Reminiscence is a method in dementia care that focuses on facilitating recollection about past events and experiences with persons living with dementia. This recollection creates opportunities to improve the wellbeing of persons with dementia, and for family and caregivers to meaningfully connect with them.
Reminiscence focuses on the discussion of activities, experiences, and events from the past. It is often referred to as “reminiscence therapy”, which is an umbrella term for different approaches to engage people in reminiscence for therapeutic purposes.1,2
It is often done with older persons, including those with dementia and depression, and nearing the end of life.1
Memory and dementia
How can persons living with dementia, who experience memory loss amongst other symptoms participate in activities that focus on the act of remembering, as the word “reminiscence” suggests?
Though the ability to form new memories weakens (i.e. anterograde amnesia), persons living with dementia still retain a weakening but still-existing ability to recall and use existing memories.
This includes the use of:
- Semantic memory (“general knowledge”)
- Episodic memory (memories of events)
- Procedural memory (memory for learnt skills that work like muscle memory, such as singing, walking, or brushing teeth), and
- Autobiographical memory (memory for personal, self-relevant events).
This means that there is a bank of memories that persons living with dementia have and can still tap on as they participate in activities.
History of Reminiscence Therapy
Aims of Reminiscence Therapy
The aim of a reminiscence activity varies with the profile of the individual or group participating (e.g. age, health conditions), and the type of reminiscence work done.
Facilitators of reminiscence activities can also tailor their activities according to the specific goals of the person it is being done with (e.g. a person living with dementia and/or their caregiver) and the personnel conducting the activity.
Potential aims include the enhancement of communication skills, to increase a sense of personal or narrative identity11, have an enjoyable social activity, improve mood and quality of life, stimulate memories. Reminiscence can also be done to make care more individualised,2 which aligns well with the aims of person-centred care.
Caregiver-related aims include: relieving caregiver burden, improving caregiver mental health, an improvement in caregiver loneliness, and improving the relationship between person living with dementia and the caregiver.
It is possible, though not guaranteed, that the achievement of some outcomes has ripple effects on other outcomes as well. For example, a person living with dementia who is encouraged to perform skills that they frequently engaged in during their earlier years may experience an increase in self-esteem, which may improve their mood and behavioural outcomes.
Evidence for outcomes
At present, there is emerging evidence that reminiscence therapy has the potential to improve some outcomes for persons living with dementia, including quality of life, communication, cognition, and mood.1,2
Components of Reminiscence Therapy
Frequently used components included:
- Memory triggers: The use of materials such as audio or visual programmes, images, sentences, or memorabilia to prompt a person to recall memories
- Themes: A focus on themes such as food, music, pop culture, or places, during the activity.
- Life stages: An exploration of the participant or participants’ life stages.
- Reality Orientation: Prompting participants to understand their present reality, including their physical surroundings and time.
- Activities: Activities for participants to participate in during the reminiscence session.
- Family-only sessions: Sessions involving family members.
The benefits of the above components were compared across five outcome domains (cognition, mood, behaviours, quality of life, caregiver-related outcomes, and communication). It was found that, across the studies surveyed:
- Memory triggers, and to a lesser degree themes, were found not to be consistently beneficial
- The component “life stages” was linked to benefits in mood, quality of life, and caregiver-related outcomes
- The component “activities” was linked to benefits in the behaviour of the person living with dementia, and caregiver-related outcomes
- Family-only sessions was a beneficial component of reminiscence work for caregiver-related outcomes
Who can facilitate reminiscence work?
Reminiscence therapy is currently facilitated by trained care personnel from a variety of professional backgrounds, including health and social service practitioners.2
Concerns about the use of Reminiscence
Though reminiscence has its benefits, it should also be facilitated with care.
Painful memories: Recall of past events may involve the recollection of traumatic or painful memories (e.g. wartime memories, memories from difficult personal events). It is important that care personnel review the life history of the person living with dementia to facilitate activities with sensitivity.
The difficulty of recalling memories: Due to the increasing difficulty of persons living with dementia to intentionally recall memories, they might feel discouraged when experiencing such difficulties during reminiscence activities.
It is important that questions facilitators ask are open-ended and exploratory, instead of close-ended and test-like. When questions are phrased this way, it is easier for participants to recall memories relevant to the conversation topic as the scope of discussion is much wider than with a close-ended question. With this lower barrier to participation in the conversation, participants may feel more encouraged to participate.
Handling life reviews with sensitivity: Reviewing one’s life comes with appraising the meaning of past seasons of life. This can be challenging, even when done in private.
When a life review is done collaboratively with loved ones or care personnel, a person must take the additional steps of articulating their thoughts to others, while trusting others that they can be vulnerable and honest about their private thoughts and feelings. It is important that care personnel be sensitive and gentle in handling such conversations.
Conclusion
Reminiscence is a useful tool in dementia care. It can increase the wellbeing of persons living with dementia and their family by providing a means of engagement, while also presenting a meaningful opportunity for persons to meet their need to evaluate their lives.
Reminiscence components can be incorporated into other activities as well. Read about reminiscence-based activities and reminiscence arts to find out more about how reminiscence may be incorporated and adapted into activities.
Tell us how we can improve?
- O’Philbin, L., Woods, B., Farrell, E. M., Spector, A. E., & Orrell, M. (2018). Reminiscence therapy for dementia: an abridged Cochrane systematic review of the evidence from randomized controlled trials. Expert review of neurotherapeutics, 18(9), 715-727.
- Macleod, F., Storey, L., Rushe, T., & McLaughlin, K. (2021). Towards an increased understanding of reminiscence therapy for people with dementia: A narrative analysis. Dementia, 20(4), 1375-1407.
- Butler, R. N. (1963). The life review: An interpretation of reminiscence in the aged. Psychiatry, 26(1), 65-76.
- Erikson, E. (1959). H. (1950), Childhood and Society. New York, 2.
- Pinquart, M., & Forstmeier, S. (2012). Effects of reminiscence interventions on psychosocial outcomes: A meta-analysis. Aging & mental health, 16(5), 541-558.
- Pam Schweitzer – Dementia Care Projects with Reminiscence. Retrieved 22 August 2022, from http://www.pamschweitzer.com/dementia.html
- Haight, B. K. (1979). The therapeutic role of the life review in elderly. Master’s thesis, University of Kansas.
- Morgan, S. (2000). The impact of a structured life review process on people with memory problems living in care homes. Bangor University (United Kingdom).
- Haight, B. K., & Burnside, I. (1993). Reminiscence and life review: explaining the differences. Archives of psychiatric nursing.
- Akanuma, K., Meguro, K., Meguro, M., Sasaki, E., Chiba, K., Ishii, H., & Tanaka, N. (2011). Improved social interaction and increased anterior cingulate metabolism after group reminiscence with reality orientation approach for vascular dementia. Psychiatry Research: Neuroimaging, 192(3), 183-187.
- Heersmink, R. (2022). Preserving narrative identities for dementia patients: Agency, active environments, and distributed memory. Neuroethics, 15(8).