The study involved a sample of eight moderately to severely demented elderly people who used psychogeriatric day services. Counselling skills were used by the interviewer to investigate informants' recall of emotional memories. Interviews were normally carried out individually each week over a number of months. Between thirteen and twenty-five interviews with individual informants were recorded and transcribed. The data form a series of longitudinal case-studies, analysed using quasi-judicial methods (Bromley 1986), and with a grounded theory approach (Glaser and Strauss 1967). Over time, it became apparent that each case-study revealed fragmented pieces of an informant's personal narrative. The emotions associated with their past experiences appeared to provide a strong cue to recall and formed a significant feature of their accounts as well as providing all informants with narrative identity. For some informants, this sense of narrative identity began to dissolve as their illness progressed and their stories faded from memory. For other informants, whose memories were not so devastated by their illness, it remained with them. Although outcomes varied for all informants, all experienced varying levels of increased well-being. The data may have important therapeutic implications for the care of dementia patients through the development of reminiscence work. Attention is drawn to some theoretical implications for understanding the relationship between emotion, memory and dementia.
The literature indicates that some moderately to severely demented elderly people can still recall their emotionally subjective past. Emotion and cognition have a relationship that can be clearly seen in the recall of nostalgic memories. This article outlines a case study that illustrates how emotional autobiographical memories of past events can be stimulated through the individual use of reminiscence and counseling skills. The authors suggest that there are possible therapeutic effects attached to this approach and that this is an area worthy of further investigation.
Spiritual wellbeing is a neglected aspect of quality of life in British research on ageing. US research emphasises the health and other benefits of religious belief for American older people. However, whereas the US is still a strongly religious society, in Britain there has been a steady erosion of membership of Christian churches, accompanied by a loss of respect for the authority of the church and an increased freedom of expression in belief. In an exploratory study the implications of spiritual belief for adjustment have been studied in a sample of 28 older bereaved spouses, who have been followed from the first to the second anniversary of the death. Using a recently developed measure of strength of spiritual belief, a clear pattern was found of greater depressive symptomatology and lower perception of personal meaning among those of moderate belief; ie those who still held to a belief in a spiritual power outside of themselves but who were not sure of its efficacy. Investigation of this group of 11 moderate believers provided many illustrations of spiritual questioning, uncertainty and unease. It appears likely that a substantial proportion of the older population in Britain has become isolated from their churches of origin, yet maintains forms of spiritual belief, often hesitant in character. Some may benefit from renewed contact. Statutory health and welfare agencies need to consider their own role in promoting such re‐engagement.
This paper reports a study of the religious, spiritual and philosophical responses to spouse bereavement. Twenty-five bereaved spouses aged 60 or more years living in the south of England and from Christian backgrounds were followed from the first to the second anniversary of the loss. The participants expressed a range of attitudes, from devout religious belief to well-articulated secular conceptions of the meaning of life, but the largest group had moderate spiritual beliefs that were characterised by doubts as much as hopes. Uncertain faith was more often associated with depressive symptoms and low levels of experienced meaning. Nine case studies are presented that illustrate different levels of adjustment to bereavement and both changing and stable expressions of faith across the one year of observation. Attention is drawn to the importance of both secular agencies and religious organisations developing a better understanding of older people's spiritual responses to loss. Although to many British older people, practise of the Christian faith may be less evident now than in their childhood, quality of life assessment should not ignore sources of spiritual satisfaction and dissatisfaction. Moreover, previous and especially early-life religious experiences provide useful points of reference for understanding present religious and spiritual attitudes. The study suggests that there may be a substantial need for pastoral counselling among today's older people, especially those of uncertain or conflicted belief.
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