Reminiscence Therapy and
Legacy Work with Older Adults
and their Caregivers
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Gerontology
A Training Resource
By Jim Messina, Ph.D., CCMHC, NCC, DCMHS-T
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Reminiscence Therapy with Older Adults
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Reminiscing is when someone shares memories from the past. Typically, with Alzheimer’s and dementia, people lose short-term memory first, but are still able to recall older memories. The goal of reminiscence therapy is to help older adults with dementia feel valued, contented, and peaceful. It can’t reverse or stop the progression of dementia, but the stress reduction and positive feelings can improve an older adult’s mood, reduce agitation, and minimize challenging behaviors like wandering (Assistedliving.org, 2022).
Benefits of reminiscence therapy for dementia Reminiscence therapy can give older adults with dementia a feeling of success and confidence because it’s something they’re still able to do. It gives them an opportunity to talk and share something meaningful rather than just listen. Talking about happy memories of the past also brings joy, which is especially helpful if older adults are having a hard time with everyday life – it helps them cope with stress.
The difference between reminiscing and remembering Reminiscing is not the same as asking someone to remember something from the past. Remembering something specific, even from long ago, can be stressful for people with dementia because they’re likely to feel pressured or put on the spot. In contrast, when a pleasant memory floats up and they share it with, they’ll feel good. For example, an older adult might not remember right away when asked even a simple question like “Where did you grow up?” But if looking through old photographs with older adults, they might spontaneously say “Oh look, there’s my house. My mom baked my favorite cookies every Saturday – chocolate chip. They were so good.”
(adapted from DailyCaring, 2019)
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4 reminiscence therapy activities
Memories can be associated with different parts of the brain, so it’s helpful to try activities that stimulate different senses. This is the time to use one’s imagination and get creative.
1. Listen to their favorite music
Music helps people reminisce and relate to emotions and past experiences. That’s why it’s often recommended for those with Alzheimer’s or dementia. Music can even reach older adults with very advanced dementia. You can play their favorite songs, have a little sing-along, or play music on simple instruments like shakers, bells, tambourines, or a do-it-yourself drum.
2. Look through photos or keepsakes
Pictures or keepsakes that bring back memories are another excellent way to reminisce. Photos of family, friends, and important life events are always good choices. Photos of things that remind them of favorite hobbies are also great. For example, someone who loves to garden might enjoy looking at a gardening magazine or plant catalog. Someone who loved to cook might like a gourmet magazine with beautiful food photos. The same goes for sports, crafts, historical events, etc.
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3. Smell familiar scents and taste favorite foods
Smell is a powerful way to access memories. You could create scent cards or jars with smells that remind them of favorite foods (use spices) or a location like a pine forest near their childhood home (use fresh pine needles or pine scented sticks).
Taste is another way to evoke fond memories. Maybe they always made a special dish for holiday celebrations – the facilitator could make it for them and reminisce while eating together. Or maybe the facilitator could recreate a favorite snack they made for as a treat when their children were young.
4. Enjoy tactile activities like painting, pottery, or other crafts
Touch can also remind someone of the past. Familiar tactile activities like drawing, painting, pottery, knitting, sewing, or other crafts can spark old memories. Even if they can’t participate in these hobbies anymore, doing things like touching paintbrushes, swirling watercolors, scribbling with drawing chalk, squeezing yarn, or playing with fabrics can evoke strong memories. Another way to use touch is through objects. Maybe wearing or handling favorite pieces of jewelry or accessories (like a watch or a necklace) would bring up memories of significant life events. Other ideas would be to bring out a significant piece of clothing (maybe a dress or suit) that they used to love or wear to important events. (adapted from DailyCaring, 2019)
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What is Reminiscence Therapy?
Psychiatrist Robert Butler created reminiscence therapy (RT) in 1963 to help treat the primary symptoms of dementia – memory loss and loss of cognitive abilities. Reminiscence therapy “targets the “reminiscence bump,” a term psychologists used to describe the time span most easily recalled by middle-aged and older adults, typically between teenage years and early adulthood. Caregivers of older adults can be taught to use this therapy with loved ones with dementia.
Reminiscence therapy uses all senses to help individuals with dementia remember events, people, and places from their past. This type of therapy is also useful for people diagnosed with Alzheimer’s and Parkinson’s disease as well as other illnesses caused by brain disease.
Reminiscence therapy works because it taps into memories that have been repeated and revisited on multiple occasions over many years. With the right triggers, these memories can be recovered and revisited. The smells of a favorite recipe or the sound of a favorite song can create wonderful memories. RT is also referred to as life review therapy and integrative reminiscence.
(Choosing Therapy at: https://www.choosingtherapy.com/reminiscence-therapy)
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How Does Reminiscence Therapy Work?
Reminiscence therapy engages both the patient and the caregiver, includes all the senses, and uses both verbal and nonverbal communication. It can be a hands-on experience for all involved and it’s often important to use “props.”
Be cognizant of time frames and use materials from the “reminiscence bump.” For example, if a person is born in 1950, find materials from the 1960’s thru 1970’s for maximum impact. Try to tap into the patient’s previous hobbies or interests.
Here are possible RT activities:
- Watching old movies
- Going through family photos and pictures
- Listen to old music; sing along
- Read poetry or a passage from a book
- Cooking old recipes
- Smell specific flowers or scented candles
- Garden, knit, or participate in woodworking
- Use a weighted Alzheimer’s/Dementia blanket to tap into tactile skills
(adapted from Choosing Therapy at: https://www.choosingtherapy.com/reminiscence-therapy/)
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How to engage an Older Adults in Reminiscence Therapy
In terms of conversation, avoid asking short term questions (e.g., “What did you have for breakfast?) and yes/no questions. Instead, use open-ended comments or questions. Be non-judgmental, empathetic, and aware that when memories return it will create a variety of emotions that may be both good and bad. Use redirection if a patient appears upset. Listen carefully, smile, and ask questions. Sit close to the patient so they can see your reactions, and speak in a clear, calm voice.
Example topics you can ask about using reminiscence therapy include:
- Food and holidays
- First jobs, best jobs, working conditions, bosses, colleagues, etc.
- Children and old housework
- Favorite shops/shopkeepers, markets, and significant places from their community (e.g., town square, library, or post office)
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Benefits of Reminiscence Therapy
Brain based diseases like early onset dementia can accelerate the process of memory loss and subsequent identity loss in younger people. Researchers have discovered that the power of reminiscence therapy is that new pathways in the brain form as the individuals recall the past.
As people age, they sometimes start telling the same story repeatedly because it reflects a time in their life that had great meaning and made them feel good about their identity. They could also remember stories that evoke painful memories about events that were never resolved or had painful personal consequences. Reminiscing often signals that they’re trying to settle unresolved issues on a conscious or unconscious level.
Reminiscence therapy can be done anywhere, so as people transition from home to different levels of care it can continue to be used in valuable ways and provide consistency for patients.
Reminiscence Therapy:
- Improves mood and some cognitive abilities
- Improves well-being and behavior in patients with dementia
- Creates intimate moments between caregivers and the loved one
- Creates less stress for caregivers
- Helps alleviate depression and can have a calming effect
- Provides a renewed sense of identity
- Helps alleviate caregiver stress
- Creates feelings of self-worth, confidence, purpose, and identity
- Decreases isolation and promotes socialization
(Cotelli, et al., 2012 and Woods, et al., 2018)
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How To Structure Reminiscing Sessions For Older Adults
Overview of what is Reminiscing (https://www.goldencarers.com/pdf/3184/ )
- Reminiscing is an important activity for everyone. No matter their age all people cherish their happy memories and enjoy talking about them.
- Reminiscing is a familiar activity; all people reminisce at one time or another - even a young child will sometimes say: 'when I was a baby'. Sometimes busy people like to remember when they had few responsibilities; others love to talk about 'the good old days’.
- Reminiscing refers to the casting of one's mind back to times gone by; to being nostalgic about happy experiences in their lifetime.
- Reminiscing is a wonderful way for aging seniors to feel a sense of purpose, especially those living with dementia.
- Experts in the field of aging say that as people age, reminiscing takes on a greater significance. There are many advantages to reminiscing with the elderly in residential care facilities.
Here are just a few of the many benefits from reminiscing in small groups for aging seniors
- Promote sociability
- Improve staff's 'person-centered' awareness
- Impart wisdom through sharing experiences
- Promote self-understanding
- Validation of personal life stories
- Build coping mechanisms
- Meaningful and enjoyable interaction
- Promote communication and creativity
- Opportunity to form new friendships
- Therapeutic for people suffering from depression
- Helpful in times of crisis and mourning
Reminiscing can be Casual or Formal (https://www.goldencarers.com/pdf/3184/ )
Formal: Videos, movies, slides, diaries, journals, Life Review (structured reminiscing) and pictures.
Casual: Questions & Answers, Themes, storytelling, feeling textures, touching objects.
Reminiscing sessions can be conducted one on one, in groups or with family.
1.One on one session:
A casual visit to older adults is an opportunity to reminisce about a theme of their choice or from a conversation you start. If during a room visit, look around at pictures or objects inside the room to start the conversation. Allow the older adult to talk at their pleasure and listen attentively; let them take you where they want to go. Older adults may say things to you they don't tell their families. One on one
reminiscing promotes communication and strengthens rapport with older adults' helpers.
2.Group Session:
One of the best ways to promote social contact in a residential setting is by matching people with similar interests into small groups; 3 to 4 people and holding regular sessions to develop trust and rapport. The focus of reminiscing can be an event, an era, past lives, themes such as 'spring' or 'Pets' or 'Favorite Toys'.
3.Family session:
Photos and videos are excellent sources for reminiscing as are cherished objects and handmade items from the past. Feeling textures such as embroidery and patch work can also be very stimulating.
How to develop a successful reminiscing group for older adults
(https://www.goldencarers.com/pdf/3184/ )
- Conduct the group in a room or a verandah where participants are not distracted by noise.
- A table with a group of participants; preferably composed of males and females.
- A theme or a list with prompting questions to start the conversation.
- Ask questions directed to all participants and allow ample time for participants to answer.
- Don't interrupt them; it may be that someone else will add a comment or volunteer a different point of view.
- Be sensitive; don't put participants in a position where they may reveal things they don't want to.
- Be supportive of those who repeat themselves; guide them gently to focus on something else by asking another question.
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How To Structure Reminiscing Sessions For older adults (more at: https://www.goldencarers.com/)
- Reminiscing sessions should last 45 to 60 minutes (more if they are having fun, less if they lose focus).
- Weekly group meetings with the same participants is one option.
- "Lend your ears'; listening to someone talk about what is important to them is very beneficial to their self-esteem.
- Use humor whenever you can.
- Bring props and other paraphernalia if the session calls for it. For example: Weddings - veil, wedding gown, bride magazines. Cooking - old utensils, rolling pin, potato peeler, strainer
Themes for Reminiscing
- School Days Reminiscing
- Best Recipes
- I Remember my Father
- Fishing Trips (for men)
- Sewing Kits (for ladies)
- The Depression Era
- Best Holidays
- Your first rock concert (for baby-boomers)
- Summer Reminiscing
- Spring Reminiscing
- Beach Reminiscing
- The Early Days of TV
- Favorite Toys
- Winter Reminiscing
- The best birthday you ever had
- Dancing days
Life Review Reminiscing Activity
- Reminiscing should focus on pleasant memories but sometimes the person may recall unhappy memories which can upset them.
- A 'Life Review' is a structured review of one's life from the earliest memories to the most recent memories.
- Life Review is a process by which you can help people overcome issues from the past. And most aging seniors are significantly more satisfied with life after a Life Review session. This is true for both people living at home and those in residential care facilities.
- The Life Review process helps people to deal with traumatic events from the past.
- Therapists who work with aging seniors are perfectly capable of conducting Life Review sessions
(more at: https://www.goldencarers.com/)
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Reminiscence Therapy Manuals and Activities
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Reminiscence Therapy References
Woods, B., O’Philbin, L., Farrell, E.M., Spector, A.E., & Orrell, M. (2018) Dementia and Cognitive Improvement group. Reminiscence Therapy for Dementia. Cochrane Database System, Cochrane Library. doi:10.1002/14651858.CD001120.pub3 Retrieved at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494367/
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Legacy Work with Older Adults
There is a real need in today's mobile society when families get spread apart all over the country to create links to one another so that the lessons learned in Aging Adults' Lives can be shared with their children and their children's children so that their personal legacy is respected and honored. This section contains a presentation and directions on how to share one's legacy with their family. It is has been inspired by the Last Lecture of Randy Pausch which was published in April 2008.
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The Last Lecture: An Example of Sharing One's Legacy with Loved Ones
Randy Pausch had an incredible ability to develop a "Last Lecture" which would become a treasured legacy not only for his wife and children of his wonderful brilliance, generosity, humanitarianism, and love of life but an outstanding example for us all of the need to record our own "Last Lecture" for our loved ones.
Before we begin reading the instructions on how to go about writing your own Last Lecture please take the time to watch Randy's Last Lecture which is available on youtube at: https://www.youtube.com/watch?v=ji5_MqicxSo
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Directions for Your Last Lecture Script-Sharing Your Legacy
So you and/or your caregivers are ready to prepare your Last Lecture! Congratulations! You are doing yourself and your family members a wonderful gift with the time it will take to complete this project.
Step 1: Gather the following before you and/or your caregivers begin to write your script:
1. All the pictures you have collected over your life time so that you can sort out the most important ones to include in your Last Lecture Album. Be sure you have the approximate date the pictures were taken and who are the people in the picture so that you can chronologically and accurately place and label the pictures in album.
2. All of the family videos or movie pictures you have collected over your life time so that you can include in your Last Picture Album those which most accurately reflect the message you want to give in your Last Lecture.
3. All Artwork (or pictures of the artwork) which have had meaning to you over your life time. You might even want to do some artwork to include in this section of your Last Lecture Album. It is amazing what wonderful emotions and lessons can be shared through the medium of art!
4. All Music which had definite meaning for you in your life time like: Songs played at your family weddings, parties, events, etc. This includes songs from your favorite artists and from concerts and shows you might have seen which have a real message for you, which you want to share with your family.
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Step 2: Brainstorm and collect the following details before you and/or your caregivers begin to write your script:
1. Birthdates of your parents, grandparents, aunts and uncles and great-grandparents (If you can get them)
2. List of significant dates in the life of your family beginning with the wedding dates of your grandparents and your own parents
3. Geographic locations where your parents’ families were raised along with the geographic locations where you lived your life from birth to present
4. List of schools you attended by date, place and the year you moved or graduated from the school
5. List of jobs you have held since you started working to present:
6. Brainstormed list of transitions you have experienced in life and what helped or would have helped to make these transitions go smoothly and successful for you such as:
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Graduation from high school and either going to college or getting a job
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Graduation from college and getting a job
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Moving permanently out of your family’s home
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Moving from one job to another
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Moving into a new community
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Getting Married
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Getting divorced
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Having children
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Seeing your children make the same transitions in life you did
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Retiring from full time employment
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Letting go of loved one who have died
7. Brainstormed list of the significant people in your life and why they were significant to you including your:
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Spouse(s)
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Parents
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Grandparents
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Aunts
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Uncles
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Cousins
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Teachers
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Spiritual Guides
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Friends
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Associates at Work
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Children
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Other (be specific)
8. Brainstormed list of cherished memories you have experienced with these different people during your life time
9. Brainstormed Lists of some "Significant Things" from your life:
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What you are most proud of in your life?
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What you most regret in your life?
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If you could have changed certain things in your life what would they be?
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What you are glad happened in your life even though at the time you wished it had not happened?
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What you always wanted to accomplish or experience but never had the time, money, or ability to accomplish or experience?
10. Brainstormed list of lessons you have learned in your life
11. Brainstormed list of values and beliefs which have guided you over your life time
12. Brainstormed list of people you have come in contact with over your lifetime who hurt you and whom you have forgiven or now want to forgive
13. Brainstormed list of hopes you have for your family members to realize in their own lifetimes
14. Brainstormed list of blessings which you wish for your family members over their own lifetime
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Step 3: You and/or Your Caregivers Now can write your script following this outline:
1. History of your family going back to your grandparents
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Background of all of your grandparents and parents
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Cherished memories and stories
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What lessons you learned coming from this family
2. Your personal history
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Describe the Family you were raised in
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Schools attended and what you learned from each school
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People you encountered in your school years and the impact they had on your life
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Cherished memories and stories about the people you encountered
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What lessons you learned from your school days
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Jobs you held
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People you met on your jobs
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Cherished memories and stories about the people you encountered
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What lessons you learned from your jobs
3. Your history of making transitions in your life
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Advice you want your family members to have on how to make successful transitions in their own lives
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What you have learned about what works and does not work in handling life’s transitions
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What steps you hope your family members will take when they face transitions in their life which mirror the transitions you have experienced in your own life
4. Values and beliefs which directed your life
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How these values and beliefs have guided your life
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What values and beliefs you wish your family to acquire and carry on
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What was the upside to you maintaining your values and beliefs in life
5. Lessons you have learned in life you want to share with your family
The lessons learned from:
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tragedies
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mistakes
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errors of judgment
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accidents
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hard knocks of life
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other (be specific)
6. Regrets for past decisions and/or actions
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What are those things in the past for which you have regrets and how this has influenced you and the twists and turns of your life
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What is your advice to your family regarding holding on to regrets over personal decisions and/or actions in their past
7. Who and what you now forgive for real or imagined hurts
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Who did something for which today you forgive this person and what you believe would have happened if you had forgiven this person earlier in your life
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Who is it that did something unintentionally which felt hurtful to you for which you held on to resentment and now are ready to forgive and what you believe would have happened if you had forgiven this person earlier in your life
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What is your advice to your family regarding the need to forgive people who have done real hurtful things to them or to those who they believe have been hurtful if not by intentional action but unintentionally
8. Your hope for the future for your family
9. Blessings and messages of Love with which you want to end your lecture
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Let your family members know how much you love them and care about them
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Let your family know that you want the best for them for the rest of their lives
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Let your family know that through this your Last Lecture that they will blessed by having this message to turn to whenever they might need a reminder or mid-course correction in their lives
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Step 4: How to Use the Script of Your Last Lecture
1. Use the script for a video you create in which you talk to your family sharing them Your Last Lecture
2. Use the script to create a PowerPoint which contains your Last Lecture which you use when you have your family members over to see what you have created for them
3. Use the Script to make an audio tape or podcast to share with your family
4. Print the script out as book which goes along with the album and video collection you have made in this process
5. Use all of the above methods to share your Last Lecture with your Family Members
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References
Alvarez, L. (2005). Farewell with Love and Instructions. New York Times: Oct. 6, 2005
Baines, B. K. (2006). Ethical Wills-Second Edition. Cambridge, MA:
Da Capo Press
Baines, B. K. (2001). The Ethical Will Writing Guide Workbook. Cambridge, MA: Josaba Ltd.
Byrne, R. (2006). The Secret. Atria Books: New York
Elgin, D & Ledrew, C.(2001). Living Legacies: How to Write, Illustrate, and Share Your Life Stories. Berkley, CA: Conari Press Books
Lemng, M.R. & Dickinson, G.E. (2007). Understanding Dyining, Death & Bereavement, Sixth Edition. Thomson-Wadsworth: Belmont, CA
McKenry, P.C. & Price, S.J. (2005). Families & Change: Coping WIth Stressful Events and Transitions. Sage: Thousand Oaks, CA
Pausch, R. & Zaslow, J. (2008). The Last Lecture. New York: Hyperion
Russert, T. (2004). Big Russ and Me Father and Son: Lessons of Life. New York: Hyperion
Russert, T. (2006). Wisdom of Our Fathers Lessons and Letters
from Daughters and Sons. New York: Random House
Scott, B. (2006). Leaving a Legacy. News-Herald.com, April 19, 2006
Siegel, J. (2003). Lessons for Dylan: From Father to Son. New York: Public Affairs
Spence, L. (1997)A Step by Step Guide to Writing Personal History. Athens, OH: Swallow Press/Ohio University Press
Randy Pausch Related sites:
Randy’s Last Lecture video: https://www.youtube.com/watch?v=ji5_MqicxSo&t=2s
Click here for: Transcript of Randy's Last Lecture
Randy’s Time Management Lecture: https://www.youtube.com/watch?v=oTugjssqOT0
The Last Lecture Website: http://www.cmu.edu/randyslecture/
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