Maximizing the Power of Life Stories: Benefits to Communities that are Beginning or Continuing Their Culture Change Journeys

For thousands of years, people from diverse cultures around the world have passed on their traditions, beliefs, and advice through the telling of stories. These stories have achieved the following:

• explained lessons of life
• how to survive in difficult circumstances• why things have happened the way they have
• and offered tales of great adventure, tragedy, or love.

In addition to the wisdom passed down, we now know that reminiscence and life review is a proven way for older adults to gain self worth, learn more about themselves, and give the gift of their stories to the next generation. Recalling life stories should be encouraged at any juncture in one’s life, but primarily as people reach end of life.

There are a number of studies that have shown that reminiscence and life review affects people’s lives in extraordinary ways. We will explore some of the outcomes from those studies.

Reminiscence and Culture Change Work Hand in Hand

Studies have shown that elder communities see remarkable results when reminiscence and life review is encouraged.

Increases Life Satisfaction

With female nursing home residents, a study randomly assigned participants to a reminiscence group, current events discussion, or no treatment group. The results showed significant increases in life satisfaction in the reminiscence group.

Improves Resident/Staff Relations

Nursing home residents were interviewed with and without staff present and in either a reminiscence/life review format or a format more focused on the present time. The attitudes of residents toward staff improved with reminiscence and with the staff’s presence at interview.

Reduces Geriatric Depression

Newly relocated nursing home residents underwent a study to examine if life review could prevent clinical depression. Significant positive results were shown in reducing depression at the short-term testing stage with an additional decrease in depression and hopelessness at one year.

Decreases Disorientation, Improves Social Interaction

A study demonstrated it is possible for older people with dementia to reminisce and that this is meaningful for them in particular, because of the losses associated with dementia. Another related case study used life review with groups of people with Alzheimer’s disease. They were assigned to groups with some participating in life reviews and others did not. Results showed significance for life review groups in decreased disorientation and improvement in social interaction.

Increases Orientation, Competence After Relocation

A case study examined the use of a life review program with newly-relocated nursing home residents and it was found to decrease depression, while increasing orientation, perceived competence, and social interaction.

Increases Sense of Purpose and Meaning

After group therapy with older adults in long-term care setting over an 8-week period, this study found that the two treatment groups were significantly different from control group showing increased sense of purpose and meaning in their lives.

Is the Telling of Life Stories Key to Human Development?

Noted psychologist Erik Erickson examined human development by looking at the conflicts we face at each stage of life.

In Middle Adulthood (40s and 50s), we are most concerned with Generativity (vs. Stagnation). Generativity, when it is developed, is the establishment and nurture of the next generation. Through stories, we help the next generation know what matters most and seek the best for their lives. There is a concern and commitment to family that’s passed on. Storytelling is vital for building generativity.

In Later Adulthood (60 years-74 years), Erickson documents the psychosocial crisis as Ego Integrity (vs. Despair). Ego integrity is the ego's accumulated assurance of its capacity for order and meaning. Despair is signified by a fear of one's own death, as well as the loss of self-sufficiency, and of loved partners and friends. At this stage, the central task for people to pursue is introspection because they must decide what will make their lives fulfilling and come together in a community. This stage can result in a development and sharing of wisdom—especially through storytelling.

In Later Adulthood, we’re concerned with life but facing the fact that death will come. According to Erickson, people in this stage of life should have new intellectual challenges and take on new roles and activities. Writing one’s autobiography fits the bill by providing that challenge but also giving them a chance for the necessity of introspection. Through life review, they may also decide, “What’s my next pursuit?”In Old Age (75 Years-Death), the psychosocial crisis is Immortality (vs. Extinction). This phase is focused on reflecting back on life. In this phase of life, Erickson cites the positive outcomes of life review, accepting death with a sense of integrity and without fear. Those who are successful in this phase do review and feel proud of their accomplishments and have a strong sense of integrity. Those who are unsuccessful during this phase will feel that their life has been wasted and will experience many regrets—leading to bitterness and despair. The developmental task, according to Erickson, is to cope with the physical changes of aging while seeing the “big picture” of life. Through reflection, individuals will see and know their own wisdom.

What the Experts Say...

• Dr. Robert Butler, author of Why Survive? Being Old in America, coined the term “life review” fifty years ago. Before that time, researchers and physicians saw reminiscence as just a stepping stone toward senility and dementia. He disagreed with this belief and proposed that, as people age, reminiscence and life review were a normal part of healthy aging. Now large bodies of research show the positive outcomes from reminiscence and life review.

• Dr. Gene Cohen, author of The Mature Mind, sees reminiscence as a critical brain activity and he recently remarked, “Autobiography for older adults is like chocolate for the brain.” Cohen cites a 2003 study by Eleanor Maguire and Christopher Frith that performed brain scans on people in their 70s and in their 30s while they were reminiscing. The found that the entire hippocampus is “lit up” in older adults, while 30 year olds only utilize one small part of the left hippocampal region.

• Dr. Andrew Weil, author of Healthy Aging, encourages older adults to keep a record of wisdom, values, and life lessons in an ethical will, or heartfelt letter to loved ones. He writes, "An ordinary will … concerns the disposition of one's material possessions at death. An ethical will has to do with nonmaterial gifts: the values and life lessons that you wish to leave to others…At critical points in your life, take your ethical will and read it over. Add to it. Revise it and share it with people you care about. An ethical will helps you organize your own experience and focus on who you are. It's a spiritual inventory about what you want to pass on to others." Life stories can lead to a letter from the heart.

SOURCES:
Webster, Jeffrey & Haight, Barbara. Critical Advances in Reminiscence Work. Springer Publishing. (2002)
Weil, Andrew. Healthy Aging. (2005)