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Life Review: An Occupational Therapy Intervention

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on 3 December 2014

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Transcript of Life Review: An Occupational Therapy Intervention

Presentation Highlights
Life Review: What is it?


Historical Perspective of Life Review and the importance to the OT profession


Model of practice to guide OTs in addressing Life Review

Presentation Highlights (cont.)
OTPF Link to Life Review and OT intervention

Learning activity to apply Life Review to OT practice

Links to learn more
Learning Objectives
Students will identify the purpose of Life Review

Students will describe three key components of Life Review intervention

Students will illustrate why life review is an effective OT intervention

Students will develop an appropriate Life Review intervention strategy for an older adult

Definition (cont.)
Storytelling of early life experiences to present

Progresses through all stages of life

Not spontaneous or random

Systematic

Life Review Intervention
Psychosocial

Structured or directed participation

Individual Treatment Approach

Group Format with Facilitator Approach

Six weeks or longer

Life Review: What is it?
Definition
Past-oriented thinking and reflecting

Associates with one’s past life experiences

Active evaluation of the past

Participation in reminiscing, storytelling, recalling for therapeutic purposes
(Chippendale & Bear-Lehman, 2012)

Life Review: An Occupational Therapy Intervention Rene’ Wren, OTR/L
Chatham University

Population
Adults

Well elderly

Chronically ill

Terminally ill

End-of-life stage

Benefits
Improves self-esteem

Restores self-worth

Encourages acceptance of one’s life

Increases socialization

Benefits (cont.)
Recovers psychological well-being

Improves quality of life/life satisfaction

Advances over-all health

Used to improve adaptation and self-integration

Facilitate pleasure

Strategies
Oral

Written

1:1 interviews

Group Discussion

Use of Prompts to inspire memories

Strategies (cont.)
The Life Review Guide (Butler, 2009)

Share Your Life Story workshop protocol (Chippendale & Bear-Lehman, 2012)

Stinson’s Protocol for Structured Reminiscence (Stinson, 2009)

Historical Perspective
Life Review as a OT psychosocial intervention

Evidence-based support

Intensive psychotherapeutic relationships: Butler, (1963)

Therapeutic psychopathology properties: Froehlich & Nelson, (1986)


Historical Perspective (cont.)
OTPF 2002: Purposeful intervention for social and mental functions

OTPF 2008: Intervention- Establish, Restore; Outcomes- health and wellness and quality of life; Client Factors-Mental Functions and social demands


Historical Perspective (cont.)
Why OTs are a good fit

Knowledgeable experts at using occupations and occupational roles involving Life Review

Skilled in adapting activities to address specific psychosocial problems

Focuses on the therapeutic use of occupation
(OTPF-3, 2014)

Model of Practice
The Model of Human Occupation (MOHO)

Focus: holistic connection between the mind and the body, motivation, and occupational performance

Emphasis: motivation, patterns of behavior, and performance of daily activities through the context of the environment leading to occupational performance or skilled action, open system cycle emphasizes the person, occupation, and environment, optimizing therapeutic use of self
OTPF Link to Life Review

OTPF-3
Client-centered: people of all ages and abilities require occupation to grow and thrive; in pursuing occupation, humans express the totality of their being, a mind-body-spirit union (S3)

Focus: to ensure that individuals, policymakers, populations, and society value and promote occupational therapy’s practice of enabling people to improve their physical and mental health, secure well-being, and enjoy higher quality of life through preventing and overcoming obstacles to participation in the activities they value (p. 1)


Learning Activity
Case Example :

Mr. Smith is a 79 yo man who recently went to live at a nursing home after living alone in his home for 25 years. He was very upset with his daughter for “forcing him” to live at the NH though he had been falling almost daily at home. Although, he was active in his community at the senior citizens center, since arriving at the NH, he spends most of his day in his room. It is a struggle for the staff to get him to shower and change his cloths. He is often heard talking about earlier times in his life when he was younger. He blames himself for being placed in the NH.


Learning Activity (cont.)
What is the purpose of Life Review as it relates to Mr. Smith?

Why would Life Review Intervention be a good fit for Mr. Smith?

What are three key components of Life Review that you could focus on to benefit Mr. Smith?

Illustrate what effective techniques you would use to get Mr. Smith to talk about his past.

Develop a life review intervention strategy for Mr. Smith that would get him out of his room, make friends, and come to terms with his new environment.


Helpful Links to Learn More
American Occupational Therapy Association: www.aota.org

Gerontological Society of America: www.geron.org

American Psychological Association: www.apa.org


References
American Occupational Therapy Association, (2002). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 56, 609-639.

American Occupational Therapy Association, (2008). Occupational therapy practice framework: Domain and process (2nd ed.) American Journal of Occupational Therapy, 62, 625-683.

American Occupational Therapy Association, (2014). Occupational therapy practice framework: Domain and process (3rd ed.) American Journal of Occupational Therapy, 68(Suppl. 1), S1-S48. doi: 10.5014/ajot.2014.682006


References (cont.)
Bohlmeijer, E., Roemer, M., Cuijpers, P., & Smit, F. (2007). The effects of reminiscence on psychological well-being in older adults: A meta-analysis. Aging & Mental Health, 11(3), 291-300.

Butler, R. (1963). The Life Review: An interpretation of reminiscence in the aged. Psychiatry, 26, 55-76.

Butler, F. (2009). Telling life stories. Journal of Psychosocial Nursing, 47(11) 21-25.


References (cont.)
Chiang, K., Lu, R., Chu, H., Chang, Y., & Chou, K. (2008). Evaluation of the effect of a life review group program on self-esteem and life satisfaction in the elderly. International Journal of Geriatric Psychiatry, 23, 7-10. doi: 10.1002/gps.1824

Chippendale, T., & Bear-Lehman, J. (2012). Effect of life review writing on depressive symptoms in older adults: A randomized controlled trial. The American Journal of Occupational Therapy, 66, 438–446. doi.org/10.5014/ajot.2012.004291


References (cont.)
Froehlich, J., & Nelson, D. (1986). Affective meanings of life review through activities and discussion. The American Journal of Occupational Therapy, 40(1) 27-33

Haber, D. (2006). Life review: Implementation, theory, research, and therapy. International Journal of Aging and Human Development, 63(2) 153-171.

Kielhofner, G. (2008). Model of human occupation. In Cole, M., & Tufano, R., Applied theories in occupational therapy: A practice approach (pp. 95-104). Thorofare, NJ: Slack Incorporated.



References (cont.)
Stevens-Ratchford, R. (1993). The effect of life review reminiscence activities on depression and self-esteem in older adults. The American Journal of Occupational Therapy, 47(5) 413-420.

Stinson, C. (2009). Structured group reminiscence: An intervention for older adults. The Journal of Continuing Education in Nursing, 20(11) 521-528. doi: 10.3928/00220124-20091023-10



How to get started
Choose a Format
1:1 Individual/Therapist
Group Sessions
Choose a Theme
Choose Questions
Example Theme
Example Questions
What was life like for you as a child?
Who were the important people in your life?
Adolescence
Childhood
(Butler, 2009)

(Stevens-Ratchford,1992)
Bohlmeijer et al., (2007); Butler, (2009)

(Chiang et al., 2007); (Bohlmeijer et al., 2006); (Stinson, 2009)

(Haber, 2006)

(Kielhofner, 2008)

(AOTA, 2014)
Full transcript