Barbara K. Haight

Life review : Preventing despair in newly relocated nursing home residents short- and long-term effects

Relocation to a nursing home places frail elders at risk for developing depression and suicide ideation. This study followed two hundred and fifty-six newly relocated nursing home residents for five years. Using a Solomon Four research design, participants were divided into four groups, two control and two experimental, one each with pretesting and all with posttesting. Participants in the control groups received a friendly visit and those in the experimental groups received the intervention of life review. Immediate short-term results showed the life review to be an effective preventive intervention for clinical depression (p = .05). Additionally, when looking at long-term effects at one year, there were significant decreases in depression (p = .05), hopelessness (p = .01), and psychological well-being (p = .02) with measurable increases in life satisfaction (p = .08). These findings support the hypothesis that life review prevents despair in frail elders newly admitted to a nursing home.

The extended effects of the life review in nursing home residents

To date, there is little information on the therapeutic effects of the life review beyond one year. This analysis followed fifty-two of 256 subjects who lived for at least three years in a nursing home. These participants received either a life review or friendly visit and took part in four repeated testings to determine the lasting effects of the life review at two and three years. Measures of integrity (life satisfaction, psychosocial well being, self-esteem) and despair (depression, hopelessness, and sucide intent) were used as pretest, posttest, and retest. Results showed a trend toward continued and by year three significant improvement over time in those who received the life review on measures of depression (t = −2.20, p < .03), life satisfaction (t = 2.51, p < .02), and self-esteem (t = −2.31, p < .03).

Reminiscing: The State of the Art as a Basis for Practice.

This integrated review presents the state of the art in reminiscing and life review as derived from a review of the literature from 1960–1990. Reports, reviews, and research are categorized and critiqued with the purpose of clarifying the use of reminiscing for practice. Out of ninety-seven published articles describing reminiscing, only seven report negative outcomes; the remainder are either positive or nonevaluative. As a result, the author concludes that clinicians should use reminiscing in their practice, and researchers should continue to define the variables that lead to successful reminiscing.

Reminiscence and life review: Explaining the differences

Although the terms reminiscence and life review continue to be used interchangeably in the literature, they are separate interventions. This article describes the differences, similarities, and commonalities in these two nursing interventions by highlighting differences in goals, theory base, the nurses role, and the clients role. The implementation process and the desired outcomes are also differentiated to move forward nurses understanding of these two important nursing interventions.

The Northern Ireland life review/life storybook project for people with dementia.

There are few interventions that help people with dementia retain or regain a sense of self. Thus, a controlled pilot study examined a life review/life storybook intervention, delivered by familiar care assistants to 30 people with dementia residing in assisted living facilities in Northern Ireland. A multivariate analysis of covariance showed significant change by group (F = 5.01, p < 0.014), particularly on depression (F = 7.54, p < 0.015), communication (F = 23.36, p < 0.005), positive mood (F = 9.47, p < 0.008), and cognition (F = 20.77, p < 0.005), suggesting a potentially promising technique to assist people with dementia.

Reminiscence and Life Review: Therapeutic Interventions for Older People

Gerontological literature in general, and gerontological nursing literature specifically, does not clearly differentiate two important therapeutic interventions for older people: reminiscence and life review. However, practitioners often implement both interventions in a variety of settings. Because of the confusion regarding the interventions, this paper explains the differences between reminiscence and life review, and offers protocols to improve the effectiveness of both interventions. The three protocols include one-to-one reminiscence therapy, group reminiscence, and one-to-one life review.

Examining Key Variables in Selected Reminiscing Modalities

This study examined the underlying variables of selected reminiscing processes to determine those that contributed to well-being. Two hundred and forty subjects randomly selected from nursing homes and high-rises participated in one of 10 different reminiscing modalities for eight weeks. Measures of life satisfaction (LSI-A), psychological well being (ABS), self-esteem (SES), and depression (BDI) were given pre- and postintervention to determine the most therapeutic treatment modalities. Results showed the most therapeutic way to reminisce was through a structured, evaluative life review performed on an individual basis. Thus, three variables contributed to successful reminiscing: individuality (one-to-one reminiscing), evaluation (a personal valuing of events), and structure (covering the whole life span).

Snoezelen®: A Multisensory Environmental Intervention

Snoezelen is a multisensory intervention delivered in a specially designed room with high-tech instruments. It is especially useful for end-stage patients with Alzheimers disease. Snoezelen provides an enabling atmosphere in a failure-free environment. It has been a popular intervention in Great Britain and is just beginning to appear in the United States.

THE EFFECT OF AURICULAR ACUPUNCTURE ON PSYCHOPHYSIOLOGICAL MEASURES OF COCAINE CRAVING

This study used a randomized pretest/posttest control group design to test the effectiveness of auricular acupuncture interventions in diminishing psychological and physiological changes associated with cocaine craving in 30 treatment-seeking cocaine-dependent patients. The experimental group received the real auricular acupuncture intervention, insertion of needles into ear point locations specifically targeted for drug withdrawal. The control group received sham or placebo auricular acupuncture, insertion of needles into ear point locations not targeted for any specific therapeutic benefit. Psychological (Cocaine Craving Questionnaire - Now) and physiological (skin conductance activity) changes associated with cocaine craving were measured. Results showed no differences between the control and the experimental group in diminishing psychological and physiological measures associated with craving. There were differences from pre- to posttest on measures of psychological but not physiological craving for the combined experimental and control groups.

AIDS IN OLDER PEOPLE

Older Americans, 50 years of age and older, account for 10% of the 400,000 reported cases of AIDS nationwide (Centers for Disease Control and Prevention, 1994). the integrated literature review format in this article examines the published literature on HIV/AIDS in older adults. Most articles are case studies and reports, with only 17% having a research basis. The information reviewed indicates that older adults have different risk factors than younger populations for contracting HIV disease and a different pattern of disease progression. These differences create a need for knowledge of HIV infection and AIDS and its parameters in aging populations so nurses may provide both timely and appropriate care.