Subramaniam and Woods (2012, p. 545) define reminiscence therapy as, “the discussion of past activities, events and experiences, aided by a range of memory triggers”. Memory triggers can be physical, such as objects and photographs and can also include non-physical triggers such as conversation and music (Subramaniam and Woods 2012).
Ito et al (2007) argue that reminiscence is a widely used intervention for people with dementia, but that there is limited robust research into the benefits of participation in the activity. Ito et al (2007) undertook a randomized control trial with the aim of filling the gap in research by establishing any cognitive or behavioural benefits experienced by people with dementia who took part in a regular reminiscence group.
60 participants took part in Ito et al’s (2007) study who were randomly assigned to one of three groups: one group who received reminiscence therapy, one group who attended a structured social group and a third group who received no new intervention. The treatment groups each had four members and sessions were held once per week, lasting one hour (Ito et al 2007).
Ito et al (2007) completed Mini-Mental State Examinations (MMSE) and the Multidimensional Observation Scale for Elderly Subjects (MOSES) assessments prior to and following the interventions. The pre and post assessment scores were used as outcome measures to determine any improvement in cognition or behaviour as a result of participation in the reminiscence group (Ito et al 2007).
Ito et al (2007) write that, from the information obtained following a detailed comparison of pre and post assessment scores for the two treatment and one control groups, there were no significant changes noted in either the MMSE or MOSES scores for participants who took part in the reminiscence groups in comparison to individuals who were involved in the social group or the control sample. With these findings in mind, Ito et al (2007) concluded that the use of reminiscence as an intervention for people with mild to moderate dementia had no impact on their cognition or behaviour.
Although these results are important to consider when reviewing the effectiveness of reminiscence as a therapeutic intervention, it should be noted that Ito et al’s (2007) research was based in Japan; a country which is arguably culturally very different to the United Kingdom. Participants based in the UK may have responded differently to the intervention, thereby more positive results may have been observed.
A study completed by Haight et al (2006) on the use of life review/life story books had more favourable results than Ito et al’s (2007) research. Haight et al’s (2006) work included 31 participants with dementia living in care homes who were randomly allocated into either a life story group run by a member of staff from the care home, or a control group who received no new treatment.
The life story sessions consisted of once weekly hour long sessions over 8 weeks (Haight et al 2006). Sessions focused on the completion of a life story book for each participant, which was created through the use of Haight’s (1988) Life Review and Experiencing Form (see appendix 2) which includes specific questions designed to trigger memories and discussion about participants’ past experiences. Each week was themed around a different phase of participants’ lives and memories, and life story books were built up using photographs (Haight et al 2006).
Haight et al (2006) used a number of standardized assessments to gather participants’ scores pre and post intervention which were used as outcome measures, the primary outcome measures used were the MMSE and Cornell Scale for Depression in Dementia. The following assessments were used as secondary outcome measures: Alzheimer’s Mood Scale, Communication Observation Scale and Memory and Behaviour Problems Checklist.
After analyzing pre and post assessment scores and comparing these with the control group scores, Haight et al (2006) found that participants in the life review/life story groups had significant improvements in depression, communication, mood and cognition. Taking these findings into consideration, Haight et al (2006) concluded that the use of life review and life story books is a justifiable and effective brief intervention for people with mild to moderate dementia, highlighting the additional benefits of the activity as the fact that it is a relatively low cost and low risk intervention to deliver.
There are some limitations to Haight et al’s (2006) research; the study includes 31 participants which is a relatively small sample size, as Aveyard (2014) explains, a smaller number of participants can have a negative impact on the validity of research results. In addition, Haight et al’s (2006) study used a ‘treatment as usual’ control group where the control group members had no new intervention. Subaramaniam and Woods (2012) argue that using a control group who are also receiving a new intervention can provide more reliable and impactful results as any argument that positive results may have been obtained following participants’ participation in any new activity is addressed.
One of Haight et al’s (2006) further conclusions was that more research into the use of life review and life story books is required, an opinion that is shared by many researchers in the field. Morgan and Woods (2010) completed a study during which participants with dementia took part in 8-12 weeks of life review/life story book sessions, and drew similar conclusions to that of Haight et al (2006). Morgan and Woods (2010) write that their research indicated that participation in life review groups had a positive effect on participants’ cognition and mood, but that further research is essential to fill the gap in knowledge of how effective the intervention is.
Parker (1995) explains that life story books originated in the field of childcare, but that the intervention has a place in the care of people with dementia. Parker (1995) goes onto argue that in order to maintain continuity and cope with the present and future, it is important for people with dementia to reflect on and address past experiences and memories.
Reflecting on the available literature, it is clear that reminiscence therapy has an important role to play for people with dementia and can be a very effective brief intervention (Haight et al 2006). Benefits associated with the intervention include the fact that it can be developed with relatively low cost and when delivered appropriately should not cause unnecessary stress or distress (Haight et al 2006). When justifying the use of reminiscence therapy for people with dementia, it is important to note that the research in the area is fairly limited, with a large number of studies having been completed with small participant numbers (Subramaniam and Woods 2010). The intervention certainly has never been found to cause harm to people with dementia, but it is not garunteed to be effective for all (Subramaniam and Woods 2010). As with any therapeutic intervention, it is important to assess each individuals’ needs, desires and preferences to ensure that participation in reminiscence therapy will be an enjoyable and beneficial experience prior to introducing it (Ito et al 2007).