What is reminiscence therapy?

At its most basic, reminiscence therapy involves listening to a patient and encouraging the individual to share his or her memories. The listener may ask directed questions to encourage further sharing. Reminiscence therapy is most beneficial in treating individuals with memory disorders such as dementia, as well as anxiety and depression, and may be useful as an alternative to drug therapies for challenging patients.

Overview

Persons benefit from knowing their experience is valued by others. Many times older individuals feel marginalized. They may have mobility issues that prevent them from seeking out company, or they may be intimidated by technology—cell phones and computers, for example—and therefore feel isolated. Individuals with cognitive challenges such as dementia may find the modern world confusing and lonely. They often lose
short-term memory
—memory of what has happened very recently—and may feel disoriented and frightened. Such feelings of isolation often lead to depression. Caregivers may be older individuals' only source of companionship. By encouraging persons to share stories and actively listening to these tales, caregivers often can help these individuals to feel connected to the modern world.

Persons with dementia generally retain their earliest memories for the longest time. Reminiscence therapy has been found to be most beneficial to individuals with mild to moderate dementia. According to the Institute for Research and Innovation in Social Services (IRISS) in Scotland, several 2009 studies found that patients who participated in reminiscence therapy had better relationships with caregivers and families, had improved cognitive abilities and mood, functioned better, and had reduced symptoms of depression. A 2010 study in Taiwan found that aged persons without dementia also benefited from reminiscence therapy, according to IRISS. They were less depressed, more sociable, and generally in better mental health than individuals in the control group. The studies found no negative effects from reminiscence therapy.

Reminiscence therapy provides both therapeutic, or healing, benefits and pleasure. Recalling happier times reinforces the individual's connection to the world and may increase feelings of self-worth. Memories of difficult experiences such as loss or tragedy may help individuals process feelings and gain a better understanding of both events and themselves. Reminiscence therapy can improve cognitive ability among patients by providing stimulation.

Working with Patients

Reminiscence therapy may be conducted one-on-one or in group settings with a therapist who facilitates discussion and encourages all participants to share stories. Therapists may use items, such as photos, or play music to spark memories. At times therapists may use one-on-one sessions to collect information and create a book of an individual's life history (life story work), which may further help a patient who struggles to maintain his or her identity as cognitive function fails. Such information also aids caregivers. For example, reminiscence therapy and life story work may reveal and document favorite or hated foods and activities such as hobbies and lifestyles—information that enables care homes and caregivers to provide appropriate opportunities. A patient who once enjoyed outdoor activities may benefit from regular walks outside, for instance. A person who once practiced needlepoint may be encouraged to try painting. Family members may even develop life stories for individuals as they prepare to move to care facilities to aid the transition and help the patient hold on to his or her identity.

Though sad memories of difficult times may bring tears, they can be therapeutic. Listeners must respect the memories and experiences of the patient and allow them to feel their emotions. Silence, too, is important—while at times a listener may need to ask questions or share appropriate stories, at other times it is best to sit in silence together.

Reminiscence may be encouraged at all times of the day, and nurses and other caregivers may be best positioned to facilitate such talk. Patients in care facilities might be open to talking about the past during meals, while receiving physical therapy, or while walking with assistance. Reminiscence also may be used as an aid to encouraging relationships with caregivers and developing friendships with other patients. This therapy may help patients transition from their home environment to an institutional setting or when moving between institutions. Caregivers such as nurses are encouraged to see patients as individuals (to see beyond the diagnosis) and be sensitive to their culture and background to deliver person-centered care, which focuses on treating patients with dignity and respect and ensuring they have personal choice and a sense of community and security. Reminiscence therapy has been shown to benefit both patients and caregivers.

For late-stage dementia patients, who often are unable to communicate well or to even speak, stimulation such as music is likely to trigger memories. By providing music associated with happy times or events, caregivers can improve patients' moods. This outcome may provide a long-lasting effect, because moods often last longer than memories.

Caregivers can provide reminiscence therapy by encouraging communication using many methods, including the following:

• Ask open-ended questions. How did you learn to paint? What were you doing when (the first astronauts went to space, World War II ended, etc.)?




• Take cues from the patient's possessions. Ask questions about photographs and souvenirs: Who are the people in the photo? Is this memento from a trip? What was it like?




• Stimulate the senses. Music, dancing, food, and smells, for example, may trigger memories.




• Turn to literature. Read an excerpt from a book set in an earlier time or an account of some event or activity from decades ago, and ask the individual to comment.

Bibliography

Huntsman, Mark. "How Reminiscence Therapy Improves the Lives of Alzheimer's Patients." Alzheimers.net. A Place for Mom, Inc. 22 Apr. 2014. Web. 3 Feb. 2015. http://www.alzheimers.net/2014-04-22/reminiscence-therapy-improves-alzheimers/

Klever, Sandy. "Reminiscence Therapy: Finding Meaning in Memories." Nursing 43.4 (Apr. 2013): 36–37. Lippincott Williams & Wilkins. Web. 3 Feb. 2015. http://journals.lww.com/nursing/Fulltext/2013/04000/Reminiscence_therapy__Finding_meaning_in_memories.11.aspx

"Supporting Those with Dementia: Reminiscence Therapy and Life Story Work." IRISS. The Institute for Research and Innovation in Social Services. May 2011. Web. 3 Feb. 2015. http://www.iriss.org.uk/resources/supporting-those-dementia-reminiscence-therapy-and-life-story-work

Watson, Karen Everett. "Reminiscence Therapy Benefits Residents." Provider. Provider. Jun. 2011. Web. 3 Feb. 2015. http://www.providermagazine.com/archives/archives-2011/Pages/0611/Reminiscence%20Therapy%20Benefits%20LTC%20Residents.aspx

"What Is Reminiscence Therapy?" Dorset HealthCare. Dorset HealthCare NHS Foundation Trust. Apr. 2009. Web. 3 Feb. 2015. http://www.dorsethealthcare.nhs.uk/WS-Dorset-HealthCare/Downloads/Managing%20Your%20Health/Therapy%20Information%20Leaflets/L141-09ReminiscenceTherapy.pdf