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STUDENT REMINISCENCE RESEARCH TEAM
PROJECT GUIDE
Juliette Shellman, Ph.D., APHN-BC.
University of Massachusetts Lowell
The Effects of Reminiscence on Mental Health and Well-Being in Older Adults
PI - Juliette Shellman, Ph.D., APHN-BC
Research Experience for Undergraduate/Graduate Students
The aim of this program is to provide a mentored research experience for students at any level. As part of this team, you will have the opportunity to:
· conduct research with a faculty member and the research team.
· examine scientific literature and its relevance to older adults, reminiscence, and mental health.
· present your findings at local, as well as possibly national and international, scientific meetings.
· develop skills that will assist you later in your career, whether you choose a career in clinical or academic nursing.
· co-author a publication.
Responsibilities:
The undergraduate or graduate student will be part of a research team composed of master’s students, a Ph.D. student, and the Primary Investigator. The student will be asked to join the Reminiscence Research Team Wiki Page to review previous work, gain an understanding of the research project, and review ideas for new projects. Some of the specific research experiences that I expect the student to have include:
1) Participate as a member of a research team
2) Review pertinent literature related to the program of research
3) Data Collection (Training and Administration).
a. survey and/or reminiscence interviews
4) Attend research team meetings
5) Have an independent project related to the reminiscence program of research
Once the student has been trained, we will discuss options for a project that is related to the program of reminiscence research in older adults. Although this is an independent project, the student will work closely under my supervision. The student will then disseminate his or her work at a conference in the spring and, if possible, participate in manuscript development with the research team. Any contributions made by the student will be cited in the manuscript/poster.
For your role in this reminiscence research project, it will be important that you: 1) take part in meetings and report on your activities, 2) join our wiki page, and 3) complete the activities/responsibilities assigned to you.
Although we are working on the same topic, each of your projects examines a different aspect of reminiscence.
The Meaning and Patterns of Reminiscence Functions in Older Black Adults
Individual and Group Reminiscence Sessions at D’Youville Senior Care Center
Nurses’ Experiences of Reminiscing with HIV Patients at End of Life
We will meet periodically throughout the study for debriefing and training follow-up.
Contributing to the research team:
1) IRB Training Certifications
2) Hourly requirements
3) Upcoming Events:
a. GSA (Nov. 18-22)
b. International Life Review and Reminiscence Conference (Nov. 16-18)
4) Student Research Symposium
5) Monthly Meetings
6) Research journal – Communication – Wiki page
The Big Picture
PRIME
Peer Reminiscence Intervention for Minority Elders
Project Summary
Serious disparities exist in utilization of mental healthcare for older black adults. This proposal addresses the
specific need for culturally tailored preventive mental health programs designed to assist older Blacks to
manage their depressive symptoms and avoid major depression. Our proposed Peer Reminiscence
Intervention for Minority Elders (PRIME) utilizes the strengths of oral traditions of older Black adults as well as
their informal support networks to mitigate the barriers associated with underutilization of mental health
services and decrease depressive symptoms and prevent major depression. Integrative reminiscence, an
intervention that validates life experiences, acknowledges past coping skills, and emphasizes
accomplishments, has been shown to decrease depressive symptoms. Our pilot work demonstrated that an
integrative reminiscence program had a significant, positive effect on reducing depressive symptoms in
community-dwelling older Blacks from an urban area in the Northeast. PRIME builds upon our pilot work with
reminiscence, but adds a community-based participatory approach and the significant innovation of using Peer
Reminiscence Facilitators (PRF) to deliver the intervention. In Phase 1 (Specific Aim #1) using CBPR
principles, we will tailor the PRIME intervention to respond to the mental health needs of the older Black adult
community in a culturally sensitive manner. Focus groups will be conducted with PRF’s from the community to
gather contextual data that will inform the process of tailoring the PRIME intervention in a culturally sensitive
manner. We will then train Peer Reminiscence Facilitators to conduct integrative reminiscence with communitydwellingolder Black adults. In Phase 2 (Specific Aim #2) using a 2 group crossover experimental study we will evaluate the efficacy of the 8 week PRIME intervention on depressive symptoms as measured by the CES-D.Participants will be randomized into the PRIME intervention or health education group. CES-D Score will be assessed at baseline, 8 weeks and 16 weeks. Our central hypothesis, based on our pilot work, is that participants in PRIME will have decreases in depressive symptoms as compared to those receiving health
education sessions. The rationale for this proposed research is that integrative reminiscence has shown to be
an effective method with older adults to address depression and low self-esteem. Using integrative
reminiscence with a culturally tailored approach will decrease depressive symptoms and prevent major
depression thus addressing a significant gap in the provision of mental health services for older Black adults.
The Meaning and Patterns of Reminiscence Functions in Older Black Adults
I. Project Description
The overall purpose of this project is to gather pertinent pilot data for the development of a peer-led reminiscence intervention. Please see Timeline in Appendices.
A. Specific Aims
1) To test the psychometric properties of the Modified Reminiscence Function Scale (MFRS) in a sample of community-dwelling older African-Americans.
2) To describe the functions and patterns of reminiscence in community-dwelling older African-Americans.
3) To test the cultural acceptability and feasibility of a peer-led reminiscence intervention in a sample of older African-Americans.
Faculty Symposium/November Conferences in Boston
Understanding Nurses’ Experiences of the Use of Reminiscence with HIV Aids Patients at End of Life
Nurses use integrative reminiscence to assist patients to come to terms with unresolved conflicts, reaffirm their self-esteem and identity, and increase life satisfaction at end of life. The purpose of this study is to explore nurses' experiences of facilitating integrative reminiscence with HIV patients at end of life. A qualitative study utilizing a phenomenological approach will be employed. Purposive sampling will be used to select nurses with experience caring for HIV patients at end of life.
Data Collection Method: Structured interviews
Sample: Purposive sample of RN’s and APRN’s who have used reminiscence with their HIV patients at end of life.
Research Project Objectives:
1. Conduct literature review to gather background information on the use of reminiscence at end of life.
2. Conduct interviews with RN’s and APRN’s until data saturation
3. Transcribe interviews
4. Poster development
November Conference in Boston
Individual and Group Reminiscence Sessions at D’Youville Senior Care Center
1st Meeting – October 13th 10:30 A.M.
Reminiscence
Background Information
Robert Butler
Erick Erickson
Integrity versus Despair
The challenge of old age is to accept and find meaning in the life the person has lived; this gives the person ego integrity that aids in adjusting and coping with the reality of aging and mortality. Feelings of anger, bitterness, depression and inadequacy can result from inadequate ego integrity.
Reminiscence
Types:
Life Review
How do reminiscence and life review differ?
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/
Assess environment
select quiet, well-lighted room, warm, let client select room
sit directly in front of client, place yourself about 3-4 feet from the client unless HOH
avoid sitting in front of the window
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
Reminiscence - Short Form
1. Let’s begin with you describing your earliest memory. Describe what life was like for you when you were young
2. Describe your family, parents and siblings as you saw them as a child.
3. Was religion important to your family as you were growing up? If so, talk about how it was
important. Has your faith been important to you over the years? In what way?
a. How would you say your religion affects your health?
4. Describe what it felt like the first time you rode in a car, a train, a plane.
5. Did you have any special aspirations or dreams for your life when you were younger? Did they become true?
6. Over the years you have seen many changes in the way people live. How do you feel about
the changes?
What do you like about the changes? What do you dislike about the changes?
7. What change in your life brought about the most pleasure?
8. Do you have any regrets about your life? Describe.
9. What does the word health mean to you? Have you ever been sick? Describe what that experience was like for you and your family. How did you or your family cope with illness?
10. What advice would you give to young people to help them enjoy life more?
11. How do you feel about growing older?
12. Describe your favorite memory.
Supplemental Questions for Conducting Reminiscence
The following are additional questions that may be helpful in conducting a reminiscence. You may want to select questions appropriate to the setting and person you are visiting.
What was it like to leave Europe and come to America? Did that event have any special meaning to you?
What was New Britain like when you were a teenager? How has it changed?
What was the factory like when you started working there?
Was there a special person or group that strongly influenced your early life? What can you tell me about them?
How did your parents meet?
Tell me about the pets you had as a child.
What was the first house you remember like? Describe your neighborhood.
What do you remember about your first boyfriend/girlfriend?
Tell me about your fist job.
What was the most memorable present you ever received?
What was the happiest birthday that you can remember?
Describe your favorite sport memory.
What first attracted you to the person you married?
What kinds of things did you and your spouse face together?
I’m glad that I decided to………
I’m sorry I decided to……….
If you could choose a symbol for your life, what would you pick?
Adapted from making Meaning out of Memories
AARP
References
Adams, K.B., Sanders, S., Auth, E.A.. (2004). Loneliness and depression in independent living retirement
communities: risk and resilience factors. Aging and Mental Health. 8:475-485.
Angst, J., Sellaro, R., & Merikangas, K.R. (2000). Depressive spectrum diagnoses.
Comprehensive Psychiatry, 41, S1, 39-47.
Baker, F. M., Velli, S. A., Freidman, J., & Wiley, C. (1995). Depressive symptoms in African-
American medical patients. International Journal of Geriatric Psychiatry, 10, 9-14.
Bailey, R., Blackmon, H., & Stevens, F. (2009). Major depressive disorder in the African- American population: Meeting the challenges of stigma, misdiagnosis, and treatment disparities. Journal of the American
Medical Association, 101(11), 1094-1089.
Banks, K.H., Kohn-Wood, L.P., & Spencer, M. (2006). An examination of the African-American experience of
everyday discrimination and symptoms of psychological distress. 42(6), 555-570.
Blazer, D. (2003). Depression in late life: Review and commentary. Journal of Gerontology: Medical Sciences,