Leading Reminiscence Groups

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LEADING REMINISCENCE GROUPS

TECHNIQUES AND TIPS

Juliette Shellman, APRN-BC, Ph.D.

GROUP WORK WITH ELDERS

Therapeutic Uses

Ventilation and Validation of Feelings

· group participation helps to validate and affirm feelings and

experiences of older adults

· interactions with peers who express similar concerns/emotional reactions encourages the group members in their efforts

to cope with adverse life events

· feeling heard, understood, and accepted are major building blocks

to self-esteem in older adults

RELATING TO EMOTIONAL TONE IS OFTEN MORE IMPORTANT

THAN FOCUSING ON CONTENT

REMINISCENCE

· reminiscence in a group helps the members share past experiences, explore disappointments, and come to new

perceptions about themselves

· reviewing past coping skills encourages members to deal with frustrations and adapt to change

· in an institutional setting this activity will become better acquainted with each other and possibly encourage more

social gatherings between the group members

· loss of loved ones and lack of social ties often leads to depression,

low self-esteem and feelings of worthlessness – this activity is

designed to assist the members to develop a sense of belonging,

and promote self-esteem and self-worth by hearing music from

past and associating this music with positive life-experiences,

Group Leader Techniques

The Environment

· seating around a table where members of the group can see each other

· private or semi-private atmosphere will encourage participation

· well-lighted, warm room

· quiet environment with no background noises

· assess hearing/sound before starting the group

· Are clients who wear hearing aids wearing them and are they working properly?

· avoid sitting in front of the window

· position yourself in the center of the circle so that everyone can see you

Promoting Group Interactions

· qualities of a good group leader – facilitator are enthusiastic, imaginative, and have sensitivity to the dynamics of the group

· developing a trusting relationship with each participant so the he or she will feel trusting enough to become involved with the group

· encourage participants to respect privacy, confidentiality is most important

· ask participants to refrain from revealing experiences shared in the group to

members outside of the group

· know all the participants names and use them frequently throughout the sessions

· you may need name tags in the beginning

· your role is to make meaning out of the memories prompted by the music

· the facilitator needs to be aware of the following:

each member should have the opportunity to participate in each session

prevent any participant from dominating the conversation

be firm with people who talk too much, go off the subject or start separate conversations with the person sitting next to them

while participation is encouraged no one at any time should feel pressured

to participate

participants need to feel in control of how much they share

ACKNOWLEDGE EACH CONTRIBUTION MADE

YOU ARE THE ROLE MODEL FOR SUPPORTIVE, ACCEPTIVE ATTITUDES AND MAINTAINING APPROPRIATE BOUNDARIES

STARTING THE GROUP

Set the tone for the group. Review Ground Rules

Introduce yourself and re-explain the purpose of the group. Remember to speak slowly and be sure that everyone can hear you.

Remind the group about confidentiality and that no one has to feel they must contribute to the session if the music brings back a painful memory.

Have participants introduce themselves. Stating their name and it might be a good idea to use an ice-breaker “Tell us a little about the place where you grew up…..” You can start with yourself.

Music clip……..

There needs to be some flexibility here but note the following:

Keep your questions short and open-ended. “I noticed that the song made you feel happy……I’d like to hear you talk about the memory that song brought back to you………”

If someone comes up with the same story repeatedly think about how you can get them to develop the story further. You may be able to ask some detailed question about an aspect of the story. Instead of cutting the person off, gently say, “I remember when you told us that. It must have been a special momemt for you.” The say, “I’d like to hear you talk about…….” Then bring up a different topic.

It is important to pay close attention to the experiences that a participant repeats – there is a reason why they are repeating the story. It could be a very special memory or give you an idea as to what is triggering depression and low self-esteem

Always keep your eyes and ears open – watch for those who fall asleep or wander – is the group going on too long?

Plan a celebration for the last session. Prepare the group a week before for termination. Think of an exercise to help with termination (good wishes exercise). The last session is key to the success of the program and should reaffirm each participant’s life. Send them off with renewed energy and sense of self.

Reminiscence Group Rules

Reminiscence Interviewer Guide

Important things to consider before beginning reminiscence

Determine if reminiscence is appropriate for your client.

agitation, severe anxiety, severe depression, traumatic childhood, cognitive impairment, and severe hearing deficit may preclude reminiscence

Examples of when reminiscence is appropriate.

encourage children to reminisce; it assists them developmentally and with retrieving and reporting skills

encourage mothers to reminisce with children, assists with attachment

reminiscence can help parents and children begin to create a shared history that maintains socials and emotional relationships

terminal illness at any age

early Alzheimer’s disease

to decrease client’s anxiety or depression

to help elders attain a sense of self-worth and life satisfaction

to assess lifetime health habits, cultural patterns, and health behaviors

to identify past coping skills

Gather available data on client prior to interview to assist in strategies for facilitating reminiscence.

married, career, children, illnesses, hobbies, pets, likes, etc/

Interview tips

open ended questions

encourage verbal expressions of both positive and negative feelings of past events

use communication skills such as focusing, reflecting, and restating

inform family members about the benefits of reminiscence

allow time to answer

use direct questions to refocus back to life events if client digresses

acknowledge previous coping skills

rephrase if client doesn’t understand question

if repetition occurs, redirect by asking client to add something else to the memories presented

Examples of questions……..also see reminiscence forms

Begin by saying “Tell me about ……” instead of direct questions

What was really important to you as you look back?

Tell me about growing up in the depression.

Closure of interview process

a few minutes before the time is up indicate closure to refocus the client to present time and place

briefly summarize the interview

thank client for sharing

make another appointment

shake hands or touch client on arm or shoulder

Other Visiting Tips

ACTIVE LISTENING TO CLIENTS’ RESPONSES; THIS IS MOST IMPORTANT NURSING FUNCTION IN REMINISCENCE

Treat all conversations as confidential material.

Be aware of pictures, or other things in their environment that can serve as triggers for reminiscence.

Last week when I was here, I loved hearing about………..

Take responsibility for the direction of the conversation. You can guide it with your questions.

gently redirect if conversation is repetitious or aimless

Let’s get back to how you began your career….

Ask “feeling” questions

Write brief notes about the visit after you leave that can help you review before your next visit.

If you suspect the person is having a serious problem, stop the conversation/

It is important that we

Know the signs and symptoms of grief/severe depression/anxiety

Be a supportive listener

Realize the importance of “presence”, this is especially important when the older

Person is sharing a painful memory

Know the benefit of “silent space’

REMEMBER THAT THE PAST CAN EASE THE PRESENT

References

Haight B. & Webster J. (1995). The Art and Science of Reminiscing: Theory, Research,

and Applications. Washington, DC ; Taylor and Francis.

Link, A. (1997). Group work with elders. Sarasota, Fla; Professional Resource

Press

Sheridan, C. (1991). Reminiscence; Uncovering a lifetime of memories.

San Francisco, Ca; Elder Press