Reynolds GET-IT Program SAGE Program Session 1 Life Reminiscence as a Clinical Tool Insert Picture Adapted By: Maureen Dever-Bumba, DrPH (c); USC Sarah Schumacher, DO; USC Original By: Kay F. McFarland, M.D.; USC Donna R. Rhoades, Ph.D.; USC Ellen Roberts, MPH, Ph.D.; USC Edited By: Maureen Dever-Bumba, DrPH (c); USC Nancy A. Richeson, M.D.; USC Sarah Schumacher, DO; USC Joshua T. Thornhill IV, M.D.; USC Jennifer Heffernan, M.D.; UNTHSC Adapted from the University of South Carolina Senior Mentor Program 11/11 Reynolds GET-IT Program Life Reminiscence CM-IV SAGE Program LIFE REMINISCENCE AS A CLINICAL TOOL Goal: You will understand the benefits of life reminiscence and patient-centered interviewing when assessing psychosocial issues, spiritual beliefs, and health perceptions in older adults Session Competencies: Attitudes The student will be able to: 1. Appreciate when and why life reminiscing may be of value to healthcare professionals and older adults Knowledge The student will be able to: 1. Discuss the role of communication skills in patient-provider satisfaction 2. Describe the psychosocial and developmental stages that are associated with older adults 3. Discuss the role of life reminiscence in treatment of depression in older adults Behaviors and Skills The student will be able to: 1. Take, read and interpret a blood pressure and pulse 2. Communicate effectively using active and reflective listening 3. Utilize patient-centered interviewing to conduct a brief clinical life reminiscence. Equipment/Material to Take to the Interview 1. White coat and nametag 2. Blood Pressure Cuff, Stethoscope 3. Senior Mentor/Client Signature/Blood Pressure Card (SAGE card) 4. Senior Mentor/Client Life Reminiscence Discussion guide 5. Instructions 6. MOW parking placard Instructions to Students: Summary and Background: Sometimes we remember because our memories have been triggered involuntarily by a favorite song or tune and sometimes we remember on purpose. Reminiscing gives us a pleasure and a sense of relatedness and connection with what has gone before. Reminiscence allows us to relive events from our past. It is a process which focuses on the personal way we experience and remember events, rather than on chronological or historical Adapted from the University of South Carolina Senior Mentor Program 11/11 Reynolds GET-IT Program Life Reminiscence accuracy. When we reminisce we don’t simply recall random events in a cold factual way. With reminiscing we are able to relive the experiences that are personal to us in a way that is vivid and engaging. Reminiscing encourages older people to become actively involved in reliving and sharing their past with others. Although reminiscence involves recalling past events it encourages the elderly to communicate and interact with a listener in the present. Involving an older person in reminiscing has many benefits for that person. Some of these benefits are: Increase the ability to communicate and practice self-expression. Increase social interaction through the sharing of experiences. Increase feelings of belonging and togetherness. Emphasize the individual identity and unique experiences of each person. Allow the older people to take on a teaching role through the sharing of their experiences. Help people to come to terms with growing older. Encourage creativity. Increase self-worth and provide a sense of achievement. Reduce apathy and confusion, especially in confused or disorientated people. Alleviate depression. Life Reminiscence is different than a related tool, life review. Life review focuses on broad themes like family history, accomplishments, and turning points. This requires that people have the ability to review their life, to select the most important events, to summarize them and find a meaning in them. For some people this may be too complicated. In the life reminiscence, explicit and narrowly focused themes are selected and more structure is given during the interaction. Steps for Module: Step One: Read the article below along with the Senior Mentor/Client Life Reminiscence Discussion Guide at the end of this Session: o Morgan, A. (2003) Psychodynamic Psychotherapy with Older Adults. Psychiatric Services . Vol. 54 No. 12 Step Two: Visit your senior mentor/client. Introduce yourself as a healthcare professional student from UNT Health Science Center in Fort Worth. Thank your senior mentor/client for participating in your education. Inform them that you are not their physician/healthcare professional and you cannot give any medical advice. Ask if your senior mentor/client has any questions before you get started. Begin the session by taking your mentor’s blood pressure. Don’t forget to record it on the blood pressure card and your senior mentor’s/client’s blood pressure log. Have your senior mentor/client sign and date your card. Adapted from the University of South Carolina Senior Mentor Program 11/11 Reynolds GET-IT Program Life Reminiscence Step Three: Choose 2-4 possible themes or areas that you think you will concentrate on during this interview. Possible themes and approaches are listed later in the instructions. Think about how these themes may relate to developmental stages, tasks, or difficulties in later life. Involve the mentor in the final choice for starting point. Step Four: Conduct a brief (1/2 -1 hour) life reminiscence with your mentor/client using a patient-centered interviewing approach (active listening). Step Five: After the interview, reflect back on the experience. Address the following student questions below. Assignment Due Date: 72 hours after senior client visit. This assignment is to be submitted electronically to Blackboard. The following are to be posted on blackboard for your faculty mentor to review: POST UNDER “ASSIGNMENT” TAB 1. The date and time you visited your senior mentor/client 2. Client’s blood pressure and pulse 3. Summarize the story that your mentor/client told. 4. What were the main issues or topics that surfaced during the interview? How do they relate to the developmental stages, tasks, or difficulties in this mentor’s/client’s later life? 5. What problems or difficulties did you encounter in conducting the interview with your senior mentor/client? How did you handle them? 6. What were your mentor’s/client’s reactions to the interview? 7. What insights were derived from the life interview by your mentor/client? 8. What did you do best when listening to the mentor/client? How could you improve your listening and/or integrative skills? 9. How might this exercise be helpful to you as a healthcare professional? 10. What other comments would you like to make about this session with your mentor/client? Adapted from the University of South Carolina Senior Mentor Program 11/11 Reynolds GET-IT Program Life Reminiscence REMEMBER TO HAVE YOUR SENIOR MENTOR/CLIENT SIGN YOUR SAGE CARD FOR THIS VISIT Senior Mentor/Client Life Reminiscence Discussion Guide 1. Ask evocative questions rather than those requiring only a yes or no answer. Encouragers: Tell me more. Where did that lead? How did that affect or influence you? What meaning does that have for you? 2. There will be some topics that will not work. Some sensitive issue cannot be approached even when trust is developed. You may be the wrong age or sex. That is okay, just expect it. 3. Take a low key approach. This helps ease both you and the mentor/client into the interview role. 4. Show interest through body language but don’t crowd. Interject remarks, take part in the conversation but don’t take over. Learn to be a good listener. 5. Know what questions you want to ask, but don’t be afraid to let your informant go off on a tangent. Getting back on track: “Before you told me about this or that we were talking about so and so. Can you tell me how so and so was affected when? 6. If you need to write down questions, put them on note cards (one or two to each card). 7. Use props whenever necessary. 8. Be sensitive to the needs of the mentor, they may tire easily especially with emotional topics Adapted from the University of South Carolina Senior Mentor Program 11/11 Reynolds GET-IT Program Life Reminiscence Brief Life Overview Approach . What is your first memory of life (or one of your significant first memories) . Tell me about your family history (genealogy): who were your grandparents, where did the come from, what did they do for living, what kind of people they were? If you knew them personally, what kind of relationships did you have with them? Are there any powerful memories you have of them? How are you similar/ different with your grandchildren? . Same for parents (and siblings) . Tell me about the values you absorbed in your family of origin. How did you learn them? What values you decided to transfer to your own family? How did you teach them? . Significant life events: Talk about living in your parent's home, meeting your partner (if both partners present each one can tell his version), moving away from home the first time, first job, first child, exciting moments in raising the kids, first great loss, retirement…. Can you talk about your philosophy of life- What are the values that are most important to you? What kept you going and hoping during difficult times? . What is your personal legacy to the significant people in your life? What way do you want them to follow in the future? Potential Themes for Discussion I was born My mother Family life My father Sundays My brothers and sisters Toys and treats Other relatives Christmas day First memories Favorite food My