Authors (including presenting author) :
Kwan KK (1), Chiu YY (1), Chan HLI (1)
Affiliation :
(1) Department of Occupational Therapy, Kowloon Hospital
Introduction :
Autobiographical memory refers to memory for one’s personal history (Robinson, 1976). It is composed of personal memories, autobiographical facts and generic personal memories. (Brewer, 1994). It is found that autobiographical memory decline in healthy elderly and further impaired in elderly with depression. Such impairment is believed related to a bias in recalling past events, i.e. an increase in rumination of negative events in life and a decrease in the recall of positive events. The bias eventually leads to a negative self-image. (Wilson & Gregory, 2018)
Life review therapy assisted the elderly to regain memories in different life themes through structured and guided interview. (Rubin, Parrish & Miyawaki, 2019) It is proved to be effective to promote mental well-being and achieve ego-integrity. (Ando, Morita, Akechi et al, 2010 ;Klejin, Lissenberg-Witte, Bohmeijer et al, 2018). Life-review therapy would provide insight to improve and prevent depression in the elderly.
Objectives :
Aim: To develop a life review booklet and explore its clinical practice to psychogeriatric (PG) patients referred for occupational therapy in Kowloon Hospital
Objectives:
1. To plan and design a life review booklet with literature support
2. To finalize the application of the booklet with trial on cases with different diagnosis
3. To review clinical use of the booklet
Methodology :
1. Design and develop the life review booklet
- Literature review on life review and autobiographical memory
- Design the content of the life review booklet and worked out the booklet with Adobe Illustrator software
2. Trial on PG patients
- PG patients diagnosed with neurocognitive disorder, depression and schizophrenia, were recruited for trial of the program.
- They completed the life review booklet through interview by carer, therapist or by self-writing.
- A modified autobiographical memory test and a personal story line before and after the life review process. In addition, a structured interview was conducted to collect their personal comments after this life review experiences.
3. Based on evaluation of their feedback comments to finalize the content of the booklet
- Consolidate the pre- and post- test result and their feedback comments and finalize the booklet content to prepare for next stage of data collection.
Result & Outcome :
Results
1. The life review booklet was designed according to components of autobiographical memory. The content consisted of personal timeline memory, generic personal memory, personal autobiographical memory and reality orientation on here and now experiences.
2. Six PG patients were recruited to complete the life review booklet. Five of them were female and one of them was male. Age ranged from 67 to 79 years old. Diagnosis included NCD, mood disorder and schizophrenia. MoCA was performed with five participants, two above 16th percentile, two below 16th percentile while one below 2nd percentile. The interview was completed by self-writing or by carer and therapist.
3. All the patients had difficulty to draw the life story line even with the prompting and assistance of therapist. One patient had increased number of listed happy events recalled after the life review process. Both the male patient and his carer enjoyed the process of life review process. They commented that it would bring joy and enhance their mutual communication. The patient diagnosed as schizophrenia presented with flat affect and could not complete some of the content. Both of the patients diagnosed with depression reflected the content for recording here and now experiences was not applicable to their contest. They found the life review process helped them to recapture happy moment in their life span.
Conclusion
The booklet was further refined after receiving the participant’s comments. The content for capture here and now experiences would have to be redesigned to two versions to suit for NCD and mood disorder patients. The life review booklet and the process could help the PG patients to build up a positive self-identity and re-establish their positive life image. Further next stage of data collection would be carried out with the finalized booklet on 20 PG patients. QOL and life satisfaction scale with modified autobiographical memory test would be used as pre-and post-assessment on top of structured interview.
