Marie A. Mills

Nostalgic memories in dementia ― a case study

The literature indicates that some moderately to severely demented elderly people can still recall their emotionally subjective past. Emotion and cognition have a relationship that can be clearly seen in the recall of nostalgic memories. This article outlines a case study that illustrates how emotional autobiographical memories of past events can be stimulated through the individual use of reminiscence and counseling skills. The authors suggest that there are possible therapeutic effects attached to this approach and that this is an area worthy of further investigation.

Spiritual belief and quality of life: The experience of older bereaved spouses

Spiritual wellbeing is a neglected aspect of quality of life in British research on ageing. US research emphasises the health and other benefits of religious belief for American older people. However, whereas the US is still a strongly religious society, in Britain there has been a steady erosion of membership of Christian churches, accompanied by a loss of respect for the authority of the church and an increased freedom of expression in belief. In an exploratory study the implications of spiritual belief for adjustment have been studied in a sample of 28 older bereaved spouses, who have been followed from the first to the second anniversary of the death. Using a recently developed measure of strength of spiritual belief, a clear pattern was found of greater depressive symptomatology and lower perception of personal meaning among those of moderate belief; ie those who still held to a belief in a spiritual power outside of themselves but who were not sure of its efficacy. Investigation of this group of 11 moderate believers provided many illustrations of spiritual questioning, uncertainty and unease. It appears likely that a substantial proportion of the older population in Britain has become isolated from their churches of origin, yet maintains forms of spiritual belief, often hesitant in character. Some may benefit from renewed contact. Statutory health and welfare agencies need to consider their own role in promoting such re‐engagement.

Memory, mood and dementia: A case study

Abstract Patients who require long term care for moderate to severe dementia are commonly assumed, by definition, to have poor recall of past events. This article outlines a case study which illustrates how memories for past events can be stimulated tghrough the use of counseling skills. It also highlights the potential therapeutic effects of recalling emotionally charged events, even when these memories are predominantly sad. Recommendations based upon these findings include the establishment of a social history for each patient in order to promote reminiscence and discussion, and the use of counseling techniques to encourage self-disclosure.

In sure and uncertain faith: belief and coping with loss of spouse in later life

ABSTRACT This paper reports a study of the religious, spiritual and philosophical responses to spouse bereavement. Twenty-five bereaved spouses aged 60 or more years living in the south of England and from Christian backgrounds were followed from the first to the second anniversary of the loss. The participants expressed a range of attitudes, from devout religious belief to well-articulated secular conceptions of the meaning of life, but the largest group had moderate spiritual beliefs that were characterised by doubts as much as hopes. Uncertain faith was more often associated with depressive symptoms and low levels of experienced meaning. Nine case studies are presented that illustrate different levels of adjustment to bereavement and both changing and stable expressions of faith across the one year of observation. Attention is drawn to the importance of both secular agencies and religious organisations developing a better understanding of older peoples spiritual responses to loss. Although to many British older people, practise of the Christian faith may be less evident now than in their childhood, quality of life assessment should not ignore sources of spiritual satisfaction and dissatisfaction. Moreover, previous and especially early-life religious experiences provide useful points of reference for understanding present religious and spiritual attitudes. The study suggests that there may be a substantial need for pastoral counselling among todays older people, especially those of uncertain or conflicted belief.

Caregiving in Dementia: From Resentment to Forgiveness

The spiritual aspect of dementia care needs more attention. Caring for a person with dementia inevitably puts at times unreasonable demands upon the family carer and arouses many negative emotions, especially resentment. In this article we discuss how the Christian concept of the person is based upon relationship and that family relationships may need to be sustained from within the larger community as dementia increases in severity. We present examples of recent individual and group focused initiatives that we have piloted in Hampshire, UK, which have aimed to help dementia caregivers in transcending their feelings of hurt.