Promotion

OLDER PEOPLE: THE RETIREMENT YEARS 193
social contact aspect of communal gardening has major effects on older individuals’
sense of worth and mental well-being (Milligan et al. 2005).
Reminiscence
For the past 30 years reminiscence has become an almost natural part of activities
in care work. For anyone particularly interested in reminiscence and life review,
Coleman and O’Hanlon (2004) provide a comprehensive overview of the historical
background, types, functions and evaluations of reminiscence with older people. Reminiscence
enables older people to recall past events and life experiences, while life
review focuses on the individual’s past life as a whole. Reminiscence is conducted in
groups or on a one to one basis. It is used for a variety of reasons, for example to find
meaning and purpose in life, to reduce boredom, to teach and inform. It has been used
therapeutically, to deal with depression and traumatic memories, with residents in
sheltered housing to improve well-being, and with demented older people. Interestingly,
it would seem that some ethnic groups utilize reminiscence more than others,
although as Coleman and O’Hanlon (2004) point out, it is not clear whether this is
because some cultures have a stronger oral tradition or because these groups have a
greater need to promote self-understanding, preserve identity and educate ensuing
generations.
Carers’ support
There is a large body of research which has evaluated ways of improving the mental
well-being of those who care for frail older people, older people with Alzheimer’s disease
and dementia. The main types of interventions that have been evaluated include
respite care, psycho-social interventions, group education and support. So far there is
little evidence that any of these interventions result in significant long-term improvements
in stress, distress, coping skills, depression or anxiety (McNally et al. 1999; Pusey
and Richards 2001; Cattan et al. 2005). McNally et al. (1999) suggest that the lack of
evidence may be because although respite provides immediate relief from caring duties,
it fails to help maintain socially supportive relationships, which are needed once respite
has come to an end. A more carer-centred approach, they say would take into
account factors such as the carer-patient relationship, the carer’s active social networks,
the effect of respite on the care recipient, the carer’s attitude to respite, any feelings of
guilt, and the level of self-efficacy with regards to their ability to make use of the respite
time. Their suggestions are in part supported by research, which has shown that the
carer–cared-for relationship improves more in one to one support and carer burden is
reduced through cognitive-behavioural interventions (including education, stress
management and coping skills). However, in one study carers attending supportive
group activities guided by peer leaders demonstrated a significant increase in network
size (and consequently a reduction in social isolation) one year after the intervention
(Toseland et al. 1990). There is some indication that psycho-social interventions that
include the use of problem-solving and a behavioural component may be effective with
carers of people with dementia (Pusey and Richards 2001). Although these interventions
show some promise in providing support for carers Marriott et al. (2000) note that
the implementation of the cognitive-behavioural intervention is lengthy and therefore
has resource implications and requires specialist training. Such critical observations