Life Review Research Articles

Effect of Life Review Therapy on self-actualization and Happiness of the Elderly in Iran

Objectives Older people experience physical and psychological changes that can negatively affect their life satisfaction and result in unhappiness. Life review therapy can be an effective intervention in increasing the positive feelings and happiness of the elderly. This study aims to determine the effects of a life review therapy program on self-actualization and happiness among older adults. Methods & Materials This is a quasi-experimental study with a pre-test/post-test/follow-up design. Participants were 22 elderly people aged ≥60 years referred to a daycare center in Tehran, Iran. They were randomly divided into two intervention (n=11) and control (n=11) groups. The perma flourishing scale and the Oxford happiness questionnaire were used to collect data before, immediately after, and one month after the intervention. The life review therapy was performed according to Haight and Webester’s protocol. The collected data were analyzed in SPSS software, version 26. Results There was a significant increase in the total mean scores of happiness and flourishing scores in the intervention group immediately and one month after the intervention (P<0.001), but no significant change was reported in the control group. The mean scores of happiness and flourishing in the intervention group in the pre-test phase were 50.27 and 98.63, respectively. In the post-test and follow-up phases, these scores reached 58.27 and 57.09 for happiness and 111.63 and 104.81 for flourishing, respectively. Conclusion The present study shows that life review intervention in can provide an opportunity for flourishing and psychological development and also an increase in the level of happiness among older adults.

A life of research on everyday sleep(iness).

This is a personal review of a research life focused on sleep in everyday life. It finds that irregular work hours shorten sleep duration and increase sleepiness, both subjectively and objectively (polysomnography). Also, experimental lab studies demonstrate reduced sleep duration (and sleep stages N2 and REM) when sleep is moved into the daylight hours (and the circadian upswing). Stage N3% seems not affected, and homeostatic experiments suggest that awakenings should not occur until the need for N3% or total spectral power has been satisfied. Furthermore, sleepiness is associated with increased alpha activity and slow eye movements, although the best indicator of dangerous sleepiness is subjective ratings (linked to perceptions of heavy eye lids). Everyday stress has very modest negative effects on objective sleep quality. Sleep loss as well as excessive sleep durations are linked to mortality, but with modest risk, and mainly in older individuals. Finally, objective sleep poorly reflects subjective sleep quality, and women appear to report poorer sleep than men, while objective data show better sleep quality in women. The discrepancy is considerably greater in older age groups.

Cohousing: A Bibliographic Review of Collaborative Living in Scopus: Trends and Perspectives

Cohousing: A Bibliographic Review of Collaborative Living in Scopus: Trends and Perspectives

Revie ⊕: Impact of a resource-based life review intervention on patients with advanced cancer: A waitlist controlled trial

PurposeLife review interventions aim to support individuals facing an incurable disease accompanied by existential concerns and health-related challenges. Based on encouraging feasibility results, this study assessed the effects of Revie ⊕ life review intervention on the self-esteem of patients with advanced cancer, and the effects on well-being, post-traumatic growth, life satisfaction, symptom burden and interaction with nurses. MethodThe study consisted of a two-arm parallel-group, waitlist-controlled trial (WCT) in the oncology division of a Swiss-French University Hospital. Revie ⊕ was composed of nurse-led meeting with the patient to address and document significant life events using a strengths-focused approach and targeting the life project. ResultsDue to Covid-19 pandemic, adjustments were made regarding study duration and participant's allocation: Fifty-eight patients received Revie ⊕, 39 completed all the measurements. Self-esteem was high at baseline and maintained stability over time. The social well-being decreased in the intervention group before-after Revie ⊕ (−1.7 (3.9), p = 0.044) while emotional and functional well-being showed stability. The intensity of symptoms decreased in the intervention group before-after Revie ⊕: 4.9 (9.4), p = 0.020. ConclusionsThis study suggests that patients living with an advanced cancer and who received Revie ⊕ intervention may have maintained their self-esteem high over time. Observed results are promising, particularly considering the influence of the pandemic. Nevertheless, these findings do not allow us to draw definitive conclusions regarding the efficacy of the intervention on self-esteem. WCT seems not to be the appropriate design to highlight the added value of Revie ⊕ for this particularly vulnerable population. Clinical trial registration numberNCT04254926.

Life Review the Impact of Combined Watson Care Theory Intervention on Psychological Status and Quality of Life in Patients with Terminal Lung Cancer

Life Review the Impact of Combined Watson Care Theory Intervention on Psychological Status and Quality of Life in Patients with Terminal Lung Cancer

The Role of Movement, Exercise, and Breathing in the Prevention and Treatment of COVID-19: An Umbrella Review

Objective: To identify the published review literature regarding movement, exercise, and breathing in the prevention and/ or treatment of the coronavirus 2019 disease (COVID-19) and long COVID, with the goal of describing the literature and identifying areas for further research and clinical application. Movement and exercise incorporate sedentary behaviours, various forms of exercise, breathing and respiratory therapies, and yoga-asanas (postures). Methods: This paper progresses from a live review and incorporates systematic reviews and narrative reviews. A literature search occurred monthly using PubMed and Google Scholar from May 2022 to May 2023. A measurement tool to assess systematic reviews (AMSTAR) scoring assessed systematic review quality, while the scale for the assessment of narrative review articles (SANRA) guidelines were used to evaluate narrative reviews. Only information and data focused on movement and exercise relevant to COVID-19 prevention and/or treatment were extracted from each review. Results: Three narrative reviews and five systematic reviews were included. Sedentary behaviours increased significantly during the pandemic. Decreased physical activity level was associated with risk of hospitalization from COVID-19. Physical activity and breathing exercises, whether conducted face-to-face (F-2-F) or via telerehabilitation were associated with improvement in dyspnea (shortness of breath), exercise capacity, lung function, fatigue, and quality of life (QoL). Extreme exercise is best avoided for at least 2 to 3 weeks after severe COVID-19 symptoms. Conclusion: Sedentary behaviour and lack of regular physical activity is correlated with an increased risk of COVID-19. Various forms of movement, exercise, and breathing may be beneficial in the treatment of COVID-19 and in long COVID. Further research and understanding of the importance of movement, exercise, and breathing as it relates to immune health is warranted.

Herbal Medicine and COVID-19: An Umbrella Review

Background: Most systems of traditional medicine have been using herbal medicines to prevent and treat acute respiratory conditions and various other conditions for centuries. The aim of this project is to identify and examine the systematic and narrative reviews reporting on the therapeutic use of herbal medicines as it relates to the prevention and treatment of COVID-19 and long COVID. Methods: This paper is part of an umbrella review of studies related to natural health products and natural therapies for the prevention or treatment of COVID-19. It is a follow-up to a live review that was conducted by the World Naturopathic Federation between May 2022 and May 2023. PubMed and Google Scholar were searched for systematic and narrative reviews that met defined quality criteria. Results: Over half of the initial systematic reviews were excluded as they did not meet the inclusion and AMSTAR criteria. The final paper included 25 narrative reviews and 41 systematic reviews (SR), with half of the SRs reporting on the safety of herbal interventions. Various therapeutic properties of over 60 herbal medicines were outlined, some individually and most of them as part of herbal formula (combinations). Conclusion/Summary: Herbal interventions demonstrated statistically significant improved recovery in patients with COVID-19. The most common therapeutic properties identified were immunological properties, anti-inflammatory, anti- microbial, and antioxidant while the most frequently investigated herbs were Glycyrrhiza glabra/uralensis, Tinospora cordifolia, and Curcuma longa. More attention is needed on the regulation of herbal medicines, the quality of research, and the safety of herbal medicines.

Life review therapy in the elderly with Alzheimer's dementia

Aging is an inevitable process experienced by everyone and is closely associated with a decline in both physical and mental functions. Physically, the elderly are vulnerable to age-related diseases, including dementia. Life Review Therapy (LRT) emerges as a non-pharmacological intervention that assists the elderly in reflecting on and contemplating various aspects of their lives. The roots of this therapy are based on Erik Erikson's psychosocial development theory and aim to enhance emotional and psychological well-being through the process of recalling and narrating life experiences. The steps of LRT involve discussions about successes, failures, and significant events in life, with the goal of rebuilding meaning and providing satisfaction. In cases of dementia, LRT can provide cognitive stimulation, allowing individuals to engage in thinking and remembering activities, potentially improving cognitive function. This therapy can also strengthen social relationships and offer opportunities for individuals to share their life stories with others.

DIGNITY THERAPY FOR OLDER ADULTS WITH CANCER: COMMUNION FACILITATES DIGNITY

Abstract Nearly 600,000 older Americans die a cancer-related death annually. Maintaining dignity is central to their quality of life. Dignity Therapy (DT; Chochinov, 2005) was designed to preserve dignity despite health declines. Patients report benefits of DT but mechanisms have not been empirically investigated. Grounded in gerontological life review research, DT involves therapists guiding patients to tell their unique life story and leave a legacy. This study investigates level of communion in the life story told in DT as a mechanism for DT efficacy. Communion reflects personal strivings for warm and close relationships (McAdams, 1986). Participants were 204 older cancer patients receiving outpatient palliative care (Mage= 66 years, SD = 7.43, 65% female) who participated in DT. Session narratives were audio-recorded and reliably (κ=.71–1) content-analyzed for communion themes (McAdams, 2001). Participants completed pre-post measures, including the Dignity Impact Scale. Mediation analyses showed significance for the direct effect of Dignity Impact from pre- to post-test, B = .50(.06), p < .001 as well as for paths from pre-test Dignity to Communion, B = .20(.08), p <.01 and from Communion to post-test Dignity, B = .20(.06), p = .001. Sobel test for the mediation effect of Communion between pre- to post-test Dignity was z = 2.06(.02), p = .039; point effect = .04. Participating in DT is shown to increase older cancer patients’ feelings of dignity. That is partially explained by the extent to which these older adults tell a life story rich in communion, reflecting on loving, caring relationships, during DT.

ADAPTING TELEHEALTH EVIDENCED BASED PROTOCOLS FOR VETERANS WITH MOOD AND NEUROCOGNITIVE DISORDERS: A CASE STUDY

Abstract Aging Veterans with mood and neurocognitive disorders typically have a complex medical and psychiatric presentations leading many providers to exclude them from treatment, expressing that psychotherapy is not appropriate. This form of exclusionary care may decrease help seeking behavior and amplify existing psychological symptoms to an already stigmatized and isolated population. The following case study, outlines a 24-session approach to integrating evidenced based protocols such as Cognitive Behavioral Therapy (CBT) and Narrative Life Review Therapy via telehealth. The presentation will discuss cultural considerations to take when working with Aging Veterans that have co-occurring mood and cognitive difficulties as well as reflect upon the successes and challenges of providing telehealth with this population.

Life Review Study: An Opportunity to Increase Quality of Life and Personal Meaning for Older Community-Dwelling Adults

Aims The purpose of this study was to examine the effects of a life review intervention on older adults’ self-perceived ratings of quality of life, depression, and mastery. Methods A sequential explanatory mixed-methods design was used. Quantitative data was gathered via a pre-posttest design. Qualitative data was gathered regarding participants’ perceived value of the life review program. Results A Wilcoxon signed rank sum test indicated that one item on the WHO-QOL BREF (modified) had a significant change, indicating fewer negative feelings after the life review intervention. Six themes emerged from the qualitative data: (1) Nostalgia; (2) Reflection; (3) Appreciation; (4) Proliferation of additional memories; (5) Sharing in similar experiences with others; and (6) Gratefulness. Conclusion Results indicated that participation in a five-week, home-based, life-review intervention program has the potential to improve self-perceived quality of life and sense of personal mastery for older adults sheltering at home during the COVID-19 pandemic.

The Impact of Social Media on Online Shopping Behavior of Gen Z Consumers In Time of Covid-19 Pandemic; The Moderating Role of Celebrity Endorsements

The purpose of this study is to examine the impact of social media (live streaming, promotional tools, and online reviews) and celebrity endorsements on online shopping behaviors. In addition, we investigate the role of celebrity endorsements as a moderator between social media and online shopping behavior. This study examines Generation Z in Indonesia with 543 respondents. This investigation employs the Structural Equal Modeling (SEM) technique. According to the findings of this study, online reviews and celebrity endorsements have a significant positive impact on online shopping behavior. When we interact with celebrity endorsements through online reviews, they have a strikingly positive impact on our online shopping behavior. This indicates that celebrities add a competitive advantage to a brand and that the brand has very good online reviews that will encourage consumers to buy products online. This study has implications for marketers and e-commerce, which can encourage consumers to make online purchases during a crisis.

Systems Training for Emotional Predictability and Problem Solving for older adults with borderline personality disorder symptoms

Objective:Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a 20-week group treatment program for patients with borderline personality disorders (BPD). STEPPS is an evidence-based treatment to reduce BPD symptoms. However, the mean age of patients studied thus far is 33 years. Studies evaluating STEPPS in older adults are lacking. Aim of this study was to investigate the feasibility of STEPPS in older adults with BPD symptoms.Method:A naturalistic, pre- vs post-treatment pilot study design. Twenty-four patients (mean age 64 years) completed the Dutch version of the STEPPS program. Primary outcome was BPD symptoms and secondary outcome was psychological distress and maladaptive personality functioning.Preliminary results of the ongoing study:The STEPPS pilot in older adults demonstrated a significant decrease in BPD symptoms (Cohen’s d = 1.6), improved self-control of emotions and impulses (r = 0.58), and improved identity integration (Cohen’s d = 0.5). No significant differences were found for psychological distress.Conclusion:STEPPS is feasible for older adults with BPD symptoms. The treatment program led to a decreased in BPD symptoms and improvement of emotion regulation skills in older adults.Future perspectives:To further improve the feasibility of STEPSS in older adults a Delphi study was performed with seven experts in the field. The results of this Delphi study will additionally be discussed in this presentation. Most important recommendations were the addition of age-specific topics to the STEPPS program, e.g., changing social roles, life review, and/or physical limitations.

What are best practices for involving family caregivers in interventions aimed at responsive behaviour stemming from unmet needs of people with dementia in nursing homes: a scoping review

ObjectivesThis study aimed to determine best practices for involving family caregivers in interventions aimed at preventing and reducing responsive behaviour stemming from unmet needs, including pain.DesignScoping review, reported according to...

Improving Policy and Practices of Hospice Live Discharge: A Historical Exploration of the Medicare Hospice Benefit

ABSTRACT Hospice care in the US is heavily regulated to ensure access to the Medicare Hospice Benefit (MHB) for individuals with serious illness. Policy changes to the MHB, many of which intended to minimize potential fraud (e.g. focused medical reviews; documentation requirements for certifications, recertifications, and discharges; requirements of physician narratives and face-to-face visits), directly impact current hospice discharge practices and experiences. When patients revoke hospice or are unable to be recertified due to a stabilized condition, they lose access to the holistic philosophy of care and experience additional stressors with increased potential for burdensome transitions. Patients with chronic conditions, such as Alzheimer’s disease or related dementias, Chronic Obstructive Pulmonary Disease, or heart failure are more likely to have longer length of stays and are more often discharged alive from hospice. Few policy changes have been made to account for growing incidents of patients dying of chronic illness though the policy was originally created primarily for cancer patients, reflecting a time when most patients were dying of cancer. This manuscript describes the uniquely American phenomenon of a hospice live discharge, reviews relevant and historical policies, and provides recommendations for future research, policy, and practice to better support patients and families during this critical healthcare transition.

Improvisation while Aging

AbstractBackgroundArtistic interventions have potential to fundamentally improve the cognitive, emotional, and social functioning of older adults. Improvisation is based on spontaneous interaction, where individuals co‐create and interact without pre‐planning. While improvisation in cognitive and mental health interventions has become more popular, there is no review to synthesize its impact on older adults.MethodsWe reviewed the literature and summarized the effects of improvisation on the cognitive, emotional, and social well‐being of older adults.ResultsThere is now a substantial body of literature on the emotional and cognitive benefits for adults without dementia. Community‐dwelling older adults (N = 78) that participated in 12 weeks of improv combined with life review techniques demonstrated a decrease in depressive symptoms, and an increase in well‐being and meaning in life (Keisari, Palgi,et al., 2022). Older adults who participated in a 9‐min mirror‐game exercise (N = 34) had improved attentional functioning and positive affect compared to those who attended a physical activity class (Keisari, Feniger‐Schaal, et al., 2022). Two single‐group studies with older adults (N = 15, 45) showed that participation in improvisation yielded significant improvements in social isolation and perceived stress (Lindquist et al., 2021), sense of spontaneity, flow, playfulness (Bassis et al., 2022). One qualitative study suggested that the participants experienced more attentiveness, relaxation, and increased stimulation and communication following improvisation practice (Lindquist et al., 2021). Other qualitative studies showed that improvisation can help build community, increase positivity, sense of comfort and ease with the unexpected, a sense of self‐development and self‐awareness (Morse et al., 2018; Yamamoto, 2020).There is also growing evidence that older adults with dementia benefit from improv interventions. Older adults participating in improvisation interventions have experienced a reduction in depressive symptoms and increase in positive affect (N = 178; Zeisel et al., 2018). One qualitative study showed that improvisation with older adults with early stage dementia have therapeutic benefits such as improvements in learning, sociability, communication and self‐esteem (Stevens, 2012).ConclusionThere is sufficient evidence that improv as an approach to improve thecognitive, emotional, and social well‐being of older adults has strong potential and warrants further study.

Meaning reconstruction 70 years later: Processing older adults' unfinished business in a drama therapy group.

Unfinished business (UB), when individuals appraise their relationship with others or themselves as incomplete or unresolved, entails difficult emotions such as regret, remorse, and guilt. UB is often associated with bereavement and is considered to be a predictor of complicated grief. Here we report two case studies describing the processing of the sudden death of a significant other in the context of a randomized controlled study of 12-week drama therapy groups for older adults. The intervention followed the format of Playback Theater, an improvised form of theater based on personal stories, and a life review paradigm. A mixed-methods approach explored the course of individual therapy within the group and potential mechanisms of change. The participants completed mental health questionnaires in a pre-post-follow-up design. The qualitative data included video recordings and postintervention interviews. One participant reported a clinically significant (CS) change in depressive symptoms and psychological well-being on the post and follow-up measurement indices. The second reported a CS change in self-esteem and relationship satisfaction at the end of the intervention, but not at follow-up. The findings suggest that the drama therapy contributed to the resolution of UB through restorative work in the three domains defined in meaning reconstruction theory: the "event story" of the loss, the "back story" of the relationship with the deceased, and the "personal story" of self. The results point to the need for additional research on meaning reconstruction in the context of drama therapy and encourage the broader application of performative techniques to treat complicated bereavement. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Older adults deserve better in society

This article provides a developmental perspective of late life, a time of growth in some areas and decline in others. In contrast to younger adults, who go through a process of expansion, productivity, and mastery, older adults increasingly experience reduced rather than expanded choices and capabilities, including many losses and a heightened awareness of death. However, they have distinct opportunities to sustain a balanced relational involve- ment (including interpersonal and group attachment), grow as a person, and achieve a sense of self-continuity and ego-integrity. This article aims to encourage healthcare professionals (including attachment-based and relational psychotherapists), and the public by and large, to reflect upon and overcome their own internalised prejudices towards old age, as well as to become more familiar with the developmental tasks of this stage in the life cycle, including life review processes. It also aims to inspire older adults to live as healthily as possible all the way to the very end.

In Every Detail: Spiritual Care in Pediatric Palliative Care Perceived by Healthcare Providers

ContextSpiritual care is an essential domain of pediatric palliative care. The current mainland China faces a lack of national guidance and a shortage of specialized personnel to provide spiritual care in a traditional developing country. ObjectivesTo identify spiritual care in pediatric palliative care services in mainland China from the perspective of healthcare professionals. MethodsA qualitative descriptive interview study was conducted individually with 27 participants: 14 physicians, seven nurses, and six social workers. The data were analyzed using thematic analysis. ResultsParticipants described that the essence of spiritual support was provided “in every detail” throughout pediatric palliative care. Four major themes and eleven subthemes were identified. 1) Assessing spiritual needs: paying attention to different perspectives; considering religion, tradition, and culture; discovering spiritual needs behind other needs. 2) Facilitating spiritual exploration: being with the family; providing resources; guiding by providers’ own faith; 3) Supporting connections: encouraging the building of personal bonds; facilitating the establishment of spiritual connections. 4) Relieving spiritual suffering: facilitating a family review of child's life; supporting building meaning in daily life; assisting in leaving a legacy for the child. ConclusionThis study illustrated that current spiritual support, though not formally organized, is provided individually in pediatric palliative care services in mainland China. Strategies for a practice guide, education and training for professionals, and cultural building need to be rationally developed to strengthen and structure spiritual support integrated into pediatric palliative care.

Meaning of Life Therapy: A Pilot Study of a Novel Psycho-Existential Intervention for Palliative Care in Cancer.

Intervention in Palliative Care aims to provide physical, psychosocial, and spiritual relief for patients and family members. Brief interventions with a psycho-existential approach have shown positive responses; however, cultural adaptations are needed. This pilot study aimed to develop the Meaning of Life Therapy (MLT), a novel psycho-existential intervention, rooted in the Dignity Therapy, Life Review, and Meaning-Centered Psychotherapy. MLT was culturally adapted to the Portuguese context to include questions about forgiveness, apology, reconciliation, farewell, and a legacy document, i.e., the Life Letter. Nine PC cancer patients answered a 14-question MLT protocol, intended to help patients find purpose and meaning in life. Eight themes emerged: Family, Preservation of Identity, Life Retrospective, Clinical Situation, Achievements, Socio-Professional Valorization, Forgiveness/Apology/Reconciliation, and Saying Goodbye. MLT has proved its ability to respond to the psycho-existential needs of PC patients. Further studies should be conducted to gain extensive knowledge of the effectiveness of culturally responsive interventions.