Understanding the Significance of Listening to Older People's Life Stories in Whole Person Care-An Interview Study of Nurses in Gerontology.

The goals of this study were to design and implement an experiential learning assignment in an undergraduate developmental psychology and aging course and to explore students' perceptions of it. One hundred and forty-three first-year students enrolled in an introductory course on developmental psychology across the life span recorded, transcribed, and analyzed the life story of an older person. Afterwards, they wrote a paper that combined theoretical concepts and reflections on this story and were asked about the benefits and difficulties of the task. The answers to these questions were content analyzed. The reported benefits were grouped into two categories: benefits related to the academic objectives of the project (improving learning of developmental concepts, research-related skills, and attitudes towards old age) and personal growth. The former were reported by approximately two-thirds of the participants and, in most cases, were related to the acquisition of theory. The latter were mentioned by 70.6% of students, and learning some kind of life lesson was the most cited benefit. Students mentioned some difficulties in interviewing, transcribing, and analyzing the interview, and in writing the paper. Interviewing seemed to be the most difficult task. Collecting and analyzing an older person's life story seems to have many positive effects, not only on students' knowledge, skills, and attitudes, but also on their personal development. Thus, despite the difficulties posed by this experiential learning assignment, it might be a useful tool to complement more traditional lecture-based teaching methods in developmental psychology and aging courses.

ABSTRACTIn this paper, we examined relationships and differences between personal and vicarious life stories, i.e., the life stories one knows of others. Personal and vicarious life stories of both members of 51 young couples (102 participants), based on McAdams’ Life Story Interview (2008), were collected. We found significant positive relationships between participants’ personal and vicarious life stories on agency and communion themes and redemption sequences. We also found significant positive relationships between participants’ vicarious life stories about their partners and those partners’ personal life stories on agency and communion, but not redemption. Furthermore, these relationships were not explained by similarity between couples’ two personal life stories, as no associations were found between couples’ personal stories on agency, communion and redemption. These results suggest that the way we construct the vicarious life stories of close others may reflect how we construct our personal life stories.

2020 International Journal of Older People Nursing awards: Celebrating excellence and innovation in gerontological nursing.

Vicarious life stories are mental representations of other people's life stories. We propose a conceptual framework that situates the study of vicarious life stories at the crossroads between personality and social cognition, identifies their potential functions, and describes possible connections between vicarious and personal life stories. Two preliminary studies compared chapters and specific memories in personal and close others' life stories in two groups of student participants. Ages associated with chapters and specific memories in personal and vicarious life stories showed similar temporal distributions. Emotion ratings of both personal and vicarious life story chapters were related to personality traits and self-esteem, although relations were more consistent for personal chapters. In conclusion, personal and vicarious life stories share important similarities. Mental models of other people include vicarious life stories that serve to expand the self as well as facilitate understanding of others.

<p>According to McAdams' (1988; 1993) Life Story Model of Identity, narrative identity is constructed through the development of the life story in adolescence and young adulthood. This theoretical claim has sparked an emerging body of research examining links between the development of the life story and psychological functioning during this developmental period (McLean & Breen, 2009; McLean, Breen, & Fournier, 2010; Tavernier & Willoughby, 2012). The aim of this thesis was to contribute to this emerging body of work by examining the relationship between autobiographical reasoning, the core process through which the life story develops, and psychological functioning in young adulthood. Across four studies, young adults constructed life story narratives of high points, low points and turning points from their life story. These narratives were coded for the presence, and valence, of autobiographical reasoning. Autobiographical reasoning was measured primarily in terms of self-event connections, statements linking an aspect of the narrated event to the young adults' sense of self (McLean & Fournier, 2008). Autobiographical reasoning valence was measured in terms of self-event connections that described the self in positive, negative, neutral and mixed (positive and negative) ways. The first study (Study 1a) showed that the valence of autobiographical reasoning found in young adults' life story narratives predicted psychological functioning. Young adults who made negative self-event connections in life story narratives experienced poorer psychological functioning (measured in terms of psychological distress and psychological well-being) than young adults who made little or no negative self-event connections. Conversely, young adults who made more positive self-event connections experienced comparatively better psychological functioning than those who made fewer positive self-event connections. The relationship between positive self-event connections and positive psychological functioning was most salient in the context of narratives about negative events from the life story. Study 1a also showed that for young adults who tended to make higher numbers of positive self-event connections, endorsing negative events as central to the life story was not associated with poor psychological functioning, whereas it was for young adults who made fewer positive connections. The second study (Study 1b) presented a methodology for examining the relationship between autobiographical reasoning valence and psychological functioning over time. Although the small sample size in Study 1b prevented firm conclusions being made, findings showed that young adults' tendency to make negative, but not positive, self-event connections remained stable over time. The preliminary findings from Study 1b also showed that positive and negative self-event connections in life story narratives were not associated with changes in psychological functioning over time. The third study (Study 2) found that young adults' tendency to reason about the self in positive and negative ways was associated with a number of cognitive response styles (explanatory style, rumination and use of cognitive reappraisal strategies). The results of Study 2 also highlight important ways that cognitive response factors, and young adults' assessments of meaning in their lives, may interact with autobiographical reasoning valence to predict psychological functioning. The fourth study (Study 3) aimed to investigate relationships between the phenomenology of life story memories and the amount, and valence, of autobiographical reasoning in narratives of these events. Findings showed few associations between autobiographical reasoning and autobiographical memory phenomenology. Possible reasons for the absence of these relationships are discussed. Wider implications and theoretical explanations for the findings reported in this thesis are discussed in terms of models of coping and Relational Frame Theory (RFT; Hayes, Barnes-Holmes, & Roche, 2001).</p>

<p>This project originates from my experience as a Palliative Care Nurse Specialist Educator working from a hospice environment. Observations and collaborative partnerships with staff in Aged Care Facilities provided insight into the palliative care needs of the residents at the end-of-life. Care Assistants (caregivers) provide the majority of direct care and spend most time with residents, with little training for providing that care, to residents with increasingly complex needs. A two phase exploratory descriptive project was designed using the life course research paradigm and life story narrative research to consider what life experience caregivers brought to their caregiving role in an Aged Care Facility in New Zealand and what influence education had on their work life. In the first phase a focus group, following education and the implementation of the Liverpool Care Pathway, was conducted and themes identified from an interdisciplinary staff team discussion. In phase two of the project four of the caregivers participated in a life story interview. The thematic analysis of these transcripts provided insight into the four caregivers' life experience. A novel method termed poetic condensation was used in the study to identify the essence of each person's life story. The researcher then reflected on each of the four life stories and identified the turning point in the person's life and a caring moment from the transcript. The discussion in the thesis reveals the impact of the education sessions and implementation of the Liverpool Care Pathway on the caregivers' practice and how this became a turning point in the delivery of care for the elderly residents particularly those who were dying in the Aged Care Facility. The researcher concludes the thesis by recognizing that her role as a palliative care clinical nurse specialist and educator is necessary to transfer specialist end-of-life knowledge and mentor staff as they shape best end-of-life practice.</p>

<p>This project originates from my experience as a Palliative Care Nurse Specialist Educator working from a hospice environment. Observations and collaborative partnerships with staff in Aged Care Facilities provided insight into the palliative care needs of the residents at the end-of-life. Care Assistants (caregivers) provide the majority of direct care and spend most time with residents, with little training for providing that care, to residents with increasingly complex needs. A two phase exploratory descriptive project was designed using the life course research paradigm and life story narrative research to consider what life experience caregivers brought to their caregiving role in an Aged Care Facility in New Zealand and what influence education had on their work life. In the first phase a focus group, following education and the implementation of the Liverpool Care Pathway, was conducted and themes identified from an interdisciplinary staff team discussion. In phase two of the project four of the caregivers participated in a life story interview. The thematic analysis of these transcripts provided insight into the four caregivers' life experience. A novel method termed poetic condensation was used in the study to identify the essence of each person's life story. The researcher then reflected on each of the four life stories and identified the turning point in the person's life and a caring moment from the transcript. The discussion in the thesis reveals the impact of the education sessions and implementation of the Liverpool Care Pathway on the caregivers' practice and how this became a turning point in the delivery of care for the elderly residents particularly those who were dying in the Aged Care Facility. The researcher concludes the thesis by recognizing that her role as a palliative care clinical nurse specialist and educator is necessary to transfer specialist end-of-life knowledge and mentor staff as they shape best end-of-life practice.</p>

There is a rapidly growing body of research focusing on how people use language to construct personal meaning and identity (de Certeau 1984, Miller et al. 1990, Rosaldo 1993). Accordingly, scholars have renewed their interest in life story narratives as a way to access the construction of self (Gee 1991, Linde 1993, Sun 1998). Life stories are a type of narrative, providing a window through which we can examine the ways that individuals actively interpret and negotiate their reality. In the process of telling their life stories, people construct meaning by selecting, evaluating and emphasising significant experiences (Linde 1993). Thus life stories are important sites of social-cultural identity construction, in which people make sense of their relation to themselves and to others.

Within feminist and queer studies, age is rarely explored or theorized, and ageing is to a great extent ignored, while social gerontology tends to rest on assumptions of stable binary gender categories. This article starts with older trans people's life stories to explore intersections between (old) age, gender, and embodiment. The analysis, using a theoretical framework developed within critical gerontology, queer theory, and feminist theory, illustrates what ageing and old age may mean for transgender people. Bodily ageing is perceived very differently by trans people, depending on bodily conditions and on how they can and want to perform gender. While some experience what they perceive as the androgyny of age positively, other narratives illustrate how ageing can complicate the possibilities of performing linear gender. The ageing body can limit prospects for undergoing sex reassignment surgery (SRS). The analysis illustrates how older trans people may face ageist attitudes during the transition processes. Later life and the future might also bring fears about situations in which one will need care. For older trans people, this could mean fears of being discriminated against, having fewer possibilities to choose which contexts to be in, and which persons to have in one's home and close to one's body. A Baradian approach, in which bodies are seen as agential and performativity as material-discursive, offers complex understandings of older transgender people's experiences. The results trouble previous theoretical concepts, while highlighting the importance of broadening understandings of age, gender, and embodiment that do not take their starting-points in younger or middle age, linear gender, or abled congruent bodies.

The present study investigated whether remembering the distant versus the recent personal past influences self-continuity levels and expected future event characteristics in a sample of immigrants. Seventy-three Turkish immigrants living in Denmark participated in three sessions involving questionnaires and life story interviews. In the first session, participants completed baseline measures of self-continuity, psychological wellbeing, acculturation, and demographics. In the second and third sessions, they recalled significant events and narrated life stories from pre-migration (distant past) and post-migration (recent past), followed by measures of self-continuity and wellbeing. After each memory recall, participants described three expected future events and rated them on phenomenological characteristics such as vividness and emotional valence. We analyzed differences in self-continuity and future event characteristics between the pre- and post-migration conditions, as well as the relationships among the variables, thematic content of future events, and their resemblance to cultural life scripts. Results revealed no significant differences in future event characteristics between the conditions. However, a small difference emerged in self-continuity levels: contrary to expectations, participants reported slightly higher self-continuity in the pre-migration condition than in the post-migration condition. These findings contribute to understanding of how autobiographical memory relate to future thinking and self in the context of migration.

This study compared life story memories of emerging adults and early adolescents to other autobiographical memories. Participants described three scenes of their respective life stories, a high point, low point, and turning point narrative, and described the connections between them in a fourth narrative. Participants also related four autobiographical narratives from corresponding time periods for comparison. Narratives were analysed for two measures of causal coherence, narrative complexity and meaning making, and for thematic coherence. Life story narratives contained more self-related lessons and insights and greater recognition of complexity than non-life-story narratives, but these differences were confined to narratives of turning points and connections between events. Thematic connections between narratives were more abstract and self-related in life story narratives. Emerging adults' narratives, when compared to those of early adolescents, showed more evidence of self-related abstract thinking and recognition of multiple dimensions. Findings indicate consistent ways in which life story memories differ from other autobiographic memories, and show evidence of development in adolescence.

A life story program was implemented in 16 nursing homes (NHs) in Ohio with partners including a company specializing in life story work and a gerontological institute. The aim was to evaluate the impact of the life story program on residents and staff. NH sites were selected from an urban/suburban and a rural county using sampling procedures ensuring variation in auspice, quality star ratings and bed size. A longitudinal design was used to conduct in-person interviews with residents at baseline (prior to the life story interview), immediately after the interview, and approximately a month after most life story books were delivered to a NH. Resident eligibility criteria included being age 60 or older, Medicaid-eligible, long-stay and having no to moderate cognitive impairment. Residents’ (n=238) average age was 77 years, 66% were female, and 52% had resided in the NH for 1-5 years. Cognitive scores declined over time, but depressive symptomatology improved significantly. Residents had very high levels of satisfaction with care, enjoyed telling their life stories and would recommend the program; these findings did not change. A pre-post study design was used with staff (n=198), who included nurse aides, nurses, administrators, social workers and activity staff. Their average age was 44 years. Although staff job satisfaction did not change significantly, the vast majority enjoyed learning about residents’ life stories and used them in care planning. The findings demonstrate that life story work may be useful in promoting person-centered care, although further testing is needed with a more generalizable sample.

PurposeThe purpose of this paper is to explore what conversation analysis has to offer when analysing a series of life story interviews aiming to capture how reading and texts are used in a rural working-class man’s identity construction.Design/methodology/approachThe conversation analysis methodology with its explicit focus on embodied social action, activity and conduct in interaction is integrated with a life story approach when analysing and describing the identity constructing processes that take place in life story interview settings.FindingsThrough a close and detailed analysis of the interaction between interviewer and interviewee, and by focusing and highlighting the phenomena and identities that are oriented to in the face-to-face interaction here and now (and in relation to there and then), descriptions of the complex and dynamic identity constructing processes that are set into play in the life story interview are possible.Research limitations/implicationsIt is argued that the approach has a lot to offer when approaching life story data, and thus is a method that can increase the transparency in life story interview research.Originality/valueThe paper explores the intersection of what is often seen as diametrically opposed forms of analysis: conversation analysis and narrative inquiry.

Introduction: This thesis consists of the three papers described below. The first paper aimed to identify sarcopenia in older people from quilombola communities using the algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP) and to determine its association with the quality of life domains overall health status (OGS) and functional capacity. Method: A transversal study was conducted with 70 participants of both sexes with a mean age of 65.58 6.67 years. Sociodemographic data were collected. Sarcopenia was defined by recommendations of EWGSOP's algorithm. The algorithm suggests to determine the muscle mass (MM) loss by DEXA method, handgrip strength (HGS) with hand-held dynamometer and physical performance assessed through a gait speed (GS) test. Quality of life was estimated using the The Medical Outcomes Study 36-item short-form healthy survey (SF-36). Results: Sample showed 10% prevalence of sarcopenia. There was no statistically significant difference between sarcopenic and not sarcopenic for the domains of quality of lifeOGS and functional capacity. Conclusions: The algorithm proposed by the EWGSOP had clinical applicability in quilombola older people. Sarcopenia prevalence was high. The second paper aimed to characterize the sarcopenia and quality of life in Quilombola's Community older people through two instruments: Baumgartner and EWGSOP and to determine the association between sarcopenia and quality of life. Method: This was a cross-sectional study of 70 male and female participants with a mean age of 65.58 6.67 years). Sarcopenia was diagnosed according to the Baumgartner cut-off for appendicular skeletal muscle mass, and the criteria recommended by the EWGSOP. Muscle mass (MM) and percent fat mass were analyzed by DEXA, while handgrip strength (HGS) was evaluated using a hand-held dynamometer. Physical performance was assessed through a gait speed (GS) test. Quality of life was evaluated using the SF-36. Results: The prevalence of sarcopenia was 15% according to the Baumgartner cutoff, and 10% according to EWGSOP criteria. Quilombola older people classified as physically active or very active are six times less likely to develop sarcopenia than those classified as irregularly active or sedentary. HGS was negatively associated with a diagnosis of sarcopenia according to both sets of criteria. Subjects with sarcopenia reported lower scores than those without the condition in the physical role functioning and bodily pain domains of the SF-36.Conclusions: Quality of life was positively associated with sarcopenia in this sample of quilombola older people. Additionally, the present results showed that diagnostic criteria for sarcopenia should include reductions in lean mass in addition to measures of functioning and physical performance, since some subjects showed the former symptom without any alteration of the latter two variables. Baumgartner cut-off was less precise than that proposed by the EWGSOP because it did not consider the functionality and physical performance. However, Baumgartner was more sensitive in the identification of sarcopenia, since the loss of lean body mass xii predicts changes in the strength and gait speed. Eventually, the third paper aimed to examine the relation between sarcopenic obesity and muscle strength with the domains of quality of life in older people belonging to the Quilombola's community or not. Method: Sample was composed of 95 female volunteers aged 64.91 6.05 years. Thirty-nine volunteers belong to the Quilombola's community and 56 no. Body mass index (BMI) and Dual-Energy X-Ray Absorptiometry (DEXA) were analyzed for all of them. Sarcopenic Obesity (OS) was defined for female older people who showed simultaneously sarcopenia, according to Baumgartner criteria) and obesity (according to the American College of Sports Medicine). HGS was determined by Jamar dynamometer. There was the following classification: Group 1: Quilombolas sarcopenic obeses; group 2: Quilombolas no sarcopenic-obeses, group 3: no Quilombolas sarcopenic obeses and group 4: no Quilombolas no sarcopenic-obeses. Quality of life was estimated using the SF-36. Results: Sample showed 23.72% prevalence of sarcopenia. Major incidence was in older people who not belong Quilombola's Community. All tested groups showed a percentage of inadequate fat. Older people Quilombolas sarcopenic obeses (group 1) had the lowest values of HGS compared to groups 2, 3 and 4. There was statistically significant difference between State General Health (SGH) and Social Aspects (SA) of quality of life between groups 2 and 4. Conclusions: Handgrip strength was an important measurement in determining the Sarcopenic Obesity, especially in older people sarcopenic obese of Quilombola's Community. There was not relation between sarcopenic obesity and strength with domains of quality of life in older people, being independent of race / ethnicity.

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