Reminiscence and Life Review in Health Care

Health Care and Reminiscence & Life Review

Whats is Reminiscence and Life Review,Similarities in Reminiscence and Life Review,Nursing Research On Reminiscence and Life Review,Reminiscence Theory "Eight Ages of Man",Critical View About Reminiscence.

Whats is Reminiscence and Life Review

    The words reminiscence and life review are often used interchangeably. They are however two different methodologies of recall; their one commonality is that they both use memory to operationalize themselves as concept and intervention. 

    Reminiscence is a multifaceted, multipurpose, naturally occurring mental phenomenon manifested across the life span in a variety of forms and contexts. Life review is one of those forms of reminiscence, but it differs in that it is more intense and has more depth. 

    The life review covers the life span, is more structured, and has an evaluative component in which people review, revise, and reintegrate both good and bad memories into a newly organized picture of their lives as they were lived. Often life review is performed on a one-to-one basis rather than in groups.

Similarities in Reminiscence and Life Review

    Presently other types of recall that have many similarities to life review and reminiscence are popular and may be confused with life review modalities. One of these is oral history, where the fact and the content are sought rather than the effect on the person recalling the memories. 

    Reminiscence, life review, and oral history differ in their origin, in that oral history arises from a historical/sociological base and life review/reminiscence arises from a psychological base. Narrative therapy is still another form of recall and arises from psychiatry.

     In narrative therapy the individual tells the story surrounding a particular problem, a problem for which he has sought help from a psychiatrist. While retelling the story, new insights are gained by both the patient and the psychiatrist, and in the process, the story tends to mend the problem. Story is becoming a term with common use in psychology as scholars and researchers begin to report stories in the narrative and analyze them qualitatively.

    In the last 10 years alone, there have been 150 new publications with increased rigor and a more scholarly approach. One of the most important advances in this field of research has been that researchers and practitioners alike now define their process so that others can easily understand it, making outcomes more comparable. 

    Two books with integrated reviews on the work done in the past 10 years, by Haight and Webster (1995) and Webster and Haight (2002), will be especially helpful for additional information on reminiscence and life review.

Nursing Research On Reminiscence and Life Review

    Reminiscence and life review research use both quantitative and qualitative paradigms. In the last decade researchers have begun to use the whole life story and larger sample sizes while employing diverse ways to look at functions, processes, and outcomes.

Reminiscence Theory "Eight Ages of Man"

    A variety of theories have been used in reminiscence research. The most common one is the Eight Ages of Man. Erickson described the last stage of life as integrity and further stated that people who do not reach integrity will be in a continual state of despair. He defined integrity as accepting one's life as it has been lived. 

    For many researchers the life review is seen as the process for reaching integrity. As people review their lives and begin to accept and reintegrate their life events, they also accept their lives as they were lived, thus reaching integrity. Tornstam (1999) argued that the theory of gerotranscendence is a better way of studying reminiscence, because gerotranscendence and reminiscence functions are intertwined. 

    Tornstam suggested that reminiscence contributes to the reconstruction of identity and the understanding of reality as a process of reorganization and reconstruction. Webster (2003) still took another approach, trying to marry the fields of autobiographical memory and reminiscence with a circumplex model that would serve as a bridging technique within and between reminiscence and autobiog raphe.

    Haight, Michel, and Hendrix (2000) conducted a longitudinal study with 256 newly admitted nursing home residents. They not only discovered a positive effect on depression; they found that the therapeutic outcomes increased over time for at least 2 years in those receiving a life review. 

    This is the only longitudinal study published to date that looks at the effect of life review over time and the information can be very important to practice, showing that in 2 years the client may be ready for another dose of life review to reinforce the positive response .

    Another very interesting study by a nurse used life review psychotherapy with depressed home bound older adults. McDougall, Blixen, and Lee-Jen (1997) conducted a retrospective analysis of notes from 80 patients over 65 years of age who were discharged from a psychiatric hospital with a primary diagnosis of depression. 

    Home health nurses then used life review as an intervention and facilitated the ability of these patients to live at home and remain independent. Most importantly, McDougal and colleagues showed that these nurses were able to bill for the intervention as a part of their services.

Critical View About Reminiscence

    A critical review and synthesis of literature on reminiscing in older adults was recently published in the Canadian Journal of Nursing Research. In this analysis and synthesis, the authors reported that despite the many publications on the topic only a few were research based. 

    However, they did conclude that the analysis resulted in clarity regarding the operational definitions of reminiscence and life review and provides guidance for the design of imaginative programs (Buchanan et al. 2002). 

    Qualitative analysis is an excellent way to study people's experiences to determine what makes them what they are. The life story is a rich resource and can contribute an enormous amount to the study of people.

    Heliker (1997) used a narrative approach similar to a modified life review to gather data on volunteers over the age of 75 years living in a nursing home. She used a seven-step hermeneutical method to analyze the data. Her results indicated that the revelation of personal and shared meaning could guide the development of new, innovative patient care interventions.

    Melia (1999) collected life stories from sisters of three religious orders to examine the question of whether the old-old undergo additional developmental stages after reaching ego integrity in their younger old age. She used a narrative approach to collect the stories and then used grounded theory to analyze 35 interviews. She found continuity and continued growth in the lives of the religious women.

    Much of the new research in 2000 looks at the functions of reminiscence, how it works, and on whom it works best. Continuing this work is necessary to understand the process. Additionally, reminiscence as intervention has been particularly effective with depression and partially with Alzheimer's disease and should be explored more fully in future work.