An Intervention Program for

Alleviating Depression and

Anxiety among the Elderly
Living in a Nursing home
Proposal for
Seniors (BAS) Intervention Program:
Reminiscence Therapy
Learning Experience
Pagkatipunan, Sidney Dawn C.
University of Santo Tomas
COLLEGE OF SCIENCE
Espaa Blvd., Manila, Philippines
Tel. No.: (63-2) 7315728, (63-2) 406-1611 loc. 8224
FAX: (63-2) 740-9730
Website: http://science.ust.edu.ph
DEPARTMENT OF PSYCHOLOGY
Proposal for Beneficial Assistance for
Seniors (BAS) Intervention Program:
Reminiscence Therapy Structured
Learning Experience (SLE) Activit
Prepared by:
Alviola, Alexandrea C.
Aoanan, Leah Marie G.
Barbacena, Ma. Coleen F.
Pagkatipunan, Sidney Dawn C.
Sernicula, Ma. Genebell F.
4Psychology4
DEPARTMENT OF PSYCHOLOGY
Beneficial Assistance for
Seniors (BAS) Intervention Program:
Structured
Activities
I. Learning Objectives
The Beneficial Assistance for Seniors (BAS) Intervention Program: Reminiscence
Therapy proposed by the researchers aim to:
1. Alleviate depression symptoms and anxiety among elderly living in a nursing
home
2. Evaluate the changes in the elderly that significantly affect their functioning
3. Facilitate improvement on living conditions by promoting a positive well-being
among the elderly through:
- Promoting a positive attitude towards life experiences
- Encouraging healthy conversations about previous life experiences
- Facilitating better and positive social interactions among the elderly
- Supporting them to evaluate earlier life recollections as meaningful events
contributing to present
4. Improve the overall quality of life of elderly living in nursing homes
II. Theoretical Background
Reminiscence Therapy
Reminiscence therapy is defined by Nursing Interventions Classification system
(as cited in Peng, Huang, Chen, & Lu 2014) as an intervention that uses recall of
past events, feelings and thought to facilitate pleasure, quality of life or adaptation to
the present. It involves using several techniques that has been found to be
successful in boosting self-esteem, enhance self-integration, and ease feelings of
depression and hopelessness (Latha, Bhandary, Tejaswini, & Sahana, 2014).
The reminiscence therapy is derived from Eriksons theory of ego development
(Chen, Li, & Li, 2012). Each stage in this development, an individual is presented by
a conflict. The last stage of development faced by the elderly is achieving ego
integrity and avoiding despair. The ego integrity is achieved when the elderly feels a
life well lived that has been worthwhile and with no regrets. Butler and Birren (as
cited in Chen et al., 2012) developed Eriksons work and proposed that ego integrity
can be achieved by recalling ones past, thus the concept of reminiscence. Other
researchers also used continuity theory in explaining the importance of
reminiscence. This theory states that when an individual faces life events that
challenge him to convert or change, the individual will use adaptive strategies to link
present to past experiences. According to Atchley, a person does this to maintain
and preserve existing internal and external structures and produce continuity in
inner psychological characteristics as well as in social behavior and in social
circumstances (as cited in Chen et al., 2012).
III. First Activity: Balloon Pop and Reminisce
A. Procedures
Objective of the game
In a large group where a big circle is be formed by the members, an elderly must
pick a balloon from which questions written on slips of paper are answered by the
members of the group.
Group Size
15 participants
Time required
Approximately 15 to 20 minutes
Physical setting
The activity should be held indoors or outdoors for and with proper ventilation or
illumination.
Instructions
1. Reminisce questions and statements such as: Who taught you how to drive?,
Tell us about your first date., Describe the house you grew up in., What was
your first job?. Tell us about your best childhood friend., What do you remember
about your grandparents?, must be written in slips of paper.
2. The slips of paper, each for every balloon must be placed inside before inflating
them.
3. Set a happy tone for the activity and then ask the participants to form a huge
circle so that all of the balloons are placed in the middle.
4. Have an elderly to pick a balloon color. It might be easier if the facilitator will be
the one to pop the balloon.
5. The elderly who picked the balloon color must answer the question. Other
residents should also answer the same question.
6. Repeat the fourth and fifth step until all the participants have picked a balloon
color.
B. Processing Questions
1. How did you feel about your trip down memory lane?
2. Was there a particular question that popped out a particular memory you are fond
of?
3. What questions were your favorites?
4. Were you expecting a question that was never asked, what would be it?
5. What is the impact of the activity to you?
C. Materials for Lecture
The materials needed for this activity are balloons of assorted colors, scissors or
pin, paper, and pencil.
D. Discussion
After the facilitator has presented the processing questions, the facilitator shall
let the participants take part in the discussion by asking them ask questions and
entertaining questions from the participants.
The objective during the activity which were to reminisce, to socialize, and to interact
were accomplished. These were fulfilled through first gathering as a big group.
Another objective which was to reminisce was accomplished by answering the
questions written in the slips placed inside the popped balloons. After the activity was
conducted, the objectives such as to instill positive outlook in life and to be more
sociable are accomplished.
E. Closing
The facilitator will have to integrate all the learning of the participants. The
facilitator will deliver the following discourse to the participants:
George Foreman once said that It's great to reminisce about good memories
of the past. It was enjoyable when it was today. So learning to enjoy today has two
benefits: they give happiness right now, and they becomes a good memory later. The
memories we have today, good or bad, are part of our lives and they are impossible to
change. The only thing possible right now is to be happy because that is what life is all
about. Life is too short for regrets and disappointments. Lets create good memories
instead.
Finally, to wrap up the entire session, all of the participants will be asked to stay
together for a group photo.
IV. Second Activity: Memory Box
A. Procedures
Objective of the game
As the facilitator brings out an item from the box, the members should engage in
conversations as each of them has something they remember upon seeing the
item which will then be passed in order for the members to see and feel them.
Group Size
All of the participants
Time required
Approximately 20 to 30 minutes
Physical setting
The activity is held indoors or outdoors for and with proper ventilation or
illumination.
Instructions
1. The facilitator will ask the participants to form a circle.
2. It will be explained that some items were brought that are to be passed
around the group later.
3. Next, the facilitator has to take an item out of the box and stand in the center
so everyone can see the item. Then, encourage conversation among
members as each will remember some experiences upon seeing a particular
item
4. Then, the item is to be passed around so that the group can see them closely.
B. Processing Questions
1. What particular item did you like the most?
2. What particular memory did you remember upon seeing that item?
3. Was there a particular memory that was your favorite?
4. Did you share the same favorite item with others?
5. If you were to do this activity again differently, what might you do next time?
C. Materials for Lecture
The materials needed in this activity can be a kettle, flat iron, vintage clothes,
jewelry box, and dressing table set or anything that is old.
D. Discussion
After the processing questions are presented by the facilitator, a brief explanation
regarding the activity done shall be presented. . The facilitator shall let the
participants take part in the discussion by asking them questions and also
entertaining questions from the participants. The bringing out of old items triggers
old memories that can be discussed in conversation to build rapport among the
participants. Also, passing these items among the group is a way for the elderly to
remember more memories through sight and tactile perception.
E. Closing
The facilitator will have to integrate all the learning of the participants. The
facilitator will deliver the following discourse to the participants:
Memories can be good or bad. These memories are treasures in our mind that
we can look back into whenever we want. These memories can make us cry
sometimes and laugh sometimes. Bad memories should be lessons, not regrets
while good memories are gems that are to be treasured forever.
Finally, to wrap up the entire session, all of the participants will be asked to stay
together for a group photo.
V. Third Activity: Let There Be Music
A. Procedures
Objective of the game
Prompt memories of the elderly individuals through the songs from the years
when the participants were teenagers and young adults that will be played.
Evoke feelings or insights, that was brought about by the song, from the elderly
individuals and help them to share these feelings.
Group Size
15 individuals (all participants)
Time Required
There will be no time limit allotted for the activity. Each participant will be given
sufficient time to share memories or feelings they wish to disclose.
Physical Setting
A room with chairs and large enough so that there will be a space where the
participants could dance.
Instructions:
1. The elderly individuals will be asked to sit in a room and form a circle.
2. The elderly participants will then be asked whether they are comfortable in
their position or if they wish to switch.
3. When the elderly participants are already seated comfortably, printed lyrics of
the songs that will be played will be distributed among the participants.
4. Five different popular songs from the years in which the elderly individuals are
teenagers and young adults will be played. While the song is playing, the
elderly participants may dance or sing along if they wish to. Instructions to the
elderly participants will be as follows:
There will be five different songs that will be played which you might be
familiar with. While the song is playing, you may sing along, dance, or do
anything you wish to do.
5. After playing all the songs, the elderly participants will then be asked to share
events or circumstances they had remembered through the song.
B. Processing Questions:
1. What was your reaction when you found out the songs that will be played through
the printed lyrics that were given to you?
2. What were you feeling when you heard the songs?
3. For those who sang along and danced, what made you did what you did?
4. What memories or emotions did the song brought about?
5. How were you feeling after the activity?
C. Materials for Lecture
Chairs will be used by the elderly so that they could sit comfortably while
listening to the songs and to the discussion.
Printed lyrics of the song will be used so that the elderly participants will be
guided of they want to sing along.
Laptop and Speaker will be used to play the song loud enough for the elderly
participants to hear
PowerPoint Presentation will be used to have a more visual presentation of the
music played during the activity.
D. Discussion
The facilitators or the researchers will discuss how reminiscence therapy was
applied in the activity. Moreover, the facilitators will also focus on how the chosen
songs cued memories and feelings from the participants and how these
remembered events affected the individual at present. Facilitators will also entertain
questions from the participants if they experienced some problems or difficulties
with the activity.
E. Closing
The facilitator will have to integrate all the learning of the participants. Finally to
wrap up the entire session, all of the participants will be asked to stay together for a
group photo.
VI. Fourth Activity: Reminiscence Target Floor Map
A. Procedures
Objective of the game
To elicit specific feelings and emotions from the questions inside the floor map
To facilitate reminiscence
To initiate storytelling among participants
Group Size
15 people (all participants)
Time required
Approximately 1 hour
Physical setting
Activity room of the nursing home, spacious enough to let the participants move
freely
Instructions
1. The group will gather around the assembled floor map in front of them.
2. A small ball will be passed around the group while music is playing in the
background.
3. Once the music stops, the person where the ball stopped will be the participant
in the main activity.
4. This person will throw the ball in the floor map in front of them. Once the ball is
thrown, he will open the cover for that square and read the question.
5. The person is expected to answer the question honestly and share feelings,
emotions, or stories about it.
B. Processing Questions
1. Upon seeing the covered floor map in front of you, what was the first thing that
came to your mind?
2. What were you feeling while passing the ball and with the music playing in the
background?
3. When the music stopped and you were the one holding the ball, what did you
feel?
4. What is your reaction after reading the question that you need to answer?
5. How much did you learn about yourself in this activity?
C. Materials for Lecture
Manila paper (target floor map) where questions that will evoke the memories
of the elderly are written
Small plastic ball will be used for identifying the main participant for the activity
Monoblock chairs will be used by the elderly so that they could sit comfortably
and listen to the discussion
Powerpoint presentation will be used for the discussion part
D. Discussion
The facilitators (researchers) would discuss how the process of reminiscence
was applied in the activity. The themes (e.g family, work, interpersonal
relationships) in the target map would be discussed and how reminiscence possibly
took place while the activity was going on.
E. Closing
The facilitator will have to integrate all the learning of the participants. Finally, to
wrap up the entire session, all of the participants will be asked to stay together for a
group photo.
VII. Fifth Activity: Interest Activity
A. Procedures
Objective of the game
To provide enjoyment
To encourage interaction among other elderly and staff or carers in the nursing
home
To help maintain their skills and give them a sense of accomplishment
To help them remember what they can do during their younger years and be
satisfied about it
Group Size
15 people (all participants) but will work individually
Time required
Approximately 30 - 45 minutes
Physical setting
A well lit room where chairs and tables are provided
Instructions
1. Each elderly will be seated and will be given a sheet of paper with the Interest
Checklist together with a pencil and an eraser.
2. Each elderly will have a facilitator attend to them and have them read the
instruction which is as follows:
For the first checklist, you can see that there are a list of activities given, just
check the box beside the activity that you are interested in.
For the second checklist, lists of activities are listed and several columns
beside them are shown. Check the box under past if you have done it in the
past and put a check underneath the column present if you are still doing it
now, and lastly, put a check underneath the box marked as future if you still
want to pursue that interest.
B. Processing Questions
1. What was your reaction when you saw the checklists given?
2. What is interest for you?
3. What makes you interested in a certain activity?
4. How did you evaluate what interests should you check?
5. Did certain interests or activities evoked memories?
6. Did you enjoy relieving those interests that you have done when you were
younger?
7. What made you want to check the activities that you still want to achieve in the
near future?
8. What have you learned from the activity given to you?
C. Materials for Lecture
Three-page sheet of paper where the interests checklists are printed will be
used to stimulate the memory of the elderly regarding their past, present and future
interests.
D. Discussion
The facilitator will help the elderly reminisce with the use of the checklists given.
For the first checklist, the facilitator will about the interests checked and ask them
about certain experiences, accomplishments, and memories regarding that interest.
Next, based from the second checklist, the facilitator should ask why the elderly has
still some interests that they want to fulfill in the near future and ask them about their
experiences regarding their past and future interests.
E. Closing
The facilitator will have to integrate all the learning of the participants. Finally, to
wrap up the entire session, a token will be given to the elderly.
VIII. Sixth Activity: Fear in a Hat
A. Procedures
Objective of the game
Each member shall be given strips of paper where they will write their fears
anonymously and put them in a hat for others to read and share some thoughts
about the fear written.
Group Size
Three groups with 5 members each and each shall write their fears anonymously
and drop them in a hat for these fears to be discussed among the group.
Time required
Approximately 10 to 15 minutes.
Physical setting
The activity should be held indoors or outdoors for and with proper ventilation or
illumination.
Instructions
1. The facilitator has to set an appropriate tone, which is being caring, as a first
step so that the elderly can find it easy to disclose their fears.
2. In is an easy way to do so, by using the wanted tone in the introduction,
commencing the topic of fear, and explaining that this is a natural feeling at
this stage. Openly acknowledging them, with being subject of ridicule can
help, and will reduce the fear.
3. The facilitator then asks everyone, to place their fears on the strips of paper
given to them.
4. These pieces of paper will be collected and then mixed in a hat or a bag.
5. The facilitator will then ask each participant to take one of the strips from the
hat and then read about someone else's fear. In turns, each group member
will then read what is or are on the paper in front of them, and then elaborate
what he/she thinks that person is most afraid of in this situation. No one is to
comment on the statement, or on what has been said, but only listens. The
facilitator should also avoid voicing out opinions about each fear unless a
member of the group misunderstands a fear mentioned during the sharing.
6. When one person is done, the facilitator can ask the next person to go on. In
case that a person does not know what to say, the following question can be
asked: Do you have the same fear?. If the person still does not elaborate
after the question, the facilitator should leave him/her to it, and move on to the
next person.
7. As soon as all fears from the hat have been read out, there would be an
elaborated on a discussion about people's notions and feelings.
B. Processing Questions
1. What is your own definition of fear?
2. Did you have the same fears as others?
3. Howwere these fears similar?
4. How do you cope or deal with your fears?
5. How do you avoid your fears?
6. How is fear different from other emotions?
7. In what way were your fears been addressed during this activity?
8. What tools do you now have to help eliminate the fears you currently have?
9. If you were to do this activity again differently, what might you do next time?
C. Materials for Lecture
For the activity, a hat, or a bag is needed, strips of paper and a pen. The strips of
paper are where the elderly will write their fears and worries on using a pen while the
hat is where these strips of paper will be placed.
D. Discussion
After the processing questions are presented by the facilitator, a brief explanation
regarding the activity done shall be presented. . The facilitator shall let the
participants take part in the discussion by asking questions and also entertaining
questions from the participants.
In conducting the activity, the objectives were fulfilled and accomplished. First
was disclosure promotion in a way that the participants were be able to share their
fears especially with regard to death anxiety and depression. Next was the fostering
of interpersonal empathy through reading someone elses fear and sharing what he
or she thinks about the fear. After the activity was conducted, the other objectives,
which were trust building and fostering emotional and esteem support, were met as
every participant shared their worries and were given strategies on how to cope with
them. In addition, participants showing that they are available for one another are
already considered social support.
E. Closing
The facilitator will have to integrate all the learning of the participants. The
facilitator will deliver the following discourse to the participants:
All of us have our own fears. Sometimes these fears are rational, sometimes
they are not. The impact of our fears in our daily living depends upon our strategy or
way of dealing with them. Whenever we are dealing of with our own problems, just
remember that there are people around us who are willing to listen to us, and even
give us pieces of advice regarding on what we are going through. Most importantly,
we should know that we are the best shields against our fears, and these fears will
never go away unless we find a strategy to fight them.
Finally, to wrap up the entire session, all of the participants will be asked to stay
together for a group photo.
IX. Seventh Activity: Lets Dance
A. Procedures
Objective of the game
Induce happiness by dancing with friends/acquaintance
Serves as a physical activity to strengthen the body
Increase socialization within the group
Recall/associate life events to dancing
Recall/associate emotions, feelings, thoughts to music
Group Size
15 participants
Time required
Approximately 45 minutes to one hour
Physical setting
Setting can be indoors or outdoors, primary requirement would be the
availability and sufficiency of space and coziness of participants during the
activity.
Instructions
1. The facilitator will give a brief overview of the activity
2. The facilitators will assist the elderly into a suitable formation for a warm-
up exercise
3. Third, the facilitators will lead the warm-up exercise focusing on the pelvic
to foot area.
4. The participants will then be asked to choose their own partner and
explain that they can change partners in the latter part of the activity
5. The participants will be instructed to have casual talks with their partner
during the activity about the blissful memory they can recall/associate with
the different kinds of music that will be played
6. The facilitators will start the music and observe the participants
7. After dancing and chatting, the participants will be given an ample time to
rest before proceeding to the next part of the session
B. Processing Questions
1. What can you say about the activity?
2. What can you say about the memories your partners were able to recall?
3. What did you feel during the activity?
4. What kind of memory/feelings/thoughts were you able to recall during the
activity?
5. Were you able to feel happiness during this activity?
C. Materials for Lecture
Laptop or music player, good quality speakers/sound system for good
production of sound
First-aid kit In preparation in case of accident
Masking tape To be used to mark the area for dancing
Water bottles Ready to drink in case the participants felt the need to quench
their thirst.
D. Discussion
After the participants have answered the processing questions the
researchers will also answer questions from the participants regarding the
activity. After the questions have been answered, the facilitators will explain the
relevance of the activity to reminiscence therapy. The facilitators should be able
to explain that the feelings, emotions and thoughts, felt or thought while listening
to music or participating to activities done in the past recalled in the latter part of
life.
E. Closing
For better or for worse, music is the language of memory. It is also the language
of love. J odi Picoult
The facilitator will have to integrate all the learning of the participants. Finally to
wrap up the entire session, all of the participants will be asked to stay together
for a group photo.
X. Eighth Activity: A Toy Story
A. Procedures
Objective of the game
To facilitate creative reminiscence of childhood memories among the
elderly
To instill positive attitudes towards their childhood
To stimulate artistic thinking among the elderly
Group Size
15 people (all participants)
Time required
Approximately 30 minutes
Physical setting
Activity room of the nursing home
Instructions
1. The elderly participants will be asked to form a circle while sitting in a room.
2. If the participants are already seated comfortably, printed pictures/ of different
toys or the toys itself will be presented to them.
3. Music will be played in the background while the pictures/toys are passed
around among the elderly participants.
4. After examining each picture/toy, the elderly individuals will be asked to
choose one picture of a toy/toy that are so familiar with, that they find unusual
and that they used to make on their own at their homes.
5. Each participant, after choosing, will share some of their insights or feelings
that were brought about by the picture. They may also share their most
memorable experience with the toy.
B. Processing Questions
1. How do you view toys?
2. Name some of the toys you can vividly remember you played with as a child?
3. How did you arrive at choosing the one that is familiar to you rather than the
unfamiliar one?
4. If there is a specific toy that you would like to add in the activity, what would it be
and why?
5. In what way did the activity affected your viewof your childhood as well as your
present?
C. Materials for Lecture
Different pictures of toys pasted on a cardboard will be provided to the
participants. The various pictures would be coming from the survey conducted to
the elderly prior the day of the activity/ Actual toys can be also presented among
the elderly depending on the resources of the facilitators
Music will also be played in the background while the participants are viewing the
pictures. The musics theme will be about happy childhood and having fun.
Chairs will be provided and finally a powerpoint presentation will be used for the
discussion part of the activity.
D. Discussion
The facilitators would discuss how the role of toys and how they can actively
involve the participants in the process of reminiscence. This evokes interest among
the elderly since childhood memories would be brought to consciousness. Often, our
childhood is associated with positive feelings towards the past since this is the part of
our lives associated with having fun, being playful and seeking enjoyment in things we
find interesting. However, the role of reminiscence can also bring negative emotions if
the childhood of the participant is not pleasant. In this case, those negative emotions
should be shared within the group. Through this, the emotions associated with the
unpleasant childhood memories of the participant would be lessened and with the help
of the facilitators storytelling can be employed.
E. Closing
The facilitator will have to integrate all the learning of the participants. Finally, to
wrap up the entire session, all of the participants will be asked to stay together for a
group photo.
Proposed Schedule for the BAS Intervention Program: Reminiscence Therapy
Week Themes/Activities
1
10 minute activity (icebreaker/exercise)
First Activity Balloon Pop and Reminisce
2
10 minute activity (icebreaker/exercise)
Second Activity Memory Box
3
10 minute activity (icebreaker/exercise)
Third Activity Let there be Music
4
10 minute activity (icebreaker/exercise)
Fourth Activity Reminiscence Target Floor Map
5
10 minute activity (icebreaker/exercise)
Fifth Activity Interest Activity
6
10 minute activity (icebreaker/exercise)
Sixth Activity Fear in a Hat
7
10 minute activity (icebreaker/exercise)
Seventh Activity Lets Dance
8
10 minute activity (icebreaker/exercise)
Eighth Activity A Toy Story
References
Chen, T., Li, H., & Li, J . (2012). The effects of reminiscence therapy on depressive
symptoms of Chinese elderly: study of protocol of a randomized controlled trial. BMC
Psychiatry, 12, 189.
Latha, K., Bhandary, P., Tejaswini, S. & Sahana, M. (2014). Reminiscence therapy: An
Overview. Middle East Journal of Age and Ageing, 11 (1), 18-22.
Peng, X., Huang, C., Chen, L., & Lu, Z. (2009). Cognitive Behavioural Therapy and
Reminiscence Techniques for the Treatment of Depression in the Elderly: A
Systematic Review. Journal of International Medical Research, 37, 975-982