An exploratory study into the use of Reminiscence Therapy amongst people with dementia and their caregivers in Ireland.

Treena Parsons - School of Social Work & Social Policy Trinity College , DublinPhD Candidate Living with Dementia Programme

The Dementia Services Information & Development Centre Ireland

IntroductionBehaviours that challenge and the non-cognitive symptoms of dementia, such as agitation, anxiety, delusions and mood changes can be particularly distressing for people diagnosed with dementia and their family caregivers and it is thought that up to 90% of people with Alzheimer’s Disease have such symptoms (Robert et al, 2005). Where there is no immediate risk of harm, non-pharmacological treatments should always be the first intervention (Royal College of Psychiatrists 2005) and amongst the most popular of these interventions is Reminiscence Therapy (RT). Defined in simple terms, as involving the discussion of past activities, events and experiences, usually with the aid of prompts (Woods et al 2005), RT has been shown to be associated with improvements in cognition, communication skills, mood and well-being (Woods et al 2005). It has also been linked to a reduction in caregiver strain and to improvements in staff motivation (Gibson 1994). RT is a very flexible intervention. It can be planned or spontaneous and can be carried out with individuals or in groups. RT can involve talking or writing and include the use of prompts such as photographs, music or historical items. RT can result in an end product such as a life story book or collage but it does not necessarily have to deliver an end product.

The Irish context

It has been estimated that approximately 38,000 people in Ireland are living with some form of dementia (O’Shea 2007). In common with many other countries today, population aging in Ireland means that there will be a very significant increase in numbers of people presenting with dementia. For example, by 2026, it is estimated that there will be 70,115 people with dementia in Ireland (O’Shea 2007).

Whilst it is known that RT is used as a therapeutic intervention with people with dementia in different settings across Ireland, to date there is an absence of research undertaken on the topic. We therefore have very limited knowledge in the Irish context about how Reminiscence Therapy is delivered and how people with dementia and their caregivers experience it.

Design and MethodsThis is a qualitative study which will draw on phenomenological theory . A multiple-case study method is being used, with cases chosen to reflect the diverse range of care settings and modalities in which RT can be delivered. Methods of data collection include (i) simple observation and (ii) semi-structured interviews with the person with dementia and their formal and informal caregivers. The data will be analysed using meaning condensation (Giorgi 1985, Kvale et al 2009), which will result in the essential themes emerging in a descriptive statement. The study’s findings will yield new and original insights into how RT is delivered and experienced in Irish care settings and the usefulness of RT as an therapeutic intervention in the care of people with dementia.

Work Carried out to date Literature Review

Methodology

Ethics Approval

Sample recruitment & access established

Interview schedules designed

References

Gibson, F. (1994). What can reminiscence contribute to people with dementia? Reminiscence Reviewed: perspectives, evaluations, achievements. J. Bornat. Buckingham, Open University Press.

Giorgi, A. (1985). Phenomenology and Psychological Research. Pittsburgh Duquesne University Press.

Kvale, S. and Brinkmann (2009). Interviews: learning the Craft of Qualitative Research Interviewing. Thousand Oaks, Sage Publications Inc.

O'Shea, E. (2007). Implementing Policy for Dementia Care in Ireland: the Time for Action is Now, Alzheimer society of Ireland.

Royal College of Psychiatrists.(2005). Forgetful but not forgotten: assessment and aspects of treatment of people with dementia by a specialist old age psychiatry service. London,

Robert, P.H. et al, (2005). Grouping for behaviour and psychological symptoms in dementia: clinical and biological aspects. Consensus paper of the European Alzheimer Disease consortium. European Psychiatry; 20; 490-496

Woods, B., A. Spector, et al. (2005). "Reminiscence therapy for dementia." Cochrane Database of Systematic Reviews 2005(2).

Aim of the studyThis exploratory study aims to provide a better understanding of the role of RT in Dementia care in Ireland and to examine how RT is delivered by care providers and how it is experienced by people with dementia and their family caregivers in a variety of different care settings

  

Sample (N=9)