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Many families of dementia patients have experienced the joy that reminiscing can bring their loved one. My grandad would fondly recall every detail of his swims in the Maltese waters as a young boy, and his marriage to his beloved ‘sweetheart’, my grandmother. Many scientific advances have been made after observations and anecdotes such as these.

It comes as no surprise then that reminiscence therapy has been deeply explored for dementia. Reminiscence therapy aims to help people with dementia recall and re-experience historical life events via physical prompts such as photographs, music, and videos (Redulla 2020). This therapy is reported to improve mental wellbeing, slow disease progression, and support restoration of autobiographical memory (Cammisuli et al. 2022). The therapy is practical and cost-effective, as it can be implemented in nursing homes with relative ease. The therapy also yields better patient outcomes than medications typically prescribed for the psychiatric symptoms of dementia (Cammisuli et al. 2022). In older people with dementia, there have been documented improvements in social withdrawal, communication, and blood flow to the frontal lobe, involved in cognition, post-reminiscence therapy (Cuevas et al. 2020).  The therapy can also support acceptance in patients of their condition and help them to find meaning in life, in turn improving depression symptoms.

Reminiscence therapy can be delivered in various ways, including ‘Simple reminiscence’, ‘Life review’, ‘Life review therapy’ and ‘Life story work’ (Macleod et al. 2021). Simple reminiscence involves the patient recalling past events and memories, often used in group settings. Life review is a structured evaluation of life events, usually 1:1. Life review therapy reframes negative life experiences in a postive way. Life story work involves working with the patient to compile their life events, like a biographer. Life story work typically involves the creation of a life story or memory book tailored to the patient, which serves as a prompt for later therapy sessions. Family sessions can also add value to the therapy; they foster improved relationships between family members (Macleod et al. 2021).

Though many people living with dementia have less experience of technology, the use of personalised digital memory books for reminiscence therapy in dementia has also proved successful in improving social withdrawal symptoms and quality of life. This shows that the effect of reminiscence therapy relies on the use of the patients’ own memories and narrative, not the way they are communicated, allowing a flexible approach (Cuevas et al. 2020). Sensory stimulation is particularly effective at prompting recall in elderly patients, such as the smell of a loved one’s perfume or tasting a meal from childhood.

The type of intervention, session content, leader and duration are not standardised across providers, which currently limits our understanding of how effective reminiscence therapy really is (Saragih et al. 2022). We don’t know which method of therapy delivery works best. It is likely the optimal therapy delivery will vary in different patient populations as well (e.g., type and stage of dementia). However, a recent review of reminiscence therapy found it is most effective in mild-moderate Alzheimer’s Disease when performed weekly in small groups for an average of 45 mins over 8-12 weeks (Cuevas et al. 2020).

There are still more questions to be answered before we fully comprehend the effectiveness of reminiscence therapy. Nevertheless, we can feel empowered that a simple photo, phrase, or song can bring so much hope and joy to our loved ones.

References:

Cammisuli, D.M. et al., 2022. Effects of Reminiscence Therapy on Cognition, Depression and Quality of Life in Elderly People with Alzheimer’s Disease: A Systematic Review of Randomized Controlled Trials [online]. Journal of Clinical Medicine, 11(19). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9570531/ [Accessed 8 November 2023].

Cuevas, P.E.G. et al., 2020. Reminiscence therapy for older adults with Alzheimer’s disease: A literature review [online]. International Journal of Mental Health Nursing, 29(3), pp.364–371. Available at: https://onlinelibrary.wiley.com/doi/full/10.1111/inm.12692 [Accessed 8 November 2023].

Macleod, F. et al., 2021. Towards an increased understanding of reminiscence therapy for people with dementia: A narrative analysis [online]. Dementia (London, England), 20(4), p.1375. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132012/ [Accessed 8 November 2023].

Redulla, R., 2020. Reminiscence Therapy for Dementia [online]. Issues in Mental Health Nursing, 41(3), pp.265–266. Available at: https://www.tandfonline.com/doi/abs/10.1080/01612840.2019.1654572 [Accessed 8 November 2023].

Saragih, I.D. et al., 2022. Effects of reminiscence therapy in people with dementia: A systematic review and meta-analysis [online]. Journal of Psychiatric and Mental Health Nursing, 29(6), pp.883–903. Available at: https://onlinelibrary.wiley.com/doi/full/10.1111/jpm.12830 [Accessed 8 November 2023].