The Handbook of Structured Life Review

Barbara K. Haight, Dr.P.H., is Professor Emeritus at the College of Nursing, Medical University of South Carolina. Now retired, Barbara conducted 8 research projects over 25 years developing the structured life review process and supervised numerous students and colleagues in the practice of life review. She was the first president of the International Life Review and Reminiscing Society and has conducted hands-on life review projects in the United States, England, Japan, and most recently Northern Ireland. She is co-editor of two books on reminiscing and life review, plus one on group process, and is widely published in the field of life review and gerontology.

Barbara is a fellow emeritus in the Gerontological Society of America where she founded and conducted a special interest group on reminiscence. She is also a Fellow in the American Academy of Nursing, and in the Florence Nightingale Society.

Barrett S. Haight, J.D., retired as a Colonel from the U.S. Army after serving 23 years in a variety of positions throughout the world. Subsequently, he served as Director of Estate Planning for The Citadel Development Foundation (Charleston, SC) for 17 years. Throughout both periods, he taught undergraduate courses in health care law at the Medical University of South Carolina. COL Haight has authored articles for the Dickinson Law Review and the U.S. Army Command and General Staff College. Additionally, he edited Focus, the newsletter of The Citadel Development Foundation. In his second retirement, he co-authored an article on reminiscence for the Encyclopedia of Gerontology and served as editor for many health care submissions.

FOREWORD by Faith Gibson

INTRODUCTION

• Overview of the Handbook


• The Therapeutic Listener

BACKGROUND

• The Beginning: Marjory’s Story


• Erikson’s Model


• Butler’s Observations About Reminiscence and Life Review


• The Growth of Life Review


• The Structure Life Review Process

PART I. FUNDAMENTALS OF STRUCTURED LIFE REVIEW

THE STRUCTURED LIFE REVIEW PROCESS

• Goals of Life Review


• The Life Review Form (LRF)
  
  
  
  • LRF Questions
  
  
  • Questions and Reviewers
  
  
  • Questions and Structure for the Life Review
  
  
  • Questions and Erikson’s Life Stages
  
  
  
  


• Schedule
  
  
  
  • Flexibility
  
  
  • Weekly Visits
  
  
  • The Process
  
  
  
  


• Unique Characteristics of the Life Review Process
  
  
  
  • Structure
  
  
  • Duration
  
  
  • Individuality
  
  
  • Evaluation
  
  
  
  


• Additional Considerations About Life Review
  
  
  
  • Hard Work
  
  
  • Self
  
  
  • Repetition
  
  
  • Power and Control
  
  
  • Supervision
  
  
  • Confidentiality
  
  
  • Audiotaping
  
  
  • Life Reviews with Relatives
  
  
  
  

THE PARTICIPANTS

• Therapeutic Listener
  
  
  
  • Interviewing Techniques
  
  
  • Counseling Skills
  
  
  
  


• Life Reviewers
  
  
  
  • Types of Reviewers
  
  
  
  


• Conclusion

PART II. CONDUCTING THE STRUCTURE LIFE REVIEW

VISIT I: GETTING STARTED

• Visit 1: Listener Guidelines


• Meeting the Prospective Life Reviewer


• Full Disclosure


• Written Agreement


• Audiotaping


• Business Cards


• Tests and Measures


• Assessing the Environment
  
  
  
  • Privacy
  
  
  • Light
  
  
  • Noise Level
  
  
  • Temperature
  
  
  • Seating Arrangement
  
  
  
  


• Assessing the Life Reviewer
  
  
  
  • Patterns and Habits
  
  
  • Functional Abilities
  
  
  • Medications
  
  
  • Speech
  
  
  • Hearing
  
  
  • Vision
  
  
  • Chronic Illness
  
  
  
  


• Reviewer File


• Next Visit

VISIT 2: CHILDHOOD

• Visit 2: Listener Guidelines


• Preliminary Tasks


• Personal Issues for the Life Reviewer


• Erikson’s Model: Childhood
  
  
  
  • Trust
  
  
  • Autonomy
  
  
  • Mistrust and Shame
  
  
  
  


• Using the Life Review Form
  
  
  
  • Beginning the Process
  
  
  • First Question
  
  
  • Order of Memories
  
  
  • Responsive Comments
  
  
  
  


• Counseling Skill: Acceptance


• Interviewing Techniques
  
  
  
  • Attentive Behavior
  
  
  • Repetition
  
  
  • Reframing
  
  
  
  


• Reviewer Types
  
  
  
  • Storyteller
  
  
  • Reluctant Reviewer
  
  
  
  


• End Visit 2
  
  
  
  • Summarize Session
  
  
  • Next Visit
  
  
  
  

VISIT 3: ADOLESCENCE

• Visit 3: Listener Guidelines


• Preliminary Tasks


• Clarify Visit 2


• Erikson’s Model: Childhood and Young Adolescence
  
  
  
  • Initiative and Industry
  
  
  • Guilt and Inferiority
  
  
  
  


• Using the Life Review Form
  
  
  
  • Questions About Adolescence
  
  
  • Probing Questions
  
  
  • Questions About School
  
  
  • Questions About Feelings
  
  
  
  


• Counseling Skill: Caring


• Interviewing Techniques
  
  
  
  • Responding
  
  
  • Reflecting Feelings
  
  
  
  


• Unique Life Review Characteristic: Structure


• Reviewer Type: The External Reviewer


• End Visit 3
  
  
  
  • Summarize Session
  
  
  • Next Visit
  
  
  
  

VISIT 4: YOUNG ADULTHOOD

• Visit 4: Listener Guidelines


• Preliminary Tasks


• Pivotal Session for Reviewer


• Clarify Visit 3
  
  
  
  • Closure on Childhood
  
  
  • Unfinished Business
  
  
  
  


• Erikson’s Model: Adolescence to Young Adulthood
  
  
  
  • Identity vs. Role Confusion
  
  
  • Intimacy vs. Isolation
  
  
  
  


• Using the Life Review Form
  
  
  
  • Customize Questions
  
  
  • Examine Past Decisions
  
  
  • Clearer Adult Memories
  
  
  
  


• Counseling Skill: Unconditional Positive Regard


• Interviewing Techniques
  
  
  
  • Sharing Behavior
  
  
  • Paraphrasing
  
  
  
  


• Unique Life Review Characteristic: Duration


• Reviewer Type: The Creative Reviewer


• End Visit 4
  
  
  
  • Summarize Session
  
  
  • Next Visit
  
  
  
  

VISIT 5: OLDER ADULTHOOD

• Visit 5: Listener Guidelines


• Preliminary Tasks


• Clarify Visit 4


• Erikson’s Model: Older Adulthood
  
  
  
  • Generativity vs. Stagnation
  
  
  
  


• Using the Life Review Form
  
  
  
  • Work and Family
  
  
  • Relationships
  
  
  • Outside Interests
  
  
  • Forgotten Memories
  
  
  
  


• Counseling Skill: Empathy


• Interviewing Techniques
  
  
  
  • Self-Disclosure
  
  
  • Encouragement to Talk
  
  
  
  


• Unique Life Review Characteristic: Individuality


• Reviewer Type: The Denying Reviewer


• End Visit 5
  
  
  
  • Summarize Session
  
  
  • Next Visit
  
  
  
  

VISIT 6: SUMMARY AND EVALUATION

• Visit 6: Listener Guidelines


• Preliminary Tasks


• Clarify Visit 5


• Erikson’s Model: Oldest Adulthood
  
  
  
  • Acceptance
  
  
  • Denial
  
  
  
  


• Using the Life Review Form
  
  
  
  • Flexibility
  
  
  • Gaining Insight
  
  
  • Repetition
  
  
  • Self-Examination
  
  
  • Revisiting Key Events
  
  
  
  


• Counseling Skill: Congruence


• Interviewing Technique: Summarizing


• Unique Life Review Characteristic: Evaluation


• Reviewer Type: The Bleeding Reviewer


• End Visit 6
  
  
  
  • Summarize Session
  
  
  • Next Visit
  
  
  
  

VISIT 7: INTEGRATION

• Visit 7: Listener Guidelines


• Preliminary Tasks


• Clarify Visit 6


• Erikson’s Model: Oldest Adulthood
  
  
  
  • Integrity
  
  
  • Despair
  
  
  
  


• Using the Life Review Form
  
  
  
  • Encourage Understanding
  
  
  • Review Significant Successes Again
  
  
  • Reframe Difficult Times Again
  
  
  • Establish a Future Emphasis
  
  
  
  


• Counseling Skills: Review All Interviewing Techniques
  
  
  
  • Integrating
  
  
  • Review of Techniques
  
  
  
  


• Unique Life Review Characteristics: Consider All Four Together


• Review Type: Recognize Your Reviewer’s Type


• End Visit 7
  
  
  
  • Summarize Session
  
  
  • Consider Referrals
  
  
  • Next Visit
  
  
  
  

VIST 8: CLOSURE AND OUTCOMES

• Visit 8: Listener Guidelines


• Professional Referrals


• Contact Information


• Thank You Note and Other Cards


• Assessment and Findings
  
  
  
  • Tested Outcomes
  
  
  • Reviewer Feedback
  
  
  • Observed Outcomes
  
  
  
  


• Summary

PART III. USES AND OUTCOMES OF THE STRUCTURED LIFE REVIEW

VARIED USES FOR THE STRUCTURED LIFE REVIEW

• Newly Relocated


• Depression Prevention


• Substance Abuse Recovery


• Dying


• Bereavement


• Dementia
  
  
  
  • Dementia Caregivers
  
  
  • People with Dementia
  
  
  
  


• Other Potential Reviewers

ANNOTATED BIBLIOGRAPHY

REFERENCES

APPENDIXES

• Appendix A: Checklist for the Life Review Process


• Appendix B: Life Review Form (LRF)


• Appendix C: Sample Agreement


• Appendix D: Baseline Assessment of Reviewer


• Appendix E: Test of Physical Function


• Appendix F: Test of Psychosocial Function (Mood Scale)

ACKNOWLEDGMENTS

ABOUT THE AUTHORS

INDEX

“A terrific book – the best I’ve seen that captures the essence of life review.”

-Robert N. Butler, M.D., President and CEO, International Longevity Center-USA

“Clearly written, comprehensive in scope, evidence-based and useful for both health professionals and the lay public … an essential guide for anyone interested in the Structured Life Review, recognized as a rewarding tool to help others review and evaluate their life journey.”

-Jean D’Meza Leuner, Ph.D., R.N., C.N.E., Professor and Dean, College of Nursing, University of Central Florida

“Life stories not only provide windows on the past, they open doors to the improvement of lives.… this book brings much experience to guide those who are in a position to assist older adults to improve their lives [with Structured Life Review]… excellent vignettes from real lives with real problems help train the therapeutic listener.”

-James E. Birren, Ph.D., Dean Emeritus, Andrus Gerontology Center, University of Southern California

“This thorough book … reflects decades of author experience with the life review process through the use of real-life, non-sugar-coated examples. It provides an up-to-date and essential training tool that promotes ethical and consistent methodological approaches for incorporation in life review research and practice.”

-John A. Kunz, M.S., Founder and Manager, International Institute for Reminiscence and Life Review, Center for Continuing Education/Extension, University of Wisconsin – Superior

“This is a long awaited text, the first handbook on conducting Structured Life Review and written by the major pioneer in this field.”

-Peter G. Coleman PhD, Professor of Psychogerontology, University of Southampton, England, UK

“An extremely readable and practical guide … rich with examples from years of research on the use of life review, the authors demonstrate that this process can be rewarding not only for the listener but also the individual reflecting on and evaluating the lived experience.”

-Barbara J. Edlund, R.N., Ph.D., A.N.P.-B.C., Professor College of Nursing, Medical University of South Carolina

“The principles of this life review process would uniquely apply to the end-of-life character of hospice care … the prevailing characteristic of hospice is to administer palliative care and comfort to the patient in the remaining few weeks and days of his life. [The Structured Life Review process can] help the patient face the reality of his or her pending demise and oftentimes, in doing so, help guide the patient to achieve ‘closure’ on certain troublesome and unresolved concerns.… [This book] will undoubtedly benefit many.”

-Dean J. Patenaude, M.B.A., Past President and Former Board Member, Treasure Cove Hospice, Stuart, Florida