing within their nursing home. She suggested that the reminiscing approach would work differently for different populations. They needed to think about the two units, the one for the physically frail and the one for the cognitively impaired. Mr. White, an 83-year-old gentleman who was in mid stage Alzheimer’s disease, would not be as appropriate a group member as Mrs. Cass. Susan said for residents like Mr. White, reminiscing can be used on a one-toone basis (Haight, 2001). Mr. White is on the Alzheimer’s unit and research indicates that while these clients may not be able to take part in the group process, reminiscing as an activity can be used even for those with dementia on a one-to-one basis.

Susan and her nurse manager decided they would start with a group on the physically frail unit where residents like Mrs. Cass are more cognitively able. She also said that they have 33 residents on the unit but not all of them would be appropriate. The literature suggests that the ideal group size is 8-10 individuals. Some of the criteria may be that they should speak the same language, be able to hear and able to sit still for an hour (see Table 1).

Based on the research and theory guiding reminiscing interventions (Tables 1 and 2), the group was set up to run twice a week for a three month period. Susan knew persons who are open to exploring and finding meaning in their life would probably be more positively responsive to this activity. It is important to find a quiet and comfortable room away from noise and disruptions to allow the group process to flow smoothly. These groups meet once or twice a week. Because they were new to trying reminiscing, Susan suggested it might be a good idea to have two individuals leading the group. She indicated that even though they want this to be the residents’ group, there were common themes that can be suggested to the group. Residents can talk about their careers, favorite jobs, travels, movies, holidays etc. and props could be used to encourage participation.

Susan and her manager found the use of reminiscing a success for residents, their families and staff. After all, reminiscing is a means of recalling one’s life – a way an individual can recall the ‘photos’ or ‘images’ of times gone by – forgotten nuggets or jewels.

These nuggets are often the gold veins that have been woven throughout their lives – that have helped them through difficult times and that have been buried below the surface of awareness in the business of life. And if buried well below the surface, these nuggets are not available to bring light to their current situation.

The authors of this article and their colleagues have noted numerous benefits from guiding reminiscing in group and one to one situations in their long term care settings. The stories that reminiscing elicit tell us who we are and help us to feel focused. The stories bring not only laughter, but also pride of actions well done, steps taken that have touched and brought meaning to a community. We can’t help but have a glow when we think of something meaningful in our life – that ‘glow’ health professionals know, changes the biochemistry of the individual. Seratonin levels change when an individual is happy or depressed. These changes impact our movement; an individual may walk slowly and awkwardly or smoothly and chipper with a bounce in their step. The changes can affect eating as residents are more likely to over or under eat and this has significant ramifications for the older adult.

Finally, it is thought that reminiscing as an intervention can have a ripple affect on the life of the older adult. In other words, feeling good about oneself, having positive memories and bringing them forth to the present, contributes a resistance to disease and has positive outcomes beyond being a pleasant activity. Reminiscing and life review are interventions that are being researched. Although they have not at this point been ‘proven’ to contribute to overall health, we can see from ourselves and our own families, that a day in which we feel we’ve made a difference or shared a ‘meaningful’ experience, makes for a ‘good’ day.