Activity and Therapy
Reminiscence Therapy (RT) involves the discussion of past activities, events and experiences with another person or group of people, usually with the aid of tangible prompts such as photographs, household and other familiar items from the past, music and archive sound recordings. Reminiscence groups typically involve group meetings in which participants are encouraged to talk about past events at least once a week. Life review typically involves individual sessions, in which the person is guided chronologically through life experiences, encouraged to evaluate them, and may produce a life story book. Family care-givers are increasingly involved in reminiscence therapy.
Reminiscence refers to recollections of memories from the past. It is familiar to us all and can be utilized for the benefit of others. For people with Alzheimer’s disease encouraging the act of reminiscence can be highly beneficial to their inner self and their interpersonal skills. Reminiscence involves exchanging memories with the old and young, friends and relatives, with caregivers and professionals, passing on information, wisdom and skills. It is about giving the person with Alzheimer’s a sense of value, importance, belonging, power and peace.
Reminiscence activity and therapies are used frequently in our own lives and well as in therapeutic settings and residential care. We all use it to cope in times of stress, such as mourning, it can also help reduce injury to our self image and it can create a feeling of intimacy and give special meaning to contact time with others.
Reminiscence is the process of recalling personally experienced episodes from one's past. Based on his theory of "life review," Butler (1963) posited that reminiscing about the past would serve an adaptive function for older adults, whereby they could achieve a sense of psychological well-being and closure in the face of their own mortality. Shortly after Butler's seminal paper, psychotherapists began using reminiscence as a therapeutic approach to improve psychological and social functioning. In studies with cognitively intact older adults, reminiscence therapy has been associated with positive changes in self-esteem and affect; increased life satisfaction; decreased depression; and increased communication skills, spontaneity, and laughter.
From a cognitive standpoint, the rationale of using reminiscence therapy with individuals with dementia is based on the theory that function is improved by decreasing demands on impaired cognitive abilities and capitalizing on preserved ones. Because individuals with dementia (in the early to moderate stages) have greater preservation of remote as compared to recent autobiographical memories, researchers have hypothesized that talking about previous life events would result in enhanced communicative interactions.
Although reminiscence can be evoked through primarily verbal means, often props such as music, pictures, objects, and sounds are used to facilitate reminiscence. For example, a reminiscence therapy session centered on "pets" may include photos and slides of different pets; objects such as dog collars; stuffed animals; and tapes of dog, cat, and bird sounds. In recent years, a number of commercially available reminiscence materials have become available. These kits are designed for both caregivers and therapists, and are often organized around historical themes such as "The Great Depression", chronological timelines arranged by decades or developmental life milestones.
Different Mediums used for Reminiscence Therapy and Activities
A variety of mediums can assist the act of remembering that use different senses. It means that people who have difficulty communicating verbally can have the opportunity to do so in other ways. Establishing identity with or without words is a good example of how we have to adapt, giving a valuable opportunity to acquire and use new skills of communication.
* Visually: photographs, slides. Painting pictures, looking at objects of autobiographical meaning.
* Music: using familiar tunes from the radio, C.Ds, or making music using various instruments.
* Smell or taste: using smell kits, different foods
* Tactile: touching objects, feeling textures, painting and pottery.
Photographs comfort patients
Photographs from the past allow patients to reminisce about pleasant times in their lives. Photographs from the present help patients relate to their current situation. The patient experiencing memory loss is able to “remember or recognize someone they love and know in a world where so many things are now unfamiliar to them.” A study by Ellen Mahoney of Boston College found that photos may efficiently distract the Alzheimer’s patient from the effects of Alzheimer’s disease.
Photographs provide additional information that allows Alzheimer’s patients to become comfortable with their environment. In one study, an Alzheimer’s patient in the United Kingdom used photographs to remember the names of members of his social club. The scrapbook is in essence, “A portable memory reacquainting the resident with themselves and familiarizing the staff with the resident.”
Types of Reminiscence Activities and Therapies
Reminiscence can be used as individual, group or family sessions and is generally categorized in three main types:
* Simple reminiscence. Here the idea is to reflect on the past in an informative and enjoyable way.
* Evaluative reminiscence is more of a therapy and may, for example, be used as a life reviewing or sometimes conflict resolving approach.
* Occasionally, unpleasant and stressful information is recalled and this has been called offensive-defensive reminiscence. It can be the either the cause or the result of behavioral and emotional issues. Dealing with them can provide resolution - a coming to terms with life events and possible closure.
Inclusion of Caregivers, Friends and Relatives in Reminiscence Activity
In a care facility, or in a professional setting, the co-operation and inclusion of relatives and friends can enhance the reminiscence time for all parties. They may be able to provide photos or remember incidents in the person’s life that can increase the pleasure and engage a person with Alzheimer’s attention more fully. Friends and relatives can also provide valuable information on any subject that a person may find distressing or upsetting that require increased support.
This therapy improves caregiver and patient relationships while utilizing the fact that Alzheimer's disease often does not affect long-term memory access until after short-term memory begins to fade. Asking questions about the past and inviting patients to tell their stories is also deeply therapeutic, encouraging life-review. Photo albums, jewelry and souvenirs can be used to trigger memories and reminiscence.
The Right to Refuse Activity Involvement and Alzheimer's
Remember to respect the individual’s involvement and contributions. By all means try to encourage participation but if a person does not want to be involved in the activity respect their right to refuse. Their refusal is as valid as yours, for self protection, privacy, as an act of autonomy and power over their situation.
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