The beginnings of the 1997 blockbuster movie, Titanic, hinged on the recollection of the main character Rose, as she was asked if she was “ready to go back to the Titanic?”. Though not literally, Rose was invited by the researchers to go on a reminiscence journey with the artefacts savaged from the ill-fated passenger liner that sunk, just like unravelling a time capsule.

Though not all of us have the privilege to be part of a historic event, many of us do enjoy an occasional dose of reminiscence when we attend class gatherings or bump into childhood friends as we spontaneously reminisce our past collective history. Senior social worker Angela Chung shares more on the benefits of reminiscence therapy and how she used it to support seniors attending the day care programme at SPD@Toa Payoh.

What is Reminiscence Therapy?

Reminiscence therapy (RT) is a popular psycho-social intervention in dementia care, which uses a variety of memory triggers to stimulate past memories.

As seniors grow older, especially those living with dementia, they may find themselves losing their short-term memory but are often able to recall older ones i.e. long term memory. Hence, RT uses the senses like sight, sound, touch, taste, to help seniors recall events, people and places from the past.

Therefore, using old photographs, treasured keepsakes as well as old movies and music can be a good way of stimulating fond thoughts in the seniors.

Benefits of Reminiscence Therapy

The act of sharing memories from the past forms the basis of RT, which can be useful in reducing negative emotions experienced by persons living with dementia (PLD). RT could help them to feel valued, contented and peaceful through recollection of pleasant memories. Talking about happy memories of the past brings joy, which is especially helpful if the senior is having a hard time with everyday life.

The positive feelings that result can decrease stress, reduce agitation as well as other challenging behaviours in dementia such as wondering and anger. Therefore, RT is recommended as a non-pharmacological intervention in managing behavioural and psychological symptoms of dementia (BPSD).

In addition, RT could give seniors a feeling of success and confidence because they can still participate in this activity. It gives them an opportunity to talk and share something meaningful rather than just listen to others speak. As such, the act of collective sharing of memories could create opportunities for caregivers to connect with the seniors.

Evidence of Reminiscence Therapy

There is a robust body of evidence supporting the efficacies of RT. An article by Gonzalez, Mayorodomo, Torres, Sales & Melendez (2015) espoused that RT reduces depressive symptoms and increases psychological well-being. An article by Subramaniam & Woods (2012) also echoed that RT led to uplifting of mood and increased well-being in general. They also emphasised on the need for individualised or personalised reminiscence approach that catered for specific needs, preferences and interests. Overall, the use of RT and other psycho-social interventions revealed that seniors showed behavioural improvement in communication and social interaction with others (Cotelli, Manenti & Zanetti, 2012).

Piloting Reminiscence Therapy Group Work

Backed by the strong evidence behind the effectiveness of RT, I piloted a reminiscence group work for five seniors at SPD@Toa Payoh Senior Day Care Centre in February to March this year. The pilot RT group work consisted of four weekly 1-hour sessions on the following themes:

The memory triggers which I used in the pilot RT groupwork were primarily visual and music triggers. Among the many reflections I had when running this RT group work is harnessing the power of music of their era to evoke collective memories. The seniors from the groupwork were relishing with joy as their favourite music of their era was played. Some were seen waving their hands and even a senior who has knee issues was seen dancing spontaneously to the rhythm of the music! Music is evidently a powerful stimulus for reaffirming personal identity and social connectedness in individuals with dementia (R., Devere, 2017).

One of the heartwarming observations I had was the third session on Special Skills. Often, many seniors I spoke with at our day care programme have low self-esteem with a pervasive low opinion of themselves. They often commented that they are not educated, illiterate, and had lowly paid jobs. But one of my goals for the RT groupwork was to amplify their strengths, resources, assets, and resiliencies that they had to cope with life demands and challenges in their earlier years. Here are some of the individualised strengths and abilities shared by the seniors during the session on Special Skills.

In our present times, such skills may not be highly valued by society. But I wanted the seniors to know that they possess the grit and resilience that had enabled them to live through the tumultuous period of nation building and not having to rely on the conveniences brought on by technological advances. As the group facilitators presented on the seniors’ skills and abilities during the group session, the nods, laughter and comments from the participants were an acknowledgement of their long-forgotten survival skills. It validated the earlier observation, and I was glad this session had helped them to rebuild their sense of self that may be fractured through functional losses brought on by ageing and various health ailments.

The RT group work would not have come to a successful fruition without the help and support by our SPD volunteers – Ms Susan and Mdm Ong. Their passion for the seniors and proficiency in dialects such as Hokkien make them effective facilitators as the seniors enjoyed interacting in their native dialects.

Feedback from Participants

Feedback was obtained from the seniors in the form of visual triggers which make for easy recollection later. Participants wrote their feedback on paper leaves which formed the Tree of Memories. The seniors have commented that they enjoyed the group interactions and felt happy to have friends to chat and laugh with. Some shared that they have learnt a lot through the sessions, while others felt an increased sense of self-worth.

Conclusion

Buoyed by the positive feedback from the participants, we will continue to run RT group work in our day care programme to augment our programming. Besides RT group work, it is our hope that our seniors could embark on various forms of RT through life reviews and life story books, so that they could improve on their autobiographical memory and enhance their experiences in SPD.

Finally, may this quote by Frederick Buechner inspire us to embark on a continuous journey of collective reminiscence at our Senior Day Care Centre – “for as long as you remember me, I am never entirely lost”.

References

Cotelli, M., Manenti, R., & Zanetti, O. (2012). Reminiscence therapy in dementia: A review: Elsvier, 203-205.

Gonazalez, J.,Mayordomo, T., Torres, M., Sales, A., & Malendez, J.C. (2015). Reminiscence and dementia: a therapeutic intervention.International psychogeriatrics, 27(10), 1731-1737.

Subramaniam, P., & Woods, B. (2012). The impact of individual reminiscence for people with dementia: systematic review.

Expert review of neurotherapeutics, 12(5), 545-555.

Woods, B., O’Phibin, L., Farrell, E., Spector, A., & Orrel, M. (2018). Reminiscence therapy for dementia (Review).Cochrane Database of Systemic Reviews, 1-110.

Devere, R., MD (2017). Music and Dementia : An Overview