experiences of reminiscence therapy in ireland · reminiscence therapy & the youtube group...
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Reminiscence Therapy &
The YouTube Group
Experiences of Reminiscence
Therapy in Ireland
Presents….
The Silver SurfersAt
“The YouTube Group”
By…
Julia O’ Rourke SLT & Fiona Tobin OT
Age Related Healthcare AMNCH
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Benefits of Group Interaction &
Cognitive Stimulation
RCT (Spector et al. 2003)
Significant changes to cognition and Quality of Life after 7 week
cognitive Stimulation Programme results comparable with those from
drug trials for Dementia
Replicated in Irish Context(Flynn et al. 2008)
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Our ProposalYouTube (the Video Sharing Website) would be
valuable tool in promoting;
• Interaction and Social Engagement
• Cognitive stimulation
• Communication
• Sharing of experiences
In Reminiscence Groups with participants with
Dementia
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Background to our Service
• In 2009 the average Length of Stay on the LTC list was
95.8 days (AMNCH Discharge Planning Team)
• SLT & OT identified a sub-group of inpatients with
Dementia awaiting LTC and otherwise discharged from
interventions
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Research Questions
1. Is it possible to run group Reminiscence
Therapy in an Acute Hospital Setting?
2. Is it possible to run it in a novel way i.e. via
YouTube?
3. Could outcomes for communicative
interaction & cognition be obtained?
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Methodology
• Approval from AMNCH & SJH Board Ethics
• Convenience Sampling – 6 participants
• Pre-Assessment Measures;– FLCI, MMSE, GDS, Social Interest Questionnaires (SIQ)
• 12 Session program run bi-weekly for 6 weeks
• 45-60min sessions
• Facilitated by SLT or OT
• User Account & Playlist Set up „silversurfergroup‟
• YouTube stimulus pre-selected from SIQs & saved to PLAYLIST
Inclusion Criteria;DSM-IV Dementia
MMSE <24
Functional Communication Capacity
Ability to see & hear as determined by
researcher
Be available for 6 weeks
Exclusion Criteria;Intellectual Disability
Major Depressive
Illness
Concurrent major/
acute physical illness
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YouTube
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Record of Stimulus & Source
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Participation Behaviour Interaction Attitude to
GroupEngagement
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Quantitative ResultsParticipant FLCI
pre
FLCI
post
No. Sessions
Attended
1 47 76↑ 12
2 77 77 12
3 71 ------- 8
4 56 63↑ 12
5 68 70↑ 12
6 46 55↑ 5
(Mean MMSE Score 17.8)
• Stable FLCI Scores remained stable
• Profiles on Participation, Engagement, Behaviour, Interaction, Attitude to
group with trend to improvement
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Qualitative Data
1. Semi-Structured Interviews with participants
2. Thematic Analysis by SLT & OT
3. Methods of deductive & inductive analysis.
4. Two independent raters reviewed &concurred for inter-rater reliability
Wellbeing & mood (sub-themes of Self-validation,
Reassurance, satisfaction & enjoyment emerging)
Inclusion (sub-themes of social interaction, social
engagement)
Personal Sense of Purpose (Undertaking a purposeful
activity; to reminisce/ to fill time/ do something different)
Entertainment Value from YouTube range of clips
(connection with an Audio Visual medium, variety,
accessibility)
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Members QuotesWellbeing & mood (sub-themes of Self-validation, Reassurance, satisfaction & enjoyment emerging)
“I like the music, that’s the reason I go over, I don’t know the words, it’s a lovely soundInteresting to look at…”“Completely enjoyed going from ward to group – big relief”“ Took me out of a terrible state, got something else. Well worth it alright.”
Inclusion (sub-themes of social interaction, social engagement)
“I’ve been a good few times…put my name down”“Good to talk to others”“Prefer to be down below (at the group) watching videos”
Personal Sense of Purpose (Undertaking a purposeful activity; to reminisce/ to fill time/ do something different)
“You’ve got to keep going…Behind it all a guy needs to keep cheery”“Of course I would (return) no problem, if it was cancelled I’d be very upset, I’d be waiting for it”“Music brings back memories, you can’t remember but it comes back into your mindIt was really enjoyable … it was nice to have something to do. Listening to music and discussing it
Entertainment Value from YouTube range of clips (connection with an Audio Visual medium, variety, accessibility)
I was singing the whole time Great facility (the TV and room)That’s very good (YouTube group) I thought I was good Great lift to the dayIt’s a terrific thing…fantastic…you’d be tramping your foot
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Staff & Family Feedback
Patients more;
• Communicative (recalling topics)
• Socially interactive with staff/families and other group
members on ward
• Improved patient mood
• Sense of group camaraderie
Duration of sustainment was not calculated
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Engagement with YouTubeVerbal
• Evaluative Statements
• Conversational Initiation (to share, inform, clarify)
• Engagement in discussions (volitional or with prompting)
• Asking and responding to questions
• Using direct requests for items to be searched from you tube
• Singing along
• Reading Text Aloud
Non-Verbal
• Observing others speaking
• Observing the screen
• Waving arms
• Dancing
• Tapping to the beat
• Humming
• Clapping when clips have ended
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Challenges & Areas for
Improvement“Rock and roll Elvis – Liven it up just that
little bit”
RESEARCH, MIX AND PROMPT LIVLIER STIMULUS
“But it’s the lack of advertising…YOU know about all these things but.. It seems to be we’re …(points to self) in one group. We’re told about it”
“CALENDARS ON PATIENTS DOORS/WARDROBES
“love to be more confident in it”
DOCUMENT AND SUPPORT PERSONAL GOALS IN
GROUP
“ It was a bit slow and no particular pattern coming up”
MAX OF 5-6 CLIPS OVER 45-60MIN PERIOD
Better Promotion
“Hard to get my brain working to remember”
“Felt uncomfortable, wasn’t able to answer the questions”
PROVIDE TRAINING & INFORMATION TO GROUP FACILITATORS ON POSITIVE NON CHALLENGING
COMMUNICATION STYLES FOR COMMUNICATION WITH PERSONS WITH DEMENTIA
Livelier Sessions
Support Memory
Retrieval/Access
Support Equal Communication
& Personal Goals
Support Attention & Set the Scene
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The Value of YouTube
• Electronic Memory Bank
• A portal to evolving Memory
Archive
• Immediate/Instant Access
• Initiates, maintains &
Enhances discussion
• Multi-modal (A-V) medium
Reduces load on Auditory
attention alone
• Provides Cognitive – Linguistic
Stimulation
• Clips act as visual & Auditory
prompts supporting recall,
expression ~ Scaffolding
narratives
• Engagement
• Social Interaction
• Flexible (pause, switch, find
other related clips, store,
categorise, replay)
• Innovative & Fun
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Limitations of Study
• Patients & staff in constant flux
• Logistical co-ordination (Nursing staff, Porters, Room bookings, IT support)
• Small convenience sample
• No control group
The Next Step….
Established YouTube as
being acceptable
patients:
• Comparative study
• Quantitative Outcome
Measures
– Behaviour
– Mood
– Cognition
– Communication
– Participant and Provider
Satisfaction
– Quality of Life
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“Great show tonight!”
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With Special Thanks to
Speech & Language Therapy Department
&
Occupational Therapy Department
Dr. Ronan Collins & Dr. Susan O’ Callaghan
AMNCH