Uncle Joe recalls the good old days when a Ford coupe was $500, gasoline cost 19 cents a gallon, a postage stamp was three cents, and penny candy was a treat. Grandma Millie tells stories about growing up on the farm and walking three miles to school every day. Alice fondly remembers the days of anticipation before boarding the paddle wheeler for an excursion on the Mississippi River. Everyone frequently reminisces and reviews life. It’s a natural part of people’s lives and is essential to human existence.

“Each time an individual tells part of his/her life story, those who listen are like a mirror, reflecting and affirming their lives.”John Kunz, founder, International Institute of Reminiscence and Life Review.

Reminiscence is a free-flowing process of thinking or talking about one’s experiences in order to reflect on and recapture significant events of a lifetime. We all live in the present, yet we still carry our “past” selves with us throughout our lives. We are part of a rich history that needs to be shared and preserved. The stories we tell about our lives are also important sources of self-identity and enable us to explore and relate our past to the present.

Older people often lose what has defined them: family, spouses, friends, careers, and their homes. They need to remember who they were to help define who they are today. Life review offers a chance to re-examine one’s life, pursue remote memories, recall past events and accomplishments, and seek personal validation. Life review, as a formal concept, is widely used in counseling therapy as people search for meaning, solve problems and strive for emotional resolutions. It also tends to occur when a person is confronted with critical decisions or is faced with the end of their life.

“A man’s most innate need is his need to be significant, to make a difference, to find purpose and meaning.” Author Patrick Morley

Research and demonstration projects involving reminiscence and life review can now be found throughout the world, especially in the United States, Europe and Japan. Recently, the author of this article attended the International Institute for Reminiscence and Life Review. The 7th biennial conference was held in San Francisco and drew together national and international experts in the field to discuss current practice, research and education in a variety of areas. These included the use of reminiscence and life review in music, poetry, drama, personal counseling, mental health, art therapy, hospice care, cross-cultural interactions, oral histories, memoir writing and other autobiographical work.

Initiating Reminiscence:

Remembering the past can bring a new awareness to the present. Memories can be explored in many creative ways that place value on a person’s unique life experience. It can be very helpful at the right moment to say to someone, “Tell me about your childhood,” or ask, “What was it like growing up during the Depression?” Triggers are often used to evoke a memory and are especially useful when working with people who have dementia. The best triggers are those that stimulate our five senses: taste (grandmother’s recipes), smell (aroma of fresh baked bread), touch (textures), sound (music) and sight (photographs). Movements such as those associated with previous work experiences, dance or family rituals can also bring back memories. Reminiscence themes and activities can provide opportunities for social interaction around shared experiences. Examples of themes may include: the childhood home and family, life on the farm, school days, games/activities, fishing and hunting, courtship and marriage, jobs, war years, holiday celebrations and festivals.

Creative memory-making brings memories back to life and can be achieved in a number of ways. Some of the most effective ideas are:

• photo albums/collages, scrapbooks
• art forms (drawing, painting or using clay can be a replacement for words)
• historical items and significant objects (toys, antiques, or clothing)
• drama (acting out short scenes that invite the role playing of past experiences)
• vocal and instrumental music (can lead to memory recall)
• life story work (recorded oral histories about childhood and early life or autobiographies)
• memory boxes (a three-dimensional box that displays personal items to signify one’s life and highlight memories)

All of these creations can generate conversations, valuable recollections and outcomes for the family and the generations that follow.

Reminiscence and Caregiving:

For many family caregivers, life may shift, causing communication and relationships to change. Caregivers of older adults often feel isolated and even overwhelmed with establishing new or different connections with their loved one. Encouraging reminiscence can offer a number of benefits. It provides companionship and helps to overcome the problem of boredom. It improves self-esteem and helps a person to feel recognized as an individual. Since people often remain alone with their memories unless they are tapped, this is an opportune time for caregivers to use reminiscing as a tool to promote communication, encourage self-expression and recollect valuable memories. Ultimately, reminiscing can be a very pleasurable experience for both the caregiver and the person receiving care.

Although no formal qualifications are required to do reminiscence work, the following skills are beneficial, especially with people with dementia:

• Ask open-ended questions that will elicit the sharing of personal stories and experiences
• Listen attentively and show an interest in the past memories that are shared
• Retain what you have heard and make reflective comments
• Empathize and relate in a sensitive way, especially when painful emotions are expressed
• Stimulate the senses and respond positively to both verbal and non-verbal attempts to communicate

“Sharing memories with my wife (who has dementia) has been the first time we have talked on the same level for many years.”“I never knew how my mother lived, until now, through her shared stories.”“I have finally found a new way to communicate with my husband through reminiscing.”Thoughts from caregivers in England.

When health changes affect the care receiver and limit or prevent verbal communication from occurring, there is an alternative way to connect, as in this poignant recollection:

“My mother had a stroke, was bedridden and could no longer speak. I mourned the relationship with her. Then one day I got in bed with her, held her and told her stories and meaningful memories of our life together. Mother cried, smiled, caressed my hand and responded positively to me without a single word. A powerful connection was made between us and I will treasure that day forever.”Shirley, a caregiver from Chicago

Reminiscence and Dementia:

There is a tendency to think of dementia as a “disaster,” a hopeless decline in a person’s memory and a loss of functioning about which nothing can be done. Yet, people with dementia often have a keen ability to recall long-term, personal memories when the details of the present may escape them. Imagine the storehouse of one’s memories as a locked box; its contents accessible only with a key, and that key is hidden in the entanglement of dementia. Perhaps through asking questions, one can make a duplicate key that allows the flow of silent experiences to come forward once again. Reminiscence increases confidence and builds on people’s remaining skills. It concentrates on early memories that remain vivid when recent events fade. It also allows a person to return to a time in their life when they were active, healthy and productive. As a result, the listener can learn more about the life of the person with dementia, which can aid in understanding current behaviors and enhance supportive feelings.

“Reminiscence encourages family interaction which is closer to ‘normal.’ The simple pleasure of recognizing a familiar object or recalling a forgotten melody are rays of sunshine in the fog of forgetfulness.”Reminiscence Group Leader, Finland

While living with dementia can be very isolating and lead to withdrawal, especially from social settings, becoming part of a reminiscence group can be one solution. These groups may be offered by senior centers, adult day programs, assisted living facilities and nursing homes. Caregivers, along with the care receiver, can attend the group together and both engage in sharing stories of the past. By revisiting their joint past, caregivers have the opportunity to re-bond with the person they care for, as well as contribute their knowledge of the person’s life history, interests and accomplishments. This is also a wonderful way for a person with dementia to make new friendly contacts, re-engage in social activities, and find acceptance, respect and understanding.

“Two male group participants had very little language left, but their body language expressed satisfaction and pleasure during the group reminiscence session. Very often they could be seen smiling and humming. Their wives shared that when coming to the group, they were both eager to get into the room and greet everyone.” Oslo Reminiscence Project.

Reminiscence and the Professional Caregiver:

The use of reminiscence can be a worthy addition to staff training in all facilities and organizations that serve older adults. Reminiscing can create opportunities for conversation between staff, clients, and residents and allow more personalized care to take place overall. It can also produce a sense of comfort by connecting people to things that are familiar in the midst of a new environment, such as in this daughter’s shared story.

“My mother’s greatest fear was living in a rest home. Then she began wandering at night, falling, getting lost and mistaking me for people from her past. She was no longer safe, and eventually was admitted to a Memory Loss Unit. She was scared, confused and very difficult for the staff to manage. I was sad and felt I had lost her.

To help staff “know” Mum and to keep her memories alive for her, I wrote out her life story with photos. I enlarged other photos, identified them and put them in a folder. The staff found this very helpful as it gave them things to do with Mum. For example: The staff has learned about Mum through reading her stories. Mum loves her “reminiscence manuals” and her memories are not lost. I found doing these things also helped me get through the first couple of months.

Then came the first Christmas, so Mum’s first Christmas (in the rest home) formed another “manual.” Then, the first birthday at the rest home and so on. I have continued to do these activities and we have one manual of the grandchildren, another of the great grand-children, favorite animals, Mum and the staff and other residents having fun, etc. These are Mum’s latest memories and they will continue.

Ten months have now passed and the manuals continue to grow. If you find yourself in the position I did, I recommend you give the “manuals” a try. Another benefit is that these records and photos are captured for future generations. By sharing the memories with Mum,I realized I had not lost her. How can you lose someone who has her life and happiness sitting in manuals next to her lazy boy, waiting to be shared? And how happy she is when she sees them again (for the first time).” Lesley, caregiver from New Zealand

Reminiscence and Counseling:

Reminiscence is frequently used in counseling therapy. During the process of reviewing life, people often express loss and regret as they look back. Negative or painful events in one’s past may also surface. This has been especially true for veterans, those who have experienced trauma and survivors of the Holocaust.

It is believed that reminiscence can foster personal growth and lead to positive outcomes while the healing of painful memories can occur in the context of a trusting relationship, such as in counseling. One-to-one sessions or group settings are especially helpful and can give people an opportunity to reflect on their lives with an attentive listener or share with others who have faced a common experience. In addition, revisiting or even acting out a difficult experience can help people change perspectives, forgive themselves and others, find closure and put meaning back into past life events. Reminiscence therapy also increases self-assuredness as a person is reminded that he overcame previous difficulties and challenges.

“We can use reminiscence as a way to remind people of past feelings of self-esteem, confidence and competence. By valuing their memories from the past, we show them that they are valued in the present.” Pam Schweitzer, UK

Reminiscence and the End of Life:

Those who face life-threatening illnesses often feel an increased need to explore the meaning of their lives and identify what has been important. Psychologist Erik Erikson suggested that as we approach the end of our days, we need to bring together the strands of our lives. Most people hope to die in a way that is consistent with how they have lived.

As Victor Frankl said, “All of us need to leave knowing the things we’ve done, the things we’ve loved, the things we will leave behind with meaning, and the things we’ve believed in.”

Hospice programs, along with family caregivers, play a vital role in this process by reminding the dying person of the specific good they have done in their lives or recalling the contributions they have made to the family and to society. In the end, the most important thing we need when we die is to have a significant life story. This can be accomplished through journaling, tape recording, celebrating a person’s life prior to death or writing an ethical will, which includes lessons learned in life and the legacy a person wishes to leave behind.

As Henry David Thoreau once said, “The mass of men live lives of quiet desperation.” Reminiscence allows ones thoughts and memories to be stimulated and gives a sense of continuity to the “remembered life.” In the end, this becomes a fulfilling experience and strengthens relationships, especially between caregivers and care receivers. Reviewing our lives and telling our stories leaves us with a sense of contentment with life and truly links our past to the present and one generation to another.