experiences of reminiscence therapy in ireland · reminiscence therapy & the youtube group...

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

www.ageandknowledge.ie

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)


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


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


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?


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

mailto:[email protected]


YouTube


Record of Stimulus & Source


Participation Behaviour Interaction Attitude to

GroupEngagement


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


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)


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


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


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


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


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


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


“Great show tonight!”


With Special Thanks to

Speech & Language Therapy Department

&

Occupational Therapy Department

Dr. Ronan Collins & Dr. Susan O’ Callaghan

AMNCH

[email protected] & [email protected]



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